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

Concept and types of disinfection

Definition 1

Disinfection - a set of measures for the destruction of pathogens of infectious diseases and their toxins located in the environment. 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 destroying pathogens and their toxins, regardless of the manifestations of the epidemic process and aimed at preventing or alleviating them. These include washing hands, equipment and premises with 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 an epidemic process (an outbreak of a disease) at the patient's bed, in isolation wards of medical centers and hospitals in order to prevent the spread of infection beyond their borders. First of all, attention is paid to the biological discharge of the patient and the discharge from the wounds, since most often it is in these environments that a large number of pathogens are located.
• Final. It is carried out after discharge or death of the patient to destroy pathogens that could remain on objects surrounding him during the illness due to the secretion of his biological fluids, in the form of an aerosol during breathing, sneezing and coughing.

Disinfection methods

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

• Mechanical
• Chemical
• Biological
• Combined

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

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

The biological method is 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, especially intestinal infections.

Remark 1

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

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

Also disinfection can be subdivided into preventive and focal.

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

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. It is carried out by workers of the outpatient clinic.

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

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

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

Types of disinfection.

Distinguish between 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 at the site 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 diseases department, recovery or death of the patient in order to completely release the infectious focus from pathogens.

Methods and means of disinfection.

Mechanical disinfection methods are:

Wet cleaning of premises and furnishings;

Beating clothes, bed linen and bedding;

Removing dust from rooms with a vacuum cleaner, whitewashing and painting

premises;

Hand washing.

Physical means and methods (thermal) -this is:

Sun rays and ultraviolet radiation;

Ironing with a hot iron, roasting, calcining;

Incineration of garbage and items of no value;

Boiling water or heating to a boil;

Pasteurization;

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

Boiling;

Air disinfection method (dry oven at t \u003d 120 0 С, exposure 45 min.);

The steam method of disinfection in special disinfection chambers - steam-air or steam-formalin - in the mode of 0.5 atm, t \u003d 90 0 С, exposure for 30 minutes.

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

Chemical disinfectantswith 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 disinfection methods include:

Irrigation;

Rubbing;

Full immersion;

Paroformalin (see above).

Characteristics of basic disinfectants.

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

Bleaching powderis 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% of active chlorine. With a decrease in chlorine activity 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. Only the patient's discharge, food debris, rinsing with water in a ratio of 1: 5 (200 g of dry bleach per 1 liter of biological fluids) are poured with dry bleach.

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

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

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

Chlorhexidine bigluconate (gibitan)(produced by firms in England and Poland). Transparent 20% solution, odorless. Does not require special storage conditions. Belongs to the class of so-called surfactants. Let's well dissolve 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 with a short (2-3 minutes) stay of instruments in solution.

The drug has no effect on proteus, acid-resistant bacilli, viruses and spores.

Designed for the 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 oxidizing agents. Produced by the industry in the form of an aqueous solution of 29-30% concentration under the name perhydrol.It is a liquid, odorless and colorless, with a bitter astringent taste. Possesses high bactericidal properties. Hydrogen peroxide solutions in an amount of 0.5-6% concentration do not damage objects, do not corrode metals, and are low-toxic. They are used in 3-4% concentration, with an exposure of 80 to 180 minutes. with detergents ("Progress", etc.), allow to combine the process of chemical disinfection after washing the blood with mechanical cleaning, as a result of which the disinfecting effect is enhanced; 0.5% concentration with 0.5% detergent for pre-sterilization cleaning at a temperature of 45-50 0 С, exposure 15 min.

Hydrogen peroxide solutions are stored in a dark, cool place out of the reach of public use. Perhydrol bottles must have a casing. Carry carefully.

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

The main objects of preventive disinfection are:

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

Prophylactic 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 hygiene and epidemiology centers of Rospotrebnadzor).

Business 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 by the forces and means of preventive disinfection centers or disinfection departments of territorial hygiene and epidemiology centers (disinfection of industrial premises after overhaul, periodic, etc.).

The effectiveness of preventive disinfection is largely determined by the sanitary and communal improvement of the settlement, 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, and the degree of population participation in the implementation of preventive measures.

Current disinfection

Current disinfection - is carried out at the patient's bedside (in the outbreak) in his presence, in isolation wards of medical centers, medical institutions, aimed at destroying pathogens as they are excreted by the patient or carrier, in order to prevent the spread of infectious diseases beyond the outbreak.

The most common indications for ongoing disinfection are:

• finding the patient in the outbreak before hospitalization;
• treatment of an infectious patient at home until recovery;
• the presence of a bacteria carrier in the outbreak until its complete reorganization;
• the presence of convalescents in the outbreak before being removed from dispensary registration.

The current disinfection in the 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, but this approach is considered unpromising, since with it the start of disinfection measures is delayed and is poorly controlled in the future.

The organizational role of a healthcare professional (most often a district doctor) during ongoing disinfection is to explain and train the patient (or caregivers) on the current disinfection procedure.

It should be emphasized that the current disinfection includes two groups of measures:

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

The current disinfection in the apartment epidemic foci is carried out by the sick (bacteria carriers) themselves or by the 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 wet cleaned and ventilated 2-3 times a day), exclusion of contact with children, limiting the number of objects with which the patient can come in contact, adherence to 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 dishes of family members;
• separate maintenance and collection of the sick linen from the linen of family members;
• maintaining cleanliness in rooms and common areas, while using separate cleaning equipment for the patient's room and other rooms;
• in the summer, they systematically fight flies;
• the family member caring for the sick should wear a gown or easy-to-clean dress; there should be a kerchief on the head; in 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 outbreaks at home, it is advisable to use physical and mechanical methods of disinfection, as well as use household chemicals. In this case, widely used soda, soap, boiling and hot water, clean rags, washing, ironing, airing, etc.

Usually, in apartment epidemic foci, chemical disinfectants are used only to disinfect secretions.

Measures of current disinfection in an infectious hospital should be carried out during the entire period of patients' stay in the hospital, from their admission to discharge.

The rooms in which patients are received are subjected to wet disinfection after examination of each patient 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 admission.

Dishes, in which food is transferred from home for infectious patients, should be returned to relatives only after disinfection.

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

Toys must be individual and, after using them by a sick child, must be subject to mandatory disinfection. Low-value toys must be burned. For disinfection secretions and utensils 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 fecal matter the latter are disinfected in this way, and a spare tank is put up for use.

The medical staff caring for the sick is 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 obligatory to use respirators in departments for patients with aerosol infections. Personnel are not allowed to eat in wards and corridors.

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

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

Upon arrival at the hearth, the disinstructor determines the place for placing the outer clothing of the de-detachment, puts on overalls, examines the hearth 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 final disinfection in the epidemic focus are:

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

In addition to observing the above sequence of disinfection actions, disinfection should be started from more distant parts of the room and corners, successively moving in the direction of the exit, after which the corridors, kitchen, and toilet are disinfected.

For chamber disinfection, things are taken from the foci for 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, rubrophytosis, favus), scabies.

Chamber disinfection should be used to expose things not only to the patient, but also to those who were in contact with him. Items 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 camera, a receipt is drawn up in duplicate, one of which is left to the owners of the things, and the second is sent to the camera along with the things.

Items placed in bags are taken out and loaded into an ambulance immediately after they are taken. Bags with things before being removed from the hearth should be watered outside with a disinfectant solution.

When working on hospitalization and focal disinfection, doctors, nurses and junior medical personnel in contact with infectious patients, material and premises contaminated with pathogens, when they come to work, must leave all personal clothes, underwear and shoes in individual closets and wear clean overalls.

When working in the hearth, disinfection personnel should not use the hangers in the hearth. The clothing removed by the personnel should be stored in a special case or folded into a previously disinfected place. Work in the hearths without work clothing is prohibited.

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

The final disinfection of the transport on which the infectious patient was evacuated is carried out by the disinfectant of the hospital reception department, and the transport that brought 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 processing transport is taken at the same concentration as for disinfection in the outbreak.

For the disinfection of transport, the admission department of the hospital must have disinfectants and the necessary equipment.

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

In the most common low-pressure lamps, almost the entire spectrum of radiation falls on a wavelength of 253.7 nm, which is in good agreement with the peak of the bactericidal efficiency curve (that is, the efficiency of UV absorption by DNA molecules). This peak is in the region of the radiation wavelength equal to 253.7 nm, which has the greatest effect on DNA, but natural substances (for example, water) delay UV penetration.

Bactericidal UV radiation at these wavelengths causes thymine to dimerize in DNA molecules. The accumulation of such changes in the DNA of microorganisms leads to a slowdown in the rate of their reproduction and extinction. Ultraviolet germicidal 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 incineration - to implement this method, special settings are used "incinerators" - Installations for thermal waste disposal.

The incineration plant serves for the timely disposal of various industrial and biological waste generated in different enterprises.

Waste disposal in the incinerator takes place 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 hazardous substances and wastes that do not decompose at high temperatures or generate harmful substances at high temperatures.

Special burners used in the incineration plant ensure reliable and safe disposal of biological and industrial residues. Thanks to them, the temperature in the tank where waste is destroyed is above 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 one-time 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 for disinfecting food products, as well as for extending their shelf life.

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

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

During pasteurization, the vegetative forms of microorganisms die in the product, however, the spores remain in a viable state and, when favorable conditions arise, 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 the taste and valuable components (vitamins, enzymes) are preserved.

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

The efficiency of pasteurization (the nature of 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 soil, 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 a drying oven at a temperature of 180 ° C for 20-40 minutes or at 200 ° C for 10-20 minutes. Glass and porcelain dishes, fats, petroleum jelly, glycerin, heat-resistant powders (kaolin, streptocide, talc, calcium sulfate, zinc oxide, etc.) are sterilized by dry heat.

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

Steam exposure This sterilization method combines the effects of high temperature and humidity. If dry heat causes mainly pyrogenetic destruction of microorganisms, then wet heat - coagulation of protein, requiring the participation of water.
In practice, wet 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, scrap materials, 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.

Disinfection chambers use physical (water vapor, steam-air mixture, dry hot air), chemical (formaldehyde, etc.), or both disinfectants at the same time.

Cameras are installed in treatment-and-prophylactic and sanitary-epidemiological institutions, as well as at industrial enterprises.

On the basis of guanidines, varnishes and paints have been developed 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 instruction on sterilization in packaged form of plastic disposable stores for surgical draining devices (approved by the USSR Ministry of Health 09.11.72 N 995-72).
5. Methodical recommendations for sterilization of heart-lung machines with gaseous ethylene oxide (approved by the USSR Ministry of Health 26.03.73 N 1013-73).
6. Temporary instructions for washing and sterilizing surgical instruments and plastic products with hydrogen peroxide and a mixture of ethylene oxide with methyl bromide (approved by the USSR Ministry of Health 25.08.72 N 988-72).
7. Methodical guidelines for the control of steam sterilizers (autoclaves) in medical institutions (type "AV", "AG", AP "and" AOV ") (approved by the Ministry of Health of the USSR on November 28, 72 N 998-72).
8. Methodical recommendations for sterilization in a portable gas apparatus (approved by the USSR Ministry of Health 26.03.72 N 1014-73).
9. Methodical instructions for 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. Methodological guidelines for sterilization in steam sterilizers of dressings, surgical underwear, surgical instruments, rubber gloves, glassware and syringes (approved by the USSR Ministry of Health 12.08.80 N 28-4 / 6).
11. Methodical recommendations for the use of deoxone-1 for disinfection and sterilization (approved by the USSR Ministry of Health 24.12.80 N 28-15 / 6).
12. Methodical instructions for pre-sterilization cleaning of medical devices (approved by the USSR Ministry of Health 08.06.82 N 28-6 / 13).
13. Order of the Ministry of Health of the USSR N 720 of July 31, 1978 "On improving medical care for 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 of 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 the approval of instructions on the sanitary - anti-epidemic regime and labor protection of the personnel of infectious diseases hospitals (departments)".
17. Methodological 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. Methodical guidelines for the use of chloramine for disinfection purposes (approved on 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 on August 29, 70 N 858-70).
20. Methodical guidelines for the use of sulfochlorantin for disinfection purposes (approved by the USSR Ministry of Health on 06/23/77 N 1755-77).
21. Methodical instructions for the use of chloropine for disinfection (approved by the USSR Ministry of Health 24.12.80 N 28-13 / 5).
22. Methodical instructions for the use of desam for disinfection (approved by the USSR Ministry of Health 24.12.80 N 28-14 / 6).
23. Methodical instructions for sterilization in a formalin sterilizer.
24. Methodical instructions for the use of gibitan for disinfection 08/26/81 N 28-6 / 4.
25. Order of the Ministry of Health of the USSR N 60 of 01/17/70 "On measures to further strengthen and develop disinfection business."
26. Methodical recommendations for the chemical cleaning of stainless steel surgical instruments (approved by the USSR Ministry of Health 14.03.83 N 28 / 6-6).
27. Instructions for disinfection and disinsection of clothes, bedding, shoes and other objects in steam-air formalin, steam and combined chambers and disinsection of these objects in air disinfection chambers (08.20.77).

Links, literature, dissertations, books

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

Disinfection is a set of measures aimed at destroying pathogens and eliminating sources of infection, as well as preventing further spread. Disinfection measures include:

disinfection(methods for the destruction of pathogens);

disinsection(methods of extermination 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. To destroy insects in clothes and bedding, special devices are used - disinfection chambers. They use dry or humid hot air and steam. Boiling or ironing linen with a hot iron kills lice and nits. For disinsection, chemicals are also used, which are called insecticides;

deratization(methods of extermination of rodents - sources and spread 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 domestic animals - cats, rat-catcher dogs. Chemical methods of deratization consist in the use of baited poisons. Different poisons are used for different types of rodents. Poisons are mixed into baits, pollinated burrows, burrows of an animal are laid in the hole. Mechanical methods for the destruction of rodents are to use various traps, traps.

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

sterilization(boiling instruments 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 with the aim of eliminating the focus of infection in a family, a hostel, a children's institution, on railway and water transport, in a medical institution. In the conditions of an epidemic focus, current and final disinfection is performed. Current disinfectionis performed in the room where the sick person is, 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 department of the hospital Final disinfectionis carried out after hospitalization of the patient, or after his recovery. All objects with which a sick person came into contact (bedding, linen, shoes, dishes, care items), as well as furniture, walls, floor, etc. are subject to disinfection.

Preventive disinfection performed once a day or 2-3 times a week at catering facilities, in child care facilities, boarding schools, general medical institutions, maternity hospitals. This is a routine disinfection.

Disinfection methods.For disinfection, mechanical, physical, chemical and biological methods of disinfection are used.

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

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

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

Biological methodsdisinfection is the destruction of microorganisms by means of a biological nature (for example, using antagonistic microbes). It is used for the disinfection of waste water, garbage and waste.

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

The request "Disinfectants" is forwarded here. A separate article is needed on this topic. 1919, Holland. The French and British, who returned from German captivity, are disinfected in the premises of the factory in Twente.

Disinfection - is a set of measures aimed at the destruction of pathogens of infectious diseases and the destruction of toxins in the environment. It is one of the types of disinfection. For disinfection, chemical disinfectants are usually used, for example, formaldehyde or sodium hypochlorite, solutions of organic substances with disinfecting properties: chlorhexidine, quaternary ammonium compounds (HOURS) ru en, peracetic acid, polyguanidines (PHMG-GC). Disinfection reduces the number of microorganisms to an acceptable level, but may not completely destroy them. Distinguish between 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 agents containing bactericidal additives.

• current - is carried out at the patient's bedside, in isolators of medical centers, medical institutions in order to prevent the spread of infectious diseases outside the outbreak.
• the 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 and shower vehicle DDA-66 based on GAZ-66

1. Mechanical - provides for the removal of the contaminated soil layer or the installation of flooring.
2. Physical - treatment with ultraviolet lamps or gamma radiation sources, boiling linen, dishes, cleaning materials, patient care items, etc. It is mainly used for intestinal infections.
   Boiling is used to treat linen (boiled in a soap and 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 disinfection of indoor air in medical and other institutions (BUV-15 or BUV-30 lamp).
3. The chemical (main method) is the destruction of pathogens and the destruction of 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 - based on the antagonistic action between various microorganisms, the action of biological agents. It is used at biological stations, for wastewater treatment.

Household disinfection

IN everyday life a person often faces the need to disinfect a skin area, whether it be a cut, abrasion, bite or for medical purposes - 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 carries a certain degree of risk. Abroad, for a long time, special disposable alcohol wipes have been used for skin disinfection. 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 for a motorist or an ambulance doctor, but also for an ordinary home first-aid kit.

Sources

1. A list of all chemical disinfectants with a certificate of state registration is given on the Rospotrebnadzor website

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

Bacteria and pathogenic microorganisms are sufficiently resistant to survival and for a long time can live and multiply at the site of infection. Their destructive effect on humans remains even without the presence of a carrier of the pathogen. To combat pathogenic microorganisms, a whole range of measures has been specially developed that has a disinfection effect. Let's figure out 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, falling into favorable conditions, are able to multiply, pose a threat to human health and life. For centuries, people have been fighting these "enemies". Modern disinfection is helping to 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 number.

Disinfection is a whole range of measures, the task of which is to destroy pathogens, destroy toxins at various household and surrounding 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 subdivided into current, preventive and final disinfection. 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 (focus of the disease).

Preventive disinfection... Regardless of the environment, this type of disinfection is carried out. This can include the same hand washing, various subjects with the use of 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, head lice, intestinal infections, scabies. After the patient is hospitalized, the processing of the premises is performed by employees of the sanitary and epidemiological service.

On a mandatory basis, the final disinfection is carried out during the demolition of buildings of medical institutions, during their redevelopment and reconstruction, necessarily in maternity hospitals, infectious diseases and tuberculosis hospitals.

Disinfection methods (mechanical, physical)

There are various methods of disinfection.

Mechanical the method involves the installation of additional decking 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 when intestinal infections are spread. What is disinfection carried out by physical factors in essence? A method based on the use of high temperatures, ultraviolet radiation and high frequency current. 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 pathogens and bacteria occurs with the help of chemical disinfecting active substances. These funds are available in the form of capsules, gel, soap, shampoos, powders, various solutions. Items requiring disinfection are wiped, poured, covered, irrigated, immersed, depending on the type of product and on the hardness of the object.

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

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

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 for 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 measures must be observed. This substance is considered a very common disinfectant. Store the bleach solution away from sun rays, it is better to cook just before use.

Disinfectant groups

Disinfectants are divided into groups depending on the active substance that is part of them:

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

All drugs are quite effective in fighting bacteria and microorganisms, but not all are capable of destroying their spores. The regulatory documents of the sanitary and epidemiological service contain detailed instructions on the use of certain disinfectants.

The ways

What is disinfection, it became clear, now let's figure out what methods of disinfection exist. The methods are chosen depending on what the task is. If preventive disinfection is required, then a detergent disinfectant such as DeMoS is quite suitable for surface treatment. It can be used to process both floors and various surfaces. The solution is prepared on the basis of 10 ml of the product per liter of water. You can use the method of spraying the product on floors, walls, furniture, objects. Irrigation works well for hard-to-reach areas. If an infection has settled in the house, you can use different methods of disinfection at the same time: wiping, irrigation. The dosage of the funds used 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 solution can also be referred to as soaking. The requirement is that the object to be processed is completely immersed in the solution. In everyday life, all of the above processing methods are suitable.

Disinfection is essential 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 preserve our health.

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

Disinfection of medical instruments

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

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

Disinfection of instruments is performed by the following methods:

Boiling. Baking soda solution 2% - sodium bicarbonate with distilled water. Recommended for metal, glass, rubber, heat-resistant materials. The exposition is 15 minutes.

Immersion.

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

Disinfection of hairdressing tools

Various methods of disinfection are used in a hairdressing salon. For the destruction of various pathogens, in order to avoid their transfer from client to client, the instruments are systematically disinfected.

For disinfection, 70% ethyl alcohol is used. Scissors, razors, working parts of clippers, 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 cosmetic and pedicure room processes the instruments most carefully, subjecting them to boiling in an electric sterilizer.

You can apply 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 body 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 objects of the external environment 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 of an infectious profile or in home foci), the final (carried out after the disappearance of the source of infection - hospitalization, recovery, death of the patient).

Distinguish between current and general cleaning, which are carried out by the type of preventive or final disinfection, and during the period of anti-epidemic measures (for example, during a flu epidemic), ongoing 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 disinfection methodsprovide the removal of microorganisms from objects by shaking out, wet wiping, airing, ventilation, washing, washing. In this case, it is possible to completely release or reduce the contamination of the external environment by microorganisms.

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

Methods and methods of disinfection

Sterilization and disinfection

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

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

Preventive disinfection reduces the risk of infection of the population and reduces the contamination of objects in the external environment. More often carried out constantly. Covers health care facilities, preschool institutions and public places and large gatherings of people: at manufacturing plants of the food industry, baths, showers, hairdressers.

Focal disinfection - measures carried out 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 outbreak where the patient or the carrier is continuously from the moment the source of infection is identified throughout the infectious period. It is carried out in apartments, hospitals, isolation wards.

In a medical facility, it is carried out by medical workers, and in an apartment center - by caregivers.

Control over the current disinfection is entrusted to a doctor, paramedic, and nurse.

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

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

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

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

2. Wet disinfection is carried out by spraying disinfectant solutions using 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 out or knocking out things, 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, calcination, incineration (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 temperature, baking soda is added 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 deeply into the tissues, which gives a high degree of disinfection.

Also, disinfection is used with the help of a steam-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.

The types of radiation used are:

UFL in hospitals (in operating rooms, dressing rooms, laboratories), the action is superficial, aimed at destroying microflora in the air and on the surface of objects. When using UVL lamps, ozone is generated, which is toxic, so the lamps are turned on when people are away.

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

TO physical methods also include pasteurization- destruction of most vegetative forms of microorganisms at a temperature of 560 C in 30 minutes. It is used for processing food (milk), and artificial respiration.

Chemical methods - the use of chemicals:

Bacteriostatic - suspending the life of a microbial cell.

Bactericidal - leading to the death of a microbial cell.

Sporicides - killing spores

Viruscides - killing viruses

Fungicides - affecting fungi

Requirements for disinfectants:

1. Quickly and completely dissolves in water

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

3. Provide a disinfectant effect in the presence of organic substances in the environment

4. Do not lose disinfecting properties during storage

5. Non-toxic to humans and the environment

Characteristics of chemical disinfectants:

1. Halogenated compounds Are means with active substances (ADV) - chlorine, bromine, iodine.

2. Chlorine compounds - inhibiting enzymatic reactions in the cell, what disinfection is based on. Their disadvantages - they lose activity during storage, irritate mucous membranes, lead to allergic reactions, and cause corrosion of metals.

- Chlorine lime is a 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 product is not suitable for disinfection. Chlorine lime is highly active 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 (DTSHC) - contains 47-52% of active chlorine, stored for 7 years. It is used for infectious diseases for disinfection of discharge, rooms, dishes, toys, synthetic materials.

- Calcium hypochlorite - 35-40% of active chlorine, is used for preventive, current and final disinfection, for viral and bacterial (vegetative spore forms) and fungal infections. It is used for disinfecting surfaces in rooms, equipment, utensils from under secretions, waste bins, etc.

Sodium hypochlorite is a colorless liquid (solution with a concentration of 0.6 to 0.9% of active chlorine). It is used for all types of disinfection, for bacterial and viral infections in hospitals, preschool institutions 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-containing disinfectants.

Distinguish:

- Chloramines - active chlorine concentration 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. They are used in the same way as bleach. To destroy the dispute.

Activated solutions are used (the activator is ammonia or ammonium salt 1: 1 in terms of active chlorine).

- Sodium and potassium salts are stable during storage. They have high bactericidal, fungicidal, virucidal and sporicidal properties. Disinfect linen, dishes, toys, indoor surfaces and furnishings. At the end of the exposure, the laundry 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 a bactericidal and fungicidal effect.