Special methods of preventive disinfection. Modern disinfectants: types, classification, requirements, purpose. Requirements for disinfectants

The concept and types of disinfection

Definition 1

Disinfection is a set of measures for the destruction of pathogens of infectious diseases and their toxins located at environmental objects. The main purpose of disinfection is to prevent the spread of pathogens by disrupting their transmission mechanisms.

There are three types of disinfection depending on the purpose:

• Preventive. It is carried out constantly and on a planned basis, aimed at the destruction of pathogens and their toxins, regardless of the manifestations of the epidemic process and is aimed at preventing or alleviating them. These include washing hands, equipment and premises with the help of special disinfectants.
• Current. It is carried out in medical institutions with the direct presence of a source of the pathogen, usually with obvious manifestations of the epidemic process (outbreak) at the patient's bed, in isolation rooms of medical posts and hospitals in order to prevent the spread of infection outside them. First of all, attention is paid to the biological functions of the patient and discharge from wounds, since most often it is in these environments that a large number of pathogens are located.
• Final. It is carried out after the discharge or death of the patient to destroy pathogens that could remain on the objects surrounding him during the illness due to the release of his biological fluids, in the form of an aerosol during breathing, sneezing and coughing.

Disinfection methods

Disinfection methods include methods of destroying or removing pathogens from surfaces and can be:

• Mechanical
• Chemical
• biological
• Combined

The mechanical method is the removal of pathogens and their toxins with the help of special cleaning items - brushes, washing machines, rags. Non-specific means can also be used, for example, if necessary, remove contaminated soil, shovels or special equipment can be used.

The physical method is the use of temperatures, radiation or ultrasound. Examples are boiling, ultraviolet irradiation, the use of plasma and gamma-ray sterilizers. In the conditions of outbreaks of especially dangerous infections and epidemics, contaminated objects or other sources of infection can be burned to destroy them.

Biological method - based on the competitive relationship of infectious agents with other microorganisms. Most often used for cleaning Wastewater with the help of activated sludge and is aimed at interrupting transmission routes in particular intestinal infections.

Remark 1

Combined methods - are used most often and are a combination of different methods of disinfection.

For example, during preventive disinfection in the processing of surgical instruments, washing with brushes in an antiseptic solution is used, and then treatment with steam under pressure, or during current disinfection, wet cleaning using antiseptic agents is combined with ultraviolet irradiation and ventilation.

Also, disinfection can be divided into preventive and focal.

Prevention is carried out almost everywhere and is aimed at preventing the spread of infections in places of public use, food production, wastewater treatment, etc. It is carried out by special sanitary services on the ground.

Focal disinfection is aimed at destroying the infection in its foci, for example, in medical institutions and places where the patient was before hospitalization - at home, at work. Carried out by outpatient clinics.

Disinfection(Latin des - a prefix denoting destruction and lat.infectio - infection) - this is the destruction of pathogens of infectious diseases in the human environment: bacteria, viruses and their (bacteria) carriers. In this case, only vegetative forms of microorganisms that contaminate the processed objects perish.

Sterilization is the destruction of not only vegetative forms of microorganisms, but also their spores, which, as you know, are particularly resistant to the effects of the external environment.

It is possible to achieve the destruction of microorganisms by exposure to both physical factors and chemical agents, depending on the duration of exposure (exposure) and the intensity (concentration) of disinfectants.

Types of disinfection.

Distinguish preventive and focal disinfection.

Preventive disinfection is carried out in order to prevent nosocomial infections.

Focal disinfection is divided into focal and current disinfection, which is carried out in the focus of infection, at the bedside of an infectious patient, is carried out repeatedly, and focal, final, disinfection, which is carried out once after isolation, hospitalization in the infectious disease department, recovery or death of the patient in order to completely release the infectious source of pathogens.

Methods and means of disinfection.

Mechanical methods of disinfection are:

Wet cleaning of premises and furnishings;

Knocking out clothes, bedding and bedding;

Removing dust from the premises with a vacuum cleaner, whitewashing and painting

premises;

Hand washing.

Physical means and methods (thermal) - this:

Sunlight and exposure to ultraviolet radiation;

Ironing with a hot iron, roasting, calcining;

Burning garbage and items that had no value;

Treatment with boiling water or heating to a boil;

Pasteurization;

Tindalization (fractional pasteurization for 6-7 days at 60 0 C, exposure -1 hour);

Boiling;

Air method of disinfection (dry oven at t=120 0 C, exposure 45 min.);

Steam method of disinfection in special disinfection chambers - steam-air or steam-formalin - in the mode of 0.5 atm, t = 90 0 С, exposure 30 minutes.

The essence of chamber disinfection consists in heating the contents of the chambers with hot air (steam) to a certain temperature and at excessive pressure, and if it is necessary to enhance the effect of steam, in the additional introduction of formaldehyde (formalin) into the chamber.

Chemical disinfectants, which have strong oxidizing properties, are used in the form of aqueous solutions, emulsions, powders, etc. These include:

Hydrogen peroxide (H 2 O 2);

Potassium permanganate (KMnO 4);

Deoxon-1 and others.

Chemical methods of disinfection include:

Irrigation;

Rubbing;

Full immersion;

Paroformalin (see above).

Characteristics of the main means of disinfection.

The main means of disinfection are chlorine-containing, oxygen-containing, surface-active agents, guanidines, aldehyde-containing, alcohols, phenol-containing agents.

Bleaching powder is a white powder, alkaline reaction, with a sharp irritating odor. The quality of bleach depends on the content of active chlorine (CL -) in the amount of 25% active chlorine. With a decrease in the activity of chlorine to 15%, bleach is unsuitable for use.

It is used to disinfect water, dishes, rooms, patient secretions, toilets, etc. in the form of 0.5-10% aqueous solutions and in dry form. Dry bleach is covered only with the patient's discharge, food debris, washing with water in a ratio of 1: 5 (200 g of dry bleach per 1 liter of biological fluids).

Chloramine-B. Activity - 26% by CL - . The starting product for the manufacture of chloramine-B is benzene (chloramine-T - toluene). Chloramine-B is soluble in water, its solutions do not spoil or discolor fabrics. Hot solutions (50, 60 0 C) and activated solutions of chloramine have a higher disinfecting effect.

Chloramine is used for disinfection of medical supplies, preventive and focal disinfection (intestinal, drip infections of bacterial and viral etiology, tuberculosis, fungal diseases).

Calcium hypochlorite is neutral. Activity 52% active CL - . In medical institutions, powdered calcium hypochlorite (DTSGK - two-thirds of the basic salt of calcium hypochlorite) is used in white color. A slightly turbid solution is formed, which can be used after 30 minutes. after cooking. It is stable during storage, slightly hygroscopic, and even in air retains activity in CL - .

Chlorhexidine bigluconate (gibitan)(manufactured by firms in England and Poland). Transparent 20% solution, odorless. Does not require special storage conditions. Belongs to the class of so-called surfactants. It is readily soluble in water, alcohol, does not change its properties during long-term storage, has a long-term antimicrobial effect, has a pronounced deodorizing effect, does not cause obvious corrosion of metals during short-term (2-3 minutes) stay of tools in solution.

On Proteus, acid-resistant rods, viruses and spores, the drug has no effect.

It is intended for disinfection of surgical instruments, hands of a surgeon, nurses, midwives. It is used as a therapeutic, antiseptic agent, as well as for current and final disinfection.

Hydrogen peroxide (H 2 O 2 ) belongs to the group of oxidizers. Produced by the industry in the form of an aqueous solution of 29-30% concentration called perhydrol. It is an odorless and colorless liquid with a bitter-astringent taste. It has high bactericidal properties. Solutions of hydrogen peroxide in an amount of 0.5-6% concentration do not spoil objects, do not corrode metals, and are of low toxicity. They are used in 3-4% concentration, with exposure from 80 to 180 minutes. with detergents ("Progress", etc.), allow you to combine the process of chemical disinfection after washing the blood with mechanical cleaning, resulting in an enhanced disinfecting effect; 0.5% concentration with 0.5% detergent for pre-sterilization cleaning at a temperature of 45-50 0 C, exposure 15 minutes.

Hydrogen peroxide solutions are stored in a dark, cool place that is not accessible to the general public. Bottles with perhydrol must have a casing. Carry carefully.

And catering, train stations, wagons, entertainment establishments and).

The main objects of preventive disinfection are:

• polyclinics, children's consultations and other similar institutions (disinfection is carried out after the end of appointments or in between them);
• preschool institutions;
• (cinemas, hostels, markets and so on);
• food industry enterprises ( , ), ;
• hairdressers, baths, showers, swimming pools, etc.;
• enterprises where it is stored and processed.

Preventive disinfection, depending on the nature of the object, is carried out either by the economic organizations themselves, or by preventive disinfection centers (disinfection departments of the territorial centers for hygiene and epidemiology of Rospotrebnadzor).

Economic organizations are engaged in the implementation of preventive disinfection measures in cases where their constant and continuous implementation is required (pasteurization of milk and dairy products, gyms, and so on).

Disinfection institutions of the sanitary and epidemiological service in these cases carry out methodological and control functions.

In some cases, when preventive disinfection is of a one-time or periodic nature, it is carried out using the forces and means of preventive disinfection centers or disinfection departments of territorial centers for hygiene and epidemiology (disinfection of production premises after overhaul, periodic, etc.).

The effectiveness of preventive disinfection is largely determined by sanitary and communal improvement locality, the sanitary and technical condition of the facility, the quality of implementation of the preventive recommendations of the sanitary and epidemiological service at the facilities, the degree of public participation in the implementation of preventive measures.

Current disinfection

Current disinfection- is carried out at the bedside of the patient (in the focus) in his presence, in the isolators of medical centers, medical institutions, aimed at the destruction of pathogens as they are released by the patient or carrier, in order to prevent the spread of infectious diseases outside the focus.

The most common indications for ongoing disinfection are:

• finding the patient in the focus before hospitalization;
• treatment of an infectious patient at home until recovery;
• the presence of a bacteriocarrier in the focus until it is completely sanitized;
• the presence of convalescents in the focus before deregistration.

Current disinfection in apartment foci of infectious diseases is organized by a medical worker who has identified an infectious patient.

In a number of cases, the organization of the current disinfection is carried out by employees of the sanitary and epidemiological service, however, this approach is considered unpromising, since with it the start of disinfection measures is delayed and subsequently poorly controlled.

The organizational role of a medical worker (most often a district doctor) during the current disinfection is that he explains and teaches the patient (or those caring for the patient) the methodology for conducting the current disinfection.

At the same time, it should be emphasized that the current disinfection includes two groups of measures:

1. Disinfection of objects of the external environment, secretions of the patient.

Current disinfection in apartment epidemic foci is carried out by the diseased themselves (bacteria carriers) or by persons caring for the sick.

Sanitary and hygienic measures in the apartment hearth as part of the current disinfection include:

• isolation of the patient in a separate room or a fenced off part of it ( the patient's room is subjected to wet cleaning and ventilation 2-3 times a day), exclusion of contact with children, limiting the number of objects with which the patient can come into contact, observing the rules of personal hygiene;
• allocation of a separate bed, towels, care items, dishes for food and drink;
• utensils and patient care items are stored separately from the utensils of family members;
• separate maintenance and collection of dirty linen of the patient from the linen of family members;
• maintaining cleanliness in rooms and common areas, while using separate cleaning equipment for the sick room and other rooms;
• in the summer, systematically carry out the fight against flies;
• a family member caring for a sick person should be dressed in a bathrobe or an easy-to-wash dress; there should be a scarf on the head; in the foci of aerosol infections, it is necessary to wear a cotton-gauze bandage. When leaving the patient's room, overalls should be removed, hung separately and covered with a sheet.

In foci at home, it is advisable to use physical and mechanical methods of disinfection, as well as the use of household chemicals. At the same time, it is widely used soda, soap, boiling and hot water, clean rags, washing, ironing, airing, etc.

Usually, in residential epidemic outbreaks, chemical disinfectants are used only to decontaminate secretions.

Current disinfection measures in an infectious diseases hospital should be carried out during the entire period of stay of patients in the hospital, from their admission to discharge.

The premises where patients are received, after examining each patient, are subjected to wet disinfection in accordance with the nature of the infection.

Particular attention should be paid to the disinfection of objects with which the patients came into contact during the reception.

crockery, in which food for infectious patients is transferred from home, it is necessary to return to relatives only after disinfection.

Linen and other washable soft items, used by patients, are collected in tanks with lids or bags moistened with disinfectant solutions and sent to the laundry. In cases where it is not possible to store contaminated laundry separately in the laundry, it is collected in a separate room in an isolated room and subjected to wet disinfection before being sent to the laundry.

Toys must be individual and, after being used by a sick child, be subject to mandatory disinfection. Toys of little value are to be burned. For disinfection secretions and dishes from under them, special devices should be more widely used in practice.

In the absence of them in the toilet of the hospital, to collect the secretions of patients with intestinal infections, it is necessary to use galvanized tanks with a lid and a mark - 5, 10, 20 liters.

After filling the tank to a certain height faecal matter the latter are subjected to disinfection in the indicated way, and a spare tank is put up for use.

Medical personnel caring for patients are obliged to strictly observe the rules of personal prevention (thorough washing and disinfection of hands after the end of patient care, before distributing food, feeding bedridden patients, children, etc.).

It is mandatory to use respirators in the departments for patients with aerosol infections. Eating by staff in the wards and corridors is prohibited.

In infectious diseases hospitals and on their territory, a systematic control of flies, other insects and rodents and to ensure the maintenance of hospital territories and outdoor sanitary installations in full sanitary order.

The disinfection squad is delivered to the outbreak, along with all disinfection equipment, by transport intended for the evacuation of an infectious patient, if it is not possible to allocate a separate car for these purposes.

Upon arrival at the outbreak, the disinstructor determines the place to place the outer clothing of the detachment, puts on overalls, examines the outbreak and finds out all the circumstances that determine the volume and content of disinfection measures, in accordance with which he outlines a plan for the final disinfection.

The main stages of the final disinfection in the epidemic focus are:

• according to indications, the destruction of flies with closed windows, vents and doors;
• disinfection of the door to the room where the patient was, the floor in the patient's room;
• disinfection of underwear and bed linen in a disinfectant solution or by boiling;
• disinfection of food residues of the patient with the help of disinfectants or boiling;
• disinfection of food utensils with a disinfectant solution or boiling;
• disinfection of secretions and dishes for secretions using a disinfectant solution or boiling;
• disinfection of toys with a disinfectant solution or boiling;
• collection of things for chamber disinfection;
• wall preparation and individual items to disinfection;
• disinfection of paintings, figurines and polished things;
• , laying overalls, washing hands.

In addition to following the above sequence of disinfection actions, disinfection should be started from more distant parts of the room and corners, sequentially moving towards the exit, after which corridors, kitchens, and toilets are disinfected.

For chamber disinfection, things are taken from the outbreaks at the following infectious diseases: plague, cholera, relapsing fever, epidemic typhus, Brill's disease, Q fever (pulmonary form), anthrax, viral hemorrhagic fevers, typhoid fever, paratyphoid fever, tuberculosis, leprosy, diphtheria, fungal diseases of hair, skin and nails (microsporia, trichophytosis, rubrophytia, favus), scabies.

Chamber disinfection should be subjected to things not only of the patient, but also of those who were in contact with him. Things subject to chamber disinfection are sorted and placed in bags separately for steam-air, steam and steam-formalin disinfection. For all things sent to the cell, a receipt is drawn up in two copies, one of which is left to the owners of the things, and the second is sent to the cell along with the things.

Things placed in bags are taken out and loaded into an ambulance immediately after their collection. Bags with things before being taken out of the hearth should be irrigated from the outside with a disinfectant solution.

When working on hospitalization and focal disinfection, doctors, middle and junior medical personnel who are in contact with infectious patients, materials and premises contaminated with pathogens, when coming to work, should leave all personal clothes, underwear and shoes in individual cabinets and put on clean overalls.

When working in the outbreaks, disinfection personnel should not use the hangers available in the outbreak. Clothing removed by personnel should be stored in a special case or folded into a previously disinfected place. Work in the hearths without protective clothing is prohibited.

When working with disinfectants, personnel must wear a respirator, make sure that the products used do not get on the skin; before taking rubber gloves, you must wash your hands (with gloves) with soap and water, wipe dry and carefully remove the gloves from your hands; disinfection equipment should be stored in a special room - cabinets, cases, containers, etc.

The final disinfection of the transport on which the infectious patient was evacuated is carried out by the disinfector of the hospital reception department, and the transport that delivered things from the outbreak for chamber disinfection and communicated people for sanitization is disinfected by the personnel who brought things and people.

The disinfectant solution for the treatment of transport is taken at the same concentration as for disinfection in the outbreak.

For disinfection of vehicles in the admission department of the hospital, there must be disinfectants and the necessary equipment.

Leatherette upholstery, oilcloth covers are wiped with rags, and soft sofas - with brushes dipped in a disinfectant solution.

In the most common low-pressure lamps, almost the entire emission spectrum falls at a wavelength of 253.7 nm, which is in good agreement with the peak of the bactericidal efficacy curve (that is, the efficiency of absorption of ultraviolet light by DNA molecules). This peak is located around the 253.7 nm wavelength, which has the greatest effect on DNA, but natural substances (eg water) delay UV penetration.

Germicidal UV radiation at these wavelengths causes thymine dimerization in DNA molecules. The accumulation of such changes in the DNA of microorganisms leads to a slowdown in their reproduction and extinction. Germicidal UV lamps are mainly used in devices such as germicidal irradiators and germicidal recirculators.

Gamma radiation- a type of electromagnetic radiation with an extremely short wavelength - less than 2·10 -10 m - and, as a result, pronounced corpuscular and weakly expressed wave properties. Gamma radiation is used as an effective sterilization of medical supplies and equipment.

Ironing fabrics with an iron- can be used at home when ironing things with an iron (temperature 200 C)

garbage burning- to implement this method, special installations are used "incinerators"- Installations for thermal waste disposal.

The incineration plant is used for the timely disposal of various industrial and biological wastes generated in various enterprises.

Waste disposal in the incinerator occurs at a high temperature, which ensures the decomposition of organic compounds to inorganic ones and destroys all pathogenic microflora.

The incinerator is not used to destroy harmful substances and wastes that do not decompose at high temperature, or form harmful substances at high temperature.

The special burners used in the incineration plant ensure the reliable and safe destruction of biological and industrial residues. Thanks to them, the temperature in the tank where the waste is destroyed is over a thousand degrees, which allows you to burn any waste and kill all microorganisms.

When destroyed in an incinerator, the volume of waste is reduced tenfold and a little practically sterile ash is obtained.

Pasteurization and fractional pasteurization (tyndalization)- the process of single heating of most often liquid products or substances to 60 C for 60 minutes or at a temperature of 70-80 C for 30 minutes. The technology was proposed in the middle of the 19th century by the French microbiologist Louis Pasteur. It is used to disinfect food products, as well as to extend their shelf life.

Depending on the type and properties of food raw materials, different modes of pasteurization are used. Distinguish long (at a temperature of 63-65 C for 30-40 minutes), short (at a temperature of 85-90 C for 0.5-1 minute) and instant pasteurization (at a temperature of 98 C for a few seconds).

When the product is heated for a few seconds to a temperature above 100 C, it is customary to speak of ultra-pasteurization.

During pasteurization, vegetative forms of microorganisms die in the product, however, the spores remain in a viable state and, when favorable conditions arise, they begin to develop intensively. Therefore, pasteurized products (milk, beer, etc.) are stored at low temperatures for a limited period of time.

It is believed that the nutritional value products during pasteurization practically does not change, since taste qualities and valuable components (vitamins, enzymes) are preserved.

Pasteurization does not mean sterilization of the product. Killed during pasteurization psychrotrophic and mesophilic lactic acid bacteria (S. lactis, S. cremoris etc.), while thermophilic lactic streptococci and enterococci, used to obtain fermented milk products, reduce activity.

The efficiency of pasteurization (the nature of the microflora in milk after pasteurization) is largely determined by the storage conditions of milk before pasteurization (in particular, the temperature of its cooling after milking).

Pasteurization cannot be used for food preservation, since a hermetically sealed container is a favorable environment for the germination of spores of anaerobic microflora (see botulism).

For the purpose of long-term preservation of products (especially those initially contaminated with earth, for example, mushrooms, berries), as well as for medical and pharmaceutical purposes, fractional pasteurization is used - tyndalization.

Exposure to dry heat. The object to be sterilized is heated in an oven at a temperature of 180 C for 20-40 minutes or at 200 C for 10-20 minutes. Dry heat sterilizes glass and porcelain dishes, fats, petroleum jelly, glycerin, heat-resistant powders (kaolin, streptocide, talc, calcium sulfate, zinc oxide, etc.).

Cannot be sterilized in ovens aqueous solutions in flasks, since water at high temperatures turns into steam and the flask can be broken.

steam exposure When using this method of sterilization, the effects are combined high temperature and humidity. If dry heat causes mainly pyrogenetic destruction of microorganisms, then moist heat causes protein coagulation, which requires the participation of water.
In practice, moist heat sterilization is carried out at a temperature of 50-150 C and is carried out in the following ways.

Disinfection chambers provide reliable disinfection or disinfestation clothes, bedding, wool, carpets, scraps, books and other things.

All other methods of disinfection of soft things, except for boiling, do not guarantee the completeness of disinfection and disinfestation, and disinfection by boiling is unacceptable for outerwear, bedding (pillows, blankets, mattresses) and some other soft things.

In disinfection chambers, physical (steam, steam-air mixture, dry hot air), chemical (formaldehyde, etc.) or both disinfectants are used.

Cameras are installed in medical and preventive and sanitary and epidemiological institutions, as well as in industrial enterprises.

On the basis of guanidines developed varnishes and paints with. Lack of funds: "film" (at high concentrations) is sticky.

List of legislative documents on sterilization and disinfection

1. ST SEV 3188-81 "Medical devices. Methods, means and modes of sterilization and disinfection. Terms and definitions".
2. GOST 25375-82 "Methods, means and modes of sterilization and disinfection of medical devices. Terms and definitions".
3. OST 64-1-337-78 "Resistance of medical metal instruments to means of pre-sterilization cleaning, sterilization and disinfection. Classification. Choice of method".
4. Temporary instructions for packaged sterilization of plastic disposable magazines for surgical draining devices (approved by the Ministry of Health of the USSR 09.11.72 N 995-72).
5. Guidelines for the sterilization of heart-lung machines with gaseous ethylene oxide (approved by the USSR Ministry of Health on March 26, 1973 N 1013-73).
6. Temporary instructions for washing and sterilizing surgical instruments and plastic products with hydrogen peroxide and a mixture of ethylene oxide and methyl bromide (approved by the USSR Ministry of Health on 25.08.72 N 988-72).
7. Guidelines for the control of steam sterilizers (autoclaves) in medical institutions (type "AB", "AG", AP" and "AOV") (approved by the Ministry of Health of the USSR on November 28, 1972 N 998-72).
8. Guidelines for sterilization in a portable gas apparatus (approved by the USSR Ministry of Health on March 26, 72 N 1014-73).
9. Guidelines for the pre-sterilization treatment and sterilization of rubber products and components for medical purposes (approved by the USSR Ministry of Health on June 29, 1976 N 1433).
10. Guidelines for the sterilization of dressings, surgical linen, surgical instruments, rubber gloves, glassware and syringes in steam sterilizers (approved by the USSR Ministry of Health on 12.08.80 N 28-4/6).
11. Guidelines for the use of deoxon-1 for disinfection and sterilization (approved by the Ministry of Health of the USSR 24.12.80 N 28-15/6).
12. Guidelines for pre-sterilization cleaning of medical devices (approved by the Ministry of Health of the USSR 08.06.82 N 28-6 / 13).
13. Order of the Ministry of Health of the USSR N 720 dated July 31, 1978 "On improving medical care patients with purulent surgical diseases and strengthening measures to combat nosocomial infections".
14. Order of the Ministry of Health of the USSR N 1230 of December 6, 1979 "On the prevention of diseases in obstetric hospitals".
15. Order of the Ministry of Health of the USSR N 752 dated July 8, 1981 "On strengthening measures to reduce the incidence of viral hepatitis".
16. Order of the Ministry of Health of the USSR N 916 of August 4, 1983 "On approval of instructions on the sanitary - anti-epidemic regime and labor protection of personnel of infectious diseases hospitals (departments)".
17. Guidelines for the classification of foci of tuberculosis infection, the conduct and quality control of disinfection measures for tuberculosis (approved by the USSR Ministry of Health on May 4, 1979 N 10-8 / 39).
18. Guidelines for the use of chloramine for disinfection purposes (approved October 21, 1975 N 1359-75).
19. Instructions for the use of hydrogen peroxide with detergents for disinfection purposes (approved by the Ministry of Health of the USSR 29.08.70 N 858-70).
20. Guidelines for the use of sulfochloranthin for disinfection purposes (approved by the Ministry of Health of the USSR on 23.06.77 N 1755-77).
21. Guidelines for the use of chlorpin for disinfection (approved by the Ministry of Health of the USSR 24.12.80 N 28-13 / 5).
22. Guidelines for the use of dezam for disinfection (approved by the Ministry of Health of the USSR 24.12.80 N 28-14 / 6).
23. Guidelines for sterilization in a formalin sterilizer.
24. Guidelines for the use of gibitan for disinfection 26.08.81 N 28-6/4.
25. Order of the Ministry of Health of the USSR N 60 dated 01/17/70 "On measures to further strengthen and develop the disinfection business".
26. Guidelines for the chemical cleaning of surgical instruments made of stainless steel (approved by the Ministry of Health of the USSR 14.03.83 N 28/6-6).
27. Instructions for the disinfection and disinfestation of clothing, bedding, footwear and other objects in steam-air-formalin, steam and combined chambers and the disinsection of these objects in air disinfection chambers (20.08.77).

References, literature, dissertations, books

• A list of all chemical disinfectants that have a certificate of state registration is given on the website of Rospotrebnadzor

Disinfection - This is a set of measures aimed at the destruction of pathogens and the elimination of sources of infection, as well as the prevention of further spread. Disinfection measures include:

disinfection(methods of destruction of pathogenic microorganisms);

pest control(methods of destruction of insects - carriers of pathogens of infectious diseases). Many insects and ticks are carriers or intermediate hosts of microbes that cause infectious diseases, such as plague, typhus, malaria, relapsing fever, encephalitis, dysentery, etc. Special devices are used to kill insects in clothes and bedding - disinfection chambers. They use dry or moist hot air and steam. When boiling or ironing linen with a hot iron, lice and nits are exterminated. For pest control, chemicals are also used, which are called insecticides;

deratization(methods of destruction of rodents - sources and spreaders of infection). The extermination of rats, mice and other rodents is carried out using biological, chemical and mechanical methods. Biological methods include the use of pets - cats, rat-catchers. Chemical methods deratization consists in the use of poisons with bait. For different types rodents use various poisons. Poisons are added to baits, pollinate burrows, and are placed in the hole of the animal's burrow. Mechanical methods for the destruction of rodents are the use of various traps, traps.

In addition to disinfection, there are other ways to destroy microorganisms:

sterilization(boiling tools for 45 minutes prevents infection with epidemic hepatitis),

pasteurization- heating liquids up to 50-60 degrees in order to disinfect them (for example, milk). Within 15-30 minutes, the vegetative forms of Escherichia coli die.

Types of disinfection. In practice, there are two main types:

Focal (anti-epidemic) disinfection is carried out in order to eliminate the focus of infection in the family, hostel, child care facility, railway and water transport, in a medical institution. Under the conditions of an epidemic focus, current and final disinfection is carried out. Current disinfection produced in the room where the sick person is located, at least 2-3 times during the day, the entire period of stay of the source of infection in the family or in the infectious diseases department of the hospital. Final disinfection carried out after hospitalization of the patient, or after his recovery. All items that a sick person has come into contact with (bedding, linen, shoes, dishes, care items), as well as furniture, walls, floors, etc., are subject to disinfection.

Preventive disinfection performed 1 time per day or 2-3 times a week in catering units, in children's institutions, boarding schools, general somatic medical institutions, maternity hospitals. This is scheduled disinfection.

Methods of disinfection. Mechanical, physical, chemical and biological disinfection methods are used for disinfection.

Application mechanical methods based on the removal of microorganisms by shaking, knocking out, using a vacuum cleaner, sweeping, wet cleaning, washing with water with brushes, washing clothes with soap, airing. Airing is a powerful disinfectant factor, as it significantly reduces the content of pathogenic microorganisms in the room, in clothes.

TO physical methods include boiling, autoclaving, heat treatment in dry ovens, in disinfection chambers, ultraviolet irradiation.

Chemical Methods disinfection is carried out using chemicals with high bactericidal activity (chlorine, chloramine, calcium and sodium hypochlorites, lysol, formalin, carbolic acid). Soaps and synthetic detergents also have a disinfecting effect.

biological methods disinfection is the destruction of microorganisms by means of a biological nature (for example, with the help of antagonist microbes). It is used for disinfection of sewage, garbage and garbage.

For focal current and final disinfection in foci of intestinal infections, a 0.5% solution of chlorine-containing disinfectants is used, with airborne infections - 1%, in foci of active tuberculosis - 5%. When working with disinfectants, care must be taken (use protective clothing, goggles, mask, gloves).

The request "Disinfectants" is redirected here. This topic needs a separate article. 1919, Holland. The French and British, who returned from German captivity, are being disinfected in a factory in Twente.

Disinfection- this is a set of measures aimed at the destruction of pathogens of infectious diseases and the destruction of toxins in environmental objects. It is one of the types of disinfection. For disinfection, chemical disinfectants are usually used, for example, formaldehyde or sodium hypochlorite, solutions organic matter with disinfecting properties: chlorhexidine, quaternary ammonium compounds (QAS)ru en, peracetic acid, polyguanidines (PHMG-GC). Disinfection reduces the number of microorganisms to an acceptable level, but may not completely eliminate them. There are preventive, current and final disinfection:

• preventive
  • planned prevention
  • unscheduled prevention

It is carried out constantly, regardless of the epidemic situation: washing hands, surrounding objects using detergents and cleaning products containing bactericidal additives.

• current- is carried out at the bedside of the patient, in the isolators of medical centers, medical institutions in order to prevent the spread of infectious diseases outside the focus.
• final- is carried out after isolation, hospitalization, recovery or death of the patient in order to free the epidemic focus from pathogens scattered by the patient.

Disinfection methods

Disinfection-shower car DDA-66 based on GAZ-66

1. Mechanical - involves the removal of an infected layer of soil or the installation of decking.
2. Physical - treatment with ultraviolet-emitting lamps or gamma radiation sources, boiling linen, dishes, cleaning material, patient care items, etc. It is mainly used for intestinal infections.
   Boiling is used to treat linen (boil in a soapy soda solution for 2 hours), dishes (in a 2% soda solution for 15 minutes), drinking water, toys, food. The steam-air mixture is the active principle in the steam-formalin disinfection chamber; in the disinfection chambers, the patient's belongings and bedding are disinfected. Ultraviolet irradiation is used for indoor air disinfection in medical and other institutions (BUV-15 or BUV-30 lamp).
3. Chemical (the main method) is to destroy pathogens and destroy toxins with antiseptics and disinfectants.
4. Combined - based on a combination of several of the listed methods (for example, wet cleaning followed by ultraviolet irradiation)
5. Biological - is based on the antagonistic action between various microorganisms, the action of means of a biological nature. It is applied at biological stations, at sewage treatment.

household disinfection

IN Everyday life a person is often faced with the need to disinfect a skin area, whether it be a cut, abrasion, bite, or for medical purposes - an injection, blood collection for analysis, etc.

For a long time, cotton, gauze balls moistened with a solution of ethyl alcohol were used to disinfect the skin. The storage and use of ethyl alcohol is associated with a certain degree of risk. Abroad, for a long time, special disposable alcohol wipes have been used to disinfect the skin. For some time now, they have become widespread in Russia and have become an attribute not only of a doctor's office or first aid kit of a motorist or an ambulance doctor, but also of an ordinary home first aid kit.

Sources

1. The list of all chemical disinfectants that have a certificate of state registration is given on the website of Rospotrebnadzor

What is disinfection: purpose, types, methods, fixed assets

Bacteria and pathogenic microorganisms are sufficiently resistant to survival and long time can live and multiply in the focus of infection. Their detrimental effect on a person remains even without the presence of a carrier of the pathogen. To combat pathogenic microorganisms, a whole range of measures has been specially developed, which has the effect of disinfection. Let's understand what disinfection is. What methods and types are used in practice to protect human life? Some of them are known to everyone, but some are used in special cases.

What is disinfection

Microorganisms, getting into favorable conditions, are able to multiply, create a threat to human health and life. For centuries, people have been fighting these "enemies". Modern disinfection helps win this battle. The purpose of disinfection is to reduce the number of pathogens in environment. Unfortunately, it is impossible to completely destroy the pathogenic flora, but it is quite realistic to minimize its numbers.

Disinfection is a whole complex of measures, the task of which is to destroy pathogens, destroy toxins in various domestic and environmental objects. When carrying out disinfection, chemicals are used, for example, sodium hypochlorite, formaldehyde. Disinfection minimizes the number of harmful microorganisms, but does not always destroy them completely.

Kinds

Types of disinfection are divided into current, preventive and final. These types of disinfection are used everywhere: at home, in preschool and school institutions, in hospitals, hotels, catering establishments.

Current disinfection. This type is used more often where there is a patient. In a medical institution, in an isolation ward, at the bedside. The goal is to prevent the spread of infection beyond the location of the patient (center of the disease).

Preventive disinfection. Regardless of the environment, this type of disinfection is carried out. This can include the same hand washing, various items using various bactericidal additives.

Final disinfection. This type is carried out after hospitalization, isolation, death or recovery of a sick person. The goal is to free the epidemic focus from those pathogens that came from the patient.

In the foci of infection

Considering the types of disinfection, special attention should be paid to the final type, which is used to identify the most dangerous infectious diseases, such as viral hepatitis, dysentery, rotavirus infections, pediculosis, intestinal infections, scabies. After the patient is hospitalized, the premises are processed by employees of the sanitary and epidemiological service.

Without fail, the final disinfection is carried out during the demolition of buildings of medical institutions, during their redevelopment and restructuring, always in maternity hospitals, infectious diseases and tuberculosis hospitals.

Disinfection methods (mechanical, physical)

There are various disinfection methods.

Mechanical the method involves the installation of additional flooring or the removal of a whole layer of contaminated soil.

Physical the method is the treatment of areas with ultraviolet lamps, boiling dishes, linen, patient care items, pillows, mattresses, shoes and clothes of the patient, cleaning materials and others. More often the physical method is used in the spread of intestinal infections. What is disinfection, which is carried out by physical factors in essence? A method based on the use of high temperatures, ultraviolet light and high frequency current. They are used in medical, sanatorium institutions to destroy all microorganisms that are sensitive to high temperatures.

Chemical, biological, combined methods

Chemical disinfection methods. The destruction of pathogenic microorganisms and bacteria occurs with the help of chemical disinfection active substances. These funds are available in the form of capsules, gel, soaps, shampoos, powders, various solutions. Items requiring disinfection are wiped, poured, covered, sprinkled, immersed, depending on the type of product and the hardness of the item.

Biological the method is based on the antagonistic interaction of different microorganisms, their effect on nature. Often used in water treatment plants.

Combined the method can combine several of the above methods of disinfection.

Means (disinfectants)

Disinfectants in public places must be used strictly in accordance with the requirements of SanPiN. For processing, a drug is selected that is as harmless as possible to human body, but at the same time it is able to destroy bacteria and pathogenic microorganisms. These products have neutral odors and hypoallergenic properties.

When working with bleach, special safety precautions must be observed. This substance is considered a very common disinfectant. Keep bleach solution away from sun rays, it is better to cook immediately before use.

Groups of disinfectants

Disinfectants are divided into groups depending on the active substance that is included in their composition:

• Alcohol disinfectants: methanol, ethyl alcohol.
• Products based on hydrogen peroxide: peroxide + catamine.
• Chlorine substances: bleach, chloramine, deactin.
• Means where the base is HOUR - benzalkonium chloride.
• Derivatives of peracetic acid.
• For chemical methods - alcohols, formaldehyde, surfactants, halogens.

All drugs are quite effective in the fight against bacteria and microorganisms, but not all are able to destroy their spores. Regulatory documents of the sanitary and epidemiological service contain detailed instructions about the use of certain disinfectants.

Ways

What is disinfection, it became clear, now let's figure out what methods of disinfection exist. Methods are chosen depending on the task at hand. If preventive disinfection is required, then a washing disinfectant, such as DeMoS, is quite suitable for surface treatment. With it, you can process both floors and various surfaces. The solution is prepared at the rate of 10 ml of the product per liter of water. You can use the method of spraying the product on the floor, walls, furniture, objects. Irrigation is well suited for the treatment of hard-to-reach places. If an infection has settled in the house, you can use it at the same time different ways disinfection: wiping, irrigation. The dosage of the means used in this case may be different, it is better to study the instructions before use.

You can also get rid of the infection by soaking. This method is suitable for processing linen, dishes, hygiene items. Immersion in a solution can also be referred to as soaking. The requirement in this case is that the object being processed is completely immersed in the solution. In everyday life, all of the above methods of processing are suitable.

Disinfection is simply necessary where there are children. It is better to use products that do not cause allergic reactions and do not have unpleasant odors.

Disinfection in public places should not be neglected, it will help protect against various diseases and maintain our health.

It is necessary to constantly carry out preventive disinfection in order to prevent the appearance of terrible infections.

Disinfection of medical instruments

Disinfection is required to destroy various pathogenic microorganisms. All medical devices must be disinfected.

A surgical instrument, before sterilization or pre-sterilization cleaning, should be disinfected if it was used for purulent operations or for infectious diseases.

Disinfection of instruments is carried out by the following methods:

Boiling. A solution of baking soda 2% - sodium bicarbonate with distilled water. Recommended for metal, glass, rubber, heat-resistant materials. Exposure - 15 minutes.

Immersion.

• A 3% solution of chloramine is used (30 g of chloramine powder is taken per 970 ml of water). In the case of tuberculosis, a 5% solution is taken by immersion for 240 minutes.
• Hydrogen peroxide solution 6% - for 60 minutes, 4% - for 90 minutes.
• Neutral anolyte solution 0.03%. Exposure for 30 minutes.
• 0.056% precept (10 tablets x 0.5g). Exposition for 90 minutes.
• 5% Lysetol (960 ml of water and 50 ml of the drug). Exposure for 15 minutes.
• Alcohol 70 degrees. Exposure for 30 minutes.
• 2% glugaral. Exposure for 15 minutes.
• 1% virkon (980 ml of water and 10 g of the drug). Exposure 10 minutes.
• 5% dezoform (950 ml of water and 50 ml of the drug). Exposure 10 minutes.
• 3% dezoform (970 ml of water and 30 ml of the drug). Exposure 30 minutes.

Disinfection of hairdressing tools

A variety of disinfection methods are used in the hairdresser. Instruments are systematically disinfected to kill various pathogens and avoid their transfer from client to client.

For disinfection, 70% ethyl alcohol is used. Scissors, razors, working parts of machines, manicure tools can be immersed in the solution. The alcohol in the vessel should be changed every 2-3 days. It should be borne in mind that microbes accumulate between the teeth, they are burned on an alcohol burner.

The beauty and pedicure parlor processes the instruments most carefully, subjecting them to boiling in an electrosterilizer.

You can use a 0.5% solution of chloramine. Plastic brushes and other tools are immersed in it. The chloramine solution must be replaced every five days.

The plastic case of the clipper must be wiped with a swab dipped in a solution of the same chloramine.

Disinfection. Kinds. Methods. Brief description of the methods. Modes

Disinfection - a set of methods for the complete, partial or selective destruction of vegetative pathogenic microorganisms for humans, both on environmental objects and on medical products.

Types of disinfection: prophylactic (carried out in the absence of a source of infection to prevent possible infection), current(performed in the presence of a source of infection throughout the infectious period, mainly in hospitals with an infectious profile or in home foci), final(carried out after the disappearance of the source of infection - hospitalization, recovery, death of the patient).

There are current and general cleaning, which are carried out according to the type of preventive or final disinfection, and during the period of anti-epidemic measures (for example, during an influenza epidemic), current disinfection is carried out.

The following methods are used for disinfection: mechanical, physical, chemical, combined. Objects are processed in various ways:

Irrigation, wiping, washing, using disinfection chambers.

Mechanical methods of disinfection ensure the removal of microorganisms from objects by shaking, wet wiping, airing, ventilation, washing, washing. In this case, a complete release or reduction of contamination by microorganisms of the external environment is possible.

Physical methods of disinfection ensure the removal of microorganisms by exposure to physical agents: drying, high temperature, steam, hot air, UV radiation, ultrasound.

Methods and methods of disinfection

Sterilization and disinfection

Disinfection - measures aimed at the destruction of the causative agent of infectious diseases in the external environment.

Disinfection is divided into preventive and focal, and focal - into current and final.

Preventive disinfection reduces the risk of infection of the population and reduces the contamination of environmental objects. Most often done on a regular basis. Covers health care facilities, kindergartens and public places and large crowds of people: at manufacturing enterprises in the food industry, baths, showers, hairdressers.

Spot disinfection - measures taken in the presence of a focus of an infectious disease or carriage. It is carried out in order to prevent infection of persons surrounded by the patient and to prevent the removal of the pathogen outside the focus.

Current disinfection - carried out in the focus, where the patient or the carrier is continuously from the moment the source of infection is identified during the entire infectious period. It is carried out in apartments, hospitals, isolation wards.

In health care facilities it is carried out by medical workers, and in an apartment hearth - by persons caring for patients.

Control over the current disinfection is assigned to the doctor, paramedic, nurse.

Final disinfection - the final stage in the elimination of the focus. It is carried out after isolation (hospitalization) of a patient or carrier, his recovery or death, with chronic infections (for example, tuberculosis) after the patient has moved to a new place of residence.

It is carried out once by the forces of the disinfection team, the State Sanitary and Epidemiological Service, the medical staff of the medical facility.

During the final disinfection, those objects that can be factors in the transmission of infection are disinfected:

1. Things selected for chamber disinfection are put into bags pre-treated with disinfectant solutions.

2. Wet disinfection is carried out by spraying disinfectant solutions with the help of an automatic machine (automax, etc.).

3. Beds, bedside tables, walls are completely irrigated.

Methods and methods of disinfection

- Mechanical methods– removal of pathogenic microorganisms by shaking or knocking things out, using a vacuum cleaner, natural ventilation, wet cleaning and washing.

Mechanical disinfection only reduces the number of pathogens in objects, however, a significant dose of the pathogen is required for infection. Therefore, the measures are effective.

- Physical Methods- destruction of microorganisms under the influence of physical factors: burning, calcining, burning (for example, cremation of corpses), dry hot air (disinfection of glass laboratory glassware, chamber disinfection), boiling (disinfection of dishes, linen, toys, patient care items).

When boiling, the exposure is calculated from the moment of boiling. To increase the boiling point, add baking soda to the water (a tablespoon per 1 liter of water).

In addition, saturated steam under pressure is used in two versions: stationary (autoclave) and fluid (steam chamber). As the pressure rises, the temperature rises. It is this factor, and the fact that steam under pressure penetrates deep into tissues, that gives a high degree of disinfection.

Disinfection is also used using a vapor-air mixture (leather and fur things), to achieve the best effect, formalin is introduced into the chamber and the temperature reaches 98-950 C. It is carried out in hospitals.

Types of irradiation used:

UFL in hospitals (in operating rooms, dressing rooms, laboratories), the action is superficial, aimed at the destruction of microflora in the air and on the surface of objects. When using UV lamps, ozone is formed, which is toxic, so the lamps are turned on in the absence of people.

Radioactive (γ-rays) for sterilizing medical instruments, especially disposable ones.

TO physical methods also refer pasteurization- the destruction of most vegetative forms of microorganisms at a temperature of 560 C in 30 minutes. It is applied to processing of products (milk), and artificial respiration apparatuses.

Chemical Methods– use of chemicals:

Bacteriostatic - suspending the vital activity of a microbial cell.

Bactericidal - leading to the death of microbial cells.

Sporocides - kill spores

Virusicides - kill viruses

Fungicides - acting on fungi

Requirements for disinfectants:

1. Quickly and completely soluble in water

2. In small concentrations and in a short time to achieve the effect

3. To have a disinfecting effect in the presence of organic substances in the environment

4. Do not lose disinfectant properties during storage

5. Non-toxic to humans and the environment

Characteristics of chemical disinfectants:

1. Halogen compounds are the means with active substances (ADV) - chlorine, bromine, iodine.

2. Chlorine compounds - inhibitory enzyme reactions in the cell, What is disinfection based on? Their disadvantages are that they lose their activity during storage, irritate mucous membranes, lead to allergic reactions, and cause corrosion of metals.

- Chlorine lime - white powder, contains 35% active chlorine, unstable. It is necessary to examine at least once every three months. If the level of active chlorine drops to 15%, the preparation is unsuitable for disinfection. Chlorine lime has a high activity in relation to vegetative and spore forms . For disinfection, a 10% solution is first prepared, and then, depending on the nature of the object and the type of pathogen, working solutions (0.2; 0.5; 1; 2; 3; 5%).

- Dibasic calcium hypochlorite salt (DTSGK) - contains 47-52% active chlorine, stored for 7 years. It is used for infectious diseases for disinfection of excretions, rooms, utensils, toys, synthetic materials.

- Calcium hypochlorite - 35-40% active chlorine, is used for preventive, current and final disinfection, with viral and bacterial (vegetative spore forms) and fungal infections. It is used for disinfection of indoor surfaces, equipment, utensils from discharges, garbage bins, etc.

Sodium hypochrorite is a colorless liquid (solution with a concentration of 0.6 to 0.9% active chlorine). It is used for all types of disinfection, with bacterial and viral infections in healthcare facilities, kindergartens and schools.

- Activated sodium chloride solutions (ECA) - concentration of 0.01-0.05% active chlorine for current and final disinfection of medical devices.

3. Organic chlorine disinfectants.

Distinguish:

- Chloramines– concentration of active chlorine from 26 to 28% of active chlorine. Prepared for future use and stored for up to 15 days. Less irritating to mucous membranes and skin. Used in the same way as bleach. To destroy spores.

Use activated solutions (activator - ammonia or ammonium salt 1:1 per active chlorine).

- Sodium and potassium salts are stable during storage. They have high bactericidal, fungicidal, virucidal and sporicidal properties. Disinfect linen, dishes, toys, room surfaces and furnishings. At the end of the exposure, the linen is washed, the toys are washed with water. Spores die in a 0.5-1% solution after 60 minutes.

4. Bromine-based preparations - used to disinfect water in swimming pools. They have bactericidal and fungicidal action.