Disinfectants and Antiseptics

Chemical germicides including disinfectants and antiseptics are used in a variety of applications from sterilizing medical instruments at hospitals to cleaning a household kitchen counter. Chemical germicides are known by several names - antimicrobials, disinfectants, sporicides, sanitizers and sterilants, just to name a few. They are used to destroy a variety of pathogenic microorganisms such as viruses, bacteria, spores, molds and fungi. Chemical germicides are divided into three categories: sterilants, disinfectants and antiseptics.

Sterilants kill microorganisms on hard surfaces. This includes bacterial spores, which can survive other germicides.

Disinfectants, which can be classified as high-, medium-, or low-level depending on the strength required, kill nearly all microbials on hard surfaces except for spores.

Antiseptics are used to inactivate or destroy organisms on skin or living tissue.

Associated key terms include:

Deciding which category of chemical germicide to use depends on the function of the device or surface that will be treated. For example, steam autoclaving or ethylene oxide sterilization might damage certain instruments, so the use of chemical germicides may be suggested for those processes. According to the Centers for Disease Control and Prevention’s (CDC) Guideline for Disinfection and Sterilization in Healthcare Facilities 2008, when properly used, cleaning, disinfection and sterilization processes can reduce the risk for infection associated with use of invasive and noninvasive medical and surgical devices.

The following factors influence the effectiveness of chemical germicides:

Generally, spores have the most resistance to chemical germicides, followed by mycobacteria such as Mycobacterium tuberculosis, non-lipid viruses such as poliovirus, fungi such as Cryptococcus, vegetative bacteria such as Salmonella choleraesuis and lipid viruses such as human immunodeficiency virus (HIV), with the least resistance.

Because of the many factors that affect chemical germicides, each object that is to be cleaned must be analyzed for the best method and germicide to use.

It is of great importance to read and understand the manufacturer's instructions to know which application the product is designed for as well as the instructions for its proper use.

This chart features the common active ingredients in many chemical germicides. It shows the normal concentrations of each ingredient, along with the activity level expressed as high (H), medium (M) and low (L) as an indicator of its disinfecting strength.

Source: Healthcare Hazard Control and Safety Management, Second Edition By James T. Tweedy

The Food and Drug Administration (FDA) oversees sterilants that are required for a specific medical device. The manufacturers must submit specific microbial activity data to the FDA before a pre-market notification or 510(k) is issued. Once the 510(k) is issued, the product is ready for trade.

The Environmental Protection Agency’s (EPA) Office of Pesticides oversees disinfectants. Manufacturers are required to test products using pre-established test procedures on product stability, toxicity to people and microbial activity. If the product passes these requirements, it is registered by the agency and ready for trade.

The FDA also oversees antiseptics or drugs used on or in the human body. This includes antimicrobial soaps, antiseptics, scrubs and wound protectants, which are simply categorized by an advisory panel that scrutinize non-prescription germicidal products. Manufacturers can voluntarily submit information on these products.

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Sources

Occupational Safety and Health Administration (OSHA), 29 CFR 1910.1030, Bloodborne Pathogens.

Basics of Infection Prevention 2-Day Mini-Course California APIC Coordinating Council 2013

Centers for Disease Control and Prevention’s (CDC) Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008

Healthcare Hazard Control and Safety Management, Second Edition, By James T. Tweedy

(Rev. 11/2015)