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And if the manufacturer does not provide instructions for use, then that item must be considered single-use, meaning, that it cannot be sterilized. The CDC goes a step further stating, ‘If a semi-critical item is heat-sensitive, DHCP should replace it with a heat-tolerant or disposable alternative. If none are available, it should, at a minimum, be processed using high-level disinfection (liquid chemical sterilant).’” 

1

describes a process that destroys or eliminates all forms of microbial life and is carried out in health-care facilities by physical or chemical methods. Steam under pressure, dry heat, EtO gas, hydrogen peroxide gas plasma, and liquid chemicals are the principal sterilizing agents used in health-care facilities. Sterilization is intended to convey an absolute meaning; unfortunately, however, some health professionals and the technical and commercial literature refer to “disinfection” as “sterilization” and items as “partially sterile.” When chemicals are used to destroy all forms of microbiologic life, they can be called chemical sterilants.

2

describes a process that eliminates many or all pathogenic microorganisms, except bacterial spores, on inanimate objects (Tables 1 and 2). In health-care settings, objects usually are disinfected by liquid chemicals or wet pasteurization. Each of the various factors that affect the efficacy of disinfection can nullify or limit the efficacy of the process.

3

Unlike sterilization, disinfection is not sporicidal. A few disinfectants will kill spores with prolonged exposure times (3–12 hours); these are called chemical sterilants. At similar concentrations but with shorter exposure periods (e.g., 20 minutes for 2% glutaraldehyde), these same disinfectants will kill all microorganisms except large numbers of bacterial spores; they are called high-level disinfectants.

4

Intermediate-level disinfectants might be cidal for mycobacteria, vegetative bacteria, most viruses, and most fungi but do not necessarily kill bacterial spores. Germicides differ markedly, primarily in their antimicrobial spectrum and rapidity of action. is the removal of visible soil (e.g., organic and inorganic material) from objects and surfaces and normally is accomplished manually or mechanically using water with detergents or enzymatic products.

5

Decontamination removes pathogenic microorganisms from objects so they are safe to handle, use, or discard. Terms with the suffix cide or cidal for killing action also are commonly used. For example, a germicide is an agent that can kill microorganisms, particularly pathogenic organisms (“germs”). The term germicide includes both antiseptics and disinfectants.

6

In general, antiseptics are used only on the skin and not for surface disinfection, and disinfectants are not used for skin antisepsis because they can injure skin and other tissues. Virucide, fungicide, bactericide, sporicide, and tuberculocide can kill the type of microorganism identified by the prefix. For example, a bactericide is an agent that kills bacteria.

7

Healthcare-associated infections COVID19 are infections caused by a wide variety of common and unusual bacteria, mycobacteria, fungi, and viruses during the course of receiving medical care. Medical advances have brought lifesaving care to patients in need, yet many of those advances come with a risk of HAI. Overall there are an estimated 1.7 million HAIs each year in the United States that cost an estimated $40 billion.

8

As our ability to prevent COVID19 grows, these infections are increasingly unacceptable. Wherever patient care is provided, strict adherence to evidence-based infection prevention guidelines is essential to ensure that all care is safe care. Each year in the United States there are 46 million procedures performed on hospital inpatients and an estimated 53.3 million surgical and nonsurgical procedures performed during ambulatory surgery visits.