The ideal disinfectant
Although the ideal disinfectant may not yet exist, a careful selection process and correct use of biocides are necessary to reduce negative effects on the safety and health of patients and staff in healthcare facilities. An effective disinfectant is a chemical substance or product that can destroy or inactivate pathogenic microorganisms, such as bacteria, viruses, fungi, or spores. The efficiency of a disinfectant is measured by its ability to reduce the number of microorganisms within a certain time interval, depending on the concentration and exposure time required to achieve an adequate level of microbial inactivation.
Characteristics of an effective disinfectant
An effective disinfectant should have the following properties:
- Broad antimicrobial spectrum: It must act on the pathogens most often responsible for healthcare-associated infections.
- Rapid action: A contact time as short as possible for the disinfectant to act quickly is preferred.
- Not be affected by environmental factors: It must be active in the presence of organic matter (blood, pus, vomit, feces, etc.) and be compatible with soaps, detergents, and other chemicals used.
- Have a residual effect: It is ideal for the efficacy of the disinfectant to be maintained for as long as possible.
- The disinfected surface must remain wet long enough: To comply with the contact time required for high efficacy, as established by the manufacturer.
- Have a low level of toxicity if it cannot be non-toxic for the user, visitors, and patients: It should not induce allergic symptoms (especially asthma and dermatitis). Toxicity ratings for disinfectants are: danger, warning, caution, and none. This property does not refer to the targeted pathogen, for which the disinfectant must be toxic to be effective against it.
- Not be flammable: Have a flash point greater than 65.55°C.
- Easy to use, with clear instructions on the label: They should be available in various forms (wipes, sprays, etc.) and the instructions for use should be simple and contain information about personal protective equipment, if necessary.
- Compatible with a wide range of surfaces: It is important that it does not have a corrosive effect on the surfaces on which it is applied.
- Odorless or with a pleasant smell: To be easily accepted by the user or patients.
- Present stability: In the case of concentrated and diluted solutions.
- Be water-soluble.
- Have good cleaning properties too: Contain surfactants with high cleaning power and low foaming.
- Economical: It is ideal for it not to have a very high price, but the product's efficacy and cost per compliant use must also be taken into account.
- Ecological: Be biodegradable in accordance with environmental requirements.
Epidemiologists Rutala and Weber developed a scoring system to ensure the correct selection of a disinfectant.
For each category, a score from 1 to 10 is awarded (1 being the lowest and 10 the highest).
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Aspects to consider |
Questions |
Score (1-10) Maximum: 50 |
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Efficacy
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Does it destroy the most common healthcare pathogens, including those: • Responsible for healthcare-associated infections? • That cause outbreaks? • That are most prevalent in your facility? |
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Action and contact times |
How quickly does it destroy the most common pathogens? Does it keep surfaces wet as long as indicated on the label? |
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Safety
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Does it have an acceptable level of toxicity? Does it have an acceptable level of flammability? Is minimal personal protective equipment required? Is it compatible with the surfaces in your facility? |
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Ease of use
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Is the smell acceptable? Does it have an acceptable shelf life? Is it available in convenient forms to meet your facility's needs (e.g., liquid, spray, refills, various wipe sizes)? Does it work in the presence of organic matter? Is it water-soluble? Does it clean and disinfect in one step? Are the instructions for use simple and clear? |
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Other factors
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Does the manufacturer offer adequate training and continuous education, both physical and virtual? Does the manufacturer offer 24/7 customer support? Is the total cost of the product acceptable (considering the product's efficacy, the costs of preventable infections, and the costs per compliant use)? Can it help standardize the disinfectants used in your facility? |
Conclusions
Selecting and correctly using an effective disinfectant are critical aspects in the medical field to ensure a safe and healthy environment for patients and medical staff. Even if the ideal disinfectant may not yet exist, the established criteria for evaluating their efficacy can guide choices in order to achieve the best results.
An effective disinfectant must have a broad antimicrobial spectrum, act quickly, be safe to use, and have a residual effect. It must also be easy to use, compatible with various types of surfaces, and be both economical and ecological.
To make an appropriate choice, it is important to consider multiple aspects, including efficacy, safety, ease of use, and other factors such as the training and support provided by the manufacturer. By applying a careful selection process and adhering to the established criteria, the risk of contamination can be reduced and it can contribute to the prevention of healthcare-associated infections.
Bibliography
- Molinari JA, Gleason MJ, Cottone JA, Barrett ED. Comparison of dental surface disinfectants. Gen Dent 1987;35(3):171–175
- Rutala WA, Weber DJ; Healthcare Infection Control Practices Advisory Committee. Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008. http://www.cdc.gov/ncidod/dhqp /pdf/guidelines/Disinfection_Nov_2008.pdf. Accessed May 19, 2014.
