Chapter 21 – Cleaning, Disinfection, and Sterilization
William A. Rutala, PhD, MPH
Hospital Epidemiology
Division of Infectious Diseases
University of North Carolina Health Care
Chapel Hill, North Carolina
David J. Weber, MD, MPH
Hospital Epidemiology
Division of Infectious Diseases
University of North Carolina Health Care
Chapel Hill, North Carolina
ABSTRACT
All invasive procedures involve contact by a medical device or surgical instrument with a patient’s sterile tissue or mucous membranes. A major risk of all such procedures is the introduction of pathogenic microbes leading to infection. Failure to properly disinfect or sterilize reusable medical equipment carries a risk associated with breach of the host barriers.
The level of disinfection or sterilization is dependent on the intended use of the object: critical (items that contact sterile tissue such as surgical instruments), semicritical (items that contact mucous membrane such as endoscopes), and noncritical (devices that contact only intact skin such as stethoscopes) require sterilization, high-level disinfection and low-level disinfection, respectively. Cleaning must always precede high-level disinfection and sterilization. Users must consider the advantages and disadvantages of specific methods when choosing a disinfection or sterilization process.
Last Revised: 12/13/09 1:02 PM
Copyright © 2013 by the Association for Professionals in Infection Control and Epidemiology, Inc. (APIC)
All rights reserved. Intended for personal use only. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopied, recorded or otherwise, without prior written permission of the publisher.