Disinfection in healthcare facilities
Disinfection in healthcare facilities, especially hospitals, plays an essential role in maintaining a safe and healthy environment for patients, medical staff, and visitors. The disinfection process in hospitals involves the use of various methods, such as surface cleaning with disinfectant solutions, steam sterilization, and the use of ultraviolet (UV) light. These methods are essential in preventing the spread of bacteria, viruses, and other pathogens that can cause infections.
Regular and thorough disinfection also promotes a positive perception of healthcare facilities and inspires confidence in patients and visitors. Hospitals have a duty to provide clean and safe environments for patient recovery and to ensure that healthcare workers can perform their tasks without unnecessary risks. Poor cleaning and disinfection practices can undermine these objectives, leading to negative experiences for patients and damage to reputation.
Although antiseptics and disinfectants have different roles in infection prevention and are intended for use in different contexts, the terms are sometimes used erroneously. It is important to properly understand the differences between these two categories of substances in order to use them appropriately according to their specific purpose:
- Antiseptic is a substance that inhibits the growth of or destroys microorganisms on living tissues.
- Disinfectant is a compound that exerts the same action (growth inhibition or destruction of microorganisms) on surfaces or objects. A disinfectant is also an antiseptic if it is non-irritating to the tissue to which it is to be applied, is not inactivated by organic matter, and does not cause toxicity upon absorption.
Disinfection is considered to be the act of reducing the presence of microorganisms dangerous to public health to levels considered safe, based on established parameters, without adversely affecting the quality and safety of products or objects. To achieve the necessary level of sanitization or disinfection, the chemical product used must be applied at a specific concentration and for a specific period of time.
1. Active substances in disinfection products
The sanitization process depends on the prior preparation of the surfaces to be treated. Most products used for this process must be applied to surfaces that are free of organic matter and detergent residues. Often the order of the process is as follows: rinse, clean, rinse, sanitize/disinfect, and, if necessary, rinse.
Some of the most commonly used substances in sanitization/disinfection processes are:
Ethyl alcohol
Ethyl alcohol has bactericidal activity, but its effectiveness is variable against fungi and viruses and it is not active against spores. It is traditionally used to clean open wounds, but it should not be used for this purpose because it is highly irritating, and in contact with organic matter, it can coagulate proteins, thus facilitating the survival of some bacteria. Ethyl alcohol used for disinfection must have an appropriate concentration to be effective against microorganisms. Usually, the optimal concentration is approximately 70-80% ethyl alcohol.
It should not be used for disinfecting surgical equipment due to its lack of sporicidal activity.
Chlorhexidine
Chlorhexidine has a rapid action and has strong bactericidal activity against gram-positive and gram-negative germs, although pseudomonads are relatively resistant. Regarding spores, it prevents their germination, but eliminates them only if the temperature is high. Alcohol enhances its power of action.
It remains active in the presence of soap, blood, and organic matter, although it may lose some efficacy. Therefore, it can be used on both open wounds and intact skin.
It is an antiseptic used as an alternative to povidone-iodine in cases where iodine derivatives cannot be applied. It is also widely used in children and pregnant women, as in these groups, the application of iodine is avoided.
Hypochlorites
Efficacy, low cost, and ease of manufacture make hypochlorites the most widely used disinfection agents. Sodium hypochlorite is the most common compound and is an ideal disinfectant because it is a strong oxidant.
Hypochlorites cause high microbial mortality by damaging the outer cell membrane, leading to a loss of permeability control. In addition, these compounds inhibit cellular enzymes and destroy DNA. Spores are resistant to the action of hypochlorites because their surface layer is not sensitive to oxidation, except in the case of using high concentrations and prolonged contact periods at high temperatures.
Tincture of iodine
Iodine is extremely effective and has a broad spectrum of action. It has a rapid action and, once applied, maintains its efficacy for several hours, which places it among the best antiseptics available. The concentration of tincture available on the market contains 2% iodine and 2.5% potassium iodide in 50% alcohol. This tincture is used on healthy skin or in the case of fungal and bacterial skin infections. The same concentration in an aqueous solution can be used for disinfecting wounds.
2. Resistance to sanitization/disinfection products
Resistance to sanitization and disinfection products has become an increasing concern in recent years. This resistance is a significant problem in healthcare settings, where sanitization and disinfection practices are essential for preventing the spread of infections. It can also lead to the transmission of antibiotic-resistant bacteria, which further aggravates the problem.
This resistance can be a natural phenomenon or can be developed over time as a result of repeated exposure to sanitization/disinfection agents. Natural or intrinsic microbial resistance is the resistance that microorganisms manifest from the beginning and is caused by their own characteristics. In most cases, this resistance occurs because the nature of the microorganisms makes them immune to certain components of disinfectants.
There is also acquired microbial resistance. In this case, microorganisms develop immunity to biocides during their lifespan (they are not born with it). This would be the case of biofilms. The main cause of resistance to disinfectants is the excessive and abusive use of disinfectants. In some cases, hospitals may rely on the same disinfectants for long periods of time, allowing bacteria to adapt and develop resistance.
Every time a chemical product is used to eradicate microorganisms, there is a possibility of fostering the development of resistance, because not all microbes are exterminated. Even if the process reduces the population by 99.999%, this means that out of 1,000,000 microbes present, 10 remain alive even if their number has been reduced to what can be considered a safe level. It is possible that the disinfectant did not act effectively on these 10 organisms, or perhaps they have a natural immunity against the chemical substances used. If these 10 microbes are indeed immune, they can multiply on that surface.
To combat resistance to disinfectants, it is important for healthcare facilities to regularly evaluate the efficiency of the products used and to rotate the use of disinfectants, follow appropriate application methods, and consider alternative disinfection strategies. Also, emphasis should be placed on correct hand hygiene and infection control practices to reduce reliance on sanitization and disinfection products and to prevent the development of further resistance.
3. Trends and new methods of disinfection
Lately, increased attention has been paid to disinfectants and disinfection procedures due to the global pandemic. New trends have emerged in this field, aiming at the effective elimination of harmful microorganisms from various surfaces and objects.
As research on disinfection techniques advances, more innovative trends are expected to continue to emerge to enhance the efficiency and comfort of disinfection procedures.
Antibacterial panels
Self-disinfecting antibacterial panels are used to prevent or reduce the growth and spread of bacteria and other microorganisms on surfaces. These walls are impregnated with antimicrobial agents that constantly release a low level of disinfectant, effectively killing any bacteria that come into contact with the surface. This continuous disinfection process helps reduce the risk of cross-contamination and the transmission of infections. The use of antibacterial panels can be beneficial in a wide range of environments, including hospitals, laboratories, and food processing areas, where maintaining a sterile environment is crucial.
In addition to their antimicrobial properties, these panels also offer durability and easy cleaning, making them an ideal choice for areas requiring frequent decontamination. The availability of self-disinfecting walls not only ensures a higher level of hygiene but also reduces the need for routine manual cleaning and disinfection, saving both time and costs.
Antimicrobial nanocoating
Antimicrobial nanocoatings are revolutionizing the field of disinfection. Through nanotechnology, a thin layer of material is applied to surfaces, effectively preventing the growth and spread of harmful microorganisms. The nanocoating offers a powerful solution against bacteria, viruses, and fungi because it uses nanoparticles that have antimicrobial properties. These particles act by disrupting cell membranes and inhibiting the metabolic pathways of microorganisms, which ultimately leads to their destruction.
Unlike traditional disinfectants that can be easily wiped off or diluted over time, nanostructures ensure long-lasting protection by forming a strong bond with the surface. They are resistant to wear, UV rays, and harsh cleaning chemicals, ensuring prolonged disinfection and reducing the need for frequent reapplication.
Cold plasma technology
Cold plasma technology for disinfection is an innovative approach that has gained momentum in various industries, including healthcare. Cold plasma is created by applying an electric field to a gas, which ionizes gas molecules and generates chemically active species. This unique property makes cold plasma an effective tool for killing pathogens and microorganisms without affecting human tissues or surfaces.
In the healthcare field, cold plasma technology is used for disinfecting medical instruments, surfaces, and even the air. In addition, cold plasma can reach even hard-to-access areas, ensuring complete decontamination. Unlike traditional disinfection methods involving chemicals and heat, cold plasma technology is environmentally friendly and leaves no residue.
Eco-friendly disinfectants
The eco-friendly disinfectant industry has seen significant growth in recent years, with increasing environmental concerns and growing demand for safer, more environmentally friendly products.
The main trend in the industry is the use of natural ingredients, such as essential oils, citric acid, hydrogen peroxide, and other bio-compounds. These ingredients are considered safer for the environment and human health than synthetic chemicals.
Companies are developing innovative methods of applying eco-friendly disinfectants, such as non-aerosol sprayers, low-water consumption nebulization systems, or concentrated solutions that can be diluted at the point of use.
Conclusions
In recent years, several new trends have emerged regarding disinfectants and disinfection procedures. A prominent trend in the disinfectant industry is the introduction of new types of disinfectants. Traditional disinfectants often contained harsh chemicals that posed health risks and potential environmental hazards. Consumers have shifted towards using eco-friendly and safe alternatives. For example, hydrogen peroxide-based disinfectants have gained popularity due to their effectiveness in killing germs while being environmentally friendly and safe for use.
Another significant trend in the disinfectant industry is the development of new disinfection technologies. With advances in science and engineering, innovative tools and devices have been created to support efficient and complete disinfection. For example, electrostatic sprayers have gained popularity due to their ability to apply disinfectants in an electrostatically charged mist, ensuring complete coverage of surfaces and hard-to-reach areas.
Ultraviolet (UV) light devices have also emerged as a popular disinfection method because they can quickly and effectively kill germs by damaging their DNA. These new technologies offer improved disinfection capabilities, allowing users to achieve higher levels of cleanliness and hygiene.
