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Volume 7, Number 2—April 2001
THEME ISSUE
4th Decennial International Conference on Nosocomial and Healthcare-Associated Infections

State of the Art

New Disinfection and Sterilization Methods

William A. RutalaComments to Author  and David J. Weber
Author affiliations: University of North Carolina (UNC) Health Care System; UNC School of Medicine, Chapel Hill, North Carolina, USA

Main Article

Table 7

Comparison of new and standard disinfection and sterilization technologies

Technology
Comparison of new with standard technology
New Standard Advantages Disadvantages Future needs
OPA Glutaraldehyde -Shorter process time (12 vs 45 min)
-No activation
-Not a known irritant to eyes and nasal passages
-No vapor ceiling limit
-Weak odor -Stains protein gray
-Higher cost -Additional studies of antimicrobial efficacy
-Study of effectiveness in actual clinical use
-Cost-effectiveness study
-Verification of more cycles per solution than glutaraldehyde
Surfacine Disinfectants
(phenolics quaternary ammonium);
Antiseptics
(alcohol, iodophor, chlorhexidine gluconate) -Antimicrobial persistence (>13 days)
-May be used on animate and inanimate surfaces
-Broad antimicrobial spectrum
-Transfers active agent (silver) to microbes on demand without elution
-Resistant to forming biofilm
-No toxicity to mammalian cells -Cost? -Assess microbicidal activity against broad spectrum of pathogens
-Demonstration of efficacy to reduce nosocomial infections
-Human safety and toxicity data for use as an antiseptic
-Demonstrate antimicrobial activity in presence of organic matter
Superoxidized water High- or low-level disinfectants; antiseptics -Basic materials (saline and electricity) inexpensive
-End product not damaging to environment
-Nontoxic to biological tissues -Production equipment expensive due to monitoring
-Endoscope compatibility unknown
-Decreased efficacy in presence of organic matter
-Limited-use life (must be freshly generated) -Evaluation of endoscope compatibility
-Cost-effectiveness study
Endoclens None -Device automatically cleans and sterilizes
-Rapid cycle time (<30 min)
-Tests endoscope for channel blockage and leaks
-Advantages of automated process (e.g., consistent exposure to sterilant, filtered water rinse, operator convenience) -Cost?
-Used for immersible instruments only
-Point-of-use system, no long-term storage -Cost-effectiveness study
-Study of effectiveness in actual clinical use
-Assessment of microbicidal activity
EO rapid readout 48-hr spore readout biological indicator -Rapid (4-hr), reliable assessment of sterilization efficacy
-Prevents recall of released sterilization loads -Cost?
-Not tested with EO and CO2 mixtures -Cost-effectiveness study
-Validation of claimed 100% sensitivity
Plasma sterilizer Hydrogen peroxide gas plasma sterilizer -Use of two hydrogen peroxide diffusion-plasma stage cycles is a more effective sterilization process
-Reduced cycle time (45 min)
-Various sized units available
-Leaves no toxic residues -Cost?
-Endoscopes with lengths >40 cm or a diameter of <3 mm cannot be processed -Cost effectiveness study
-Study of effectiveness in actual clinical use

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