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. Rutala
and David J. Weber
and David J. WeberTable 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 |
