Cleaning, Disinfection, and Sterilization

Author(s):
William A. Rutala, PhD, MPH Department of Hospital Epidemiology University of North Carolina Health Care

 Division of Infectious Diseases, UNC School of Medicine
Chapel Hill, NC

David J. Weber, MD, MPH Department of Hospital Epidemiology University of North Carolina Health Care

Division of Infectious Diseases, UNC School of Medicine
Chapel Hill, NC

Published:
February 25, 2016
Declarations of Conflicts of Interest:
  • William Rutala served as a consultant for Advanced Sterilization Products and Clorox.
  • David J. Weber served as a consultant for Johnson & Johnson and Clorox.

Abstract

All invasive procedures involve contact by a medical device or surgical instrument with a patient's sterile tissue or mucous membranes. 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) items require sterilization, high-level disinfection, and low-level disinfection, respectively. Cleaning must always precede high-level disinfection and sterilization.