2/10/2025

Principles of infection
Host-parasite interaction
prevention
Host-parasite interaction
Disinfection and Sterilization

Host-parasite interaction Host-parasite interaction

• On the basis of their life habits, microorganisms are classified as
• Learning Objectives
– Saprophytes

• At the end of this chapter the students will • Mode of life of free-living organisms

• Obtain their nourishment from soil and water

be able to • Saprophytes in general do not require a living host

– Describe types of host-parasite interaction – Parasites

• Organisms living on or in other higher organisms

– Explain normal microbial flora
– The relationship between microorganisms and the host is called
– Explain determinants of host-parasite interaction symbiosis

• A relationship between two organisms in which at least one organism is

– Describe principles of infection prevention
dependent on the other

Host-parasite interaction Host-parasite interaction

• The association may take one of the three forms • Normal microbial flora
1. Commensalism – Microorganism that inhabit the skin and mucous
• One of the organisms benefits, and the other is unaffected membranes of healthy persons
• Many of the microorganisms that make up our normal micro biota arc
1. The resident flora
commensals
– Consists of relatively fixed types of microbes regularly found in a given
2. Mutualism area at a given age
• Is a type of symbiosis that benefits both organisms. 2. The transient flora
• For example, the large intestine contains bacteria, such as E. coli, that – Consists of non pathogenic or potentially pathogenic microbes that
synthesize vitamin K and some B vitamins inhabit the body for hours, days, or weeks;

3. Parasitism » It is derived from the environment,

• One (the host) is harmed and the other(the parasite ) is benefited » Does not produce disease but if the resident flora is disturbed,
they may produce disease.
• Many disease-causing bacteria

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Host-parasite interaction

Host-parasite interaction

• Benefits of the normal flora

– Synthesis and excretion of vitamins used by the host
– Aid in digestion of food
– Protect the host from pathogenic microbes via:
• Competition for receptors or binding sites on host cells,
competition for nutrients,
• Inhibition by metabolic or toxic products,
• Inhibition by antibiotic materials

– Help the development of mucosa immunity

Host-parasite interaction Host-parasite interaction

• Pathogenicity vs. Virulence
• Harmful effects of the normal flora
– Colonization
– Competition with host for nutrients • Establishment of a site of reproduction of microbes on a person without
necessarily resulting in tissue invasion or damage.
– Transformation of food to carcinogens – Infection
• Growth and multiplication of a microbe in or on the body with or without the
– Bacterial synergism between normal flora and production of disease.
– Pathogenicity
potential pathogens • The capacity of a bacterium to cause disease

– Carrier state – Virulence

• The measure of the pathogenicity of a microorganism.
– Causes diseases – Measuring virulence =ID50 & LD50
– Pathogenesis
• Transition to an abnormal region • Refers both to
– The mechanism of infection and
• Opportunistic infection (immunocompromised) – The mechanism by which disease develops

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Host-parasite interaction Host-parasite interaction

• Host-pathogen interaction and disease – The interaction between the host and the invading
pathogen.
outcome
• It is bidirectional
– Disease state depends on: • The host defense mechanism on one side and the pathogens
• Portal of entry virulence and escaping mechanism on the other side.

• Host condition/ degree of resistance – Both the host and pathogen factors determine the fate
• Pathogenicity of the exposed individual.
– Virulence factors

• Number of organisms present

Host-parasite interaction Host-parasite interaction

• Virulence factors the various traits or features that • Adhesion factors

– Enhance attachment of microorganisms on the surface of mammalian
allow or enhance the microorganisms ability to
cells to establish infection.
cause disease.
– Can be protein or polysaccharides
– Adhesins: host attachment & colonization – Some of adhesive factors are capsule, flagella, pili (fimbriae)
– Ability to invade host tissues, • Invasiveness
– Toxin production, – Ability of microorganism to invade tissue and reproduce with in the body

– Immune avoidance factors – Enzymes of microorganisms enhance invasiveness by destroying

different body tissue and cells.
– Intracellular survival and growth
– Resistance to antibiotics

Host-parasite interaction Host-parasite interaction

• Invasiveness
– Some of the enzymes that enhance invasiveness are:
• Hyaluronidase -breaks down hyaluronic acid (spreading factor)

• Collagenase -split collagen

• Coagulase -converts fibrinogen to fibrin

• Fibrinolysin -catalyze the break up of fibrin clot

• Hemolysin- lyses red blood cells

• Leukocidin -lyses leukocytes

• Lecithinase -break down phospholipids collectively called lecithin.

• Protease, nuclease and lipase- break protein, nucleic acid and lipids
respectively

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Host-parasite interaction Host-parasite interaction

• Growth and survival enhancing factors

– Enable microorganisms to escape from host defense mechanism and
cause disease

– Capsules-protects some bacteria from phagocytosis

– Siderophores-enable the organisms to grow the iron deficiency

• Toxigenicity
– The ability of microorganisms to produce biological poisons called toxins

– Toxin can be protein (exotoxin) or polysaccharide (endotoxin) in nature

Host-parasite interaction

• A. Endotoxin (Lipopolysaccharide=LPS)
– LPS is part of the Gram-negative outer membrane

– Lipid A: generally not released (and toxic) until death of cell.

– LPS is heat stable and not strongly immunogenic so it can not be

converted to a toxoid

– Mechanism
• LPS activates macrophages, leading to release of TNF-alpha, 1L-l, and 1L-6

• IL-l is a major mediator of fever

• Macrophage activation and products lead to tissue damage

• Damage to the endothelium from bradykinin-induced vasodilation leads to shock

• Coagulation is mediated through the activation of Hageman factor.

Host-parasite interaction Host-parasite interaction

• B. Exotoxin • Some of the exotoxins are:

– Are protein toxins, generally quite toxic and secreted by bacterial cells – Neurotoxin
(some Gram +, some Gram -) • Interferes with the function of the nervous system
– Can be modified by chemicals or heat to produce a toxoid that still is • Botulinum toxin, Tetanospasmin
immunogenic, but no longer toxic so can be used as a vaccine – Enterotoxin
– Are specific to the microorganism and cause specific disease because • Affect the entrocytes
of their mode of action. • Produced by various enteropathogenic bacteria, such as shiga toxin,

– A-B (or "two") component protein toxins Vibrio cholera toxin (choleragen)

• B component binds to specific cell receptors to facilitate the internalization of A. – Cytotoxins

• A component is the active (toxic) component (often an enzyme such as an ADP • They may interfere in transcription or translation
ribosyl transferase).
• eg. Diphtheria toxin

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Host-parasite interaction Host-parasite interaction

• Components of the infectious process

– Steps of infection includes;
• Colonization →invasion →multiplication →diseases
• Depends up on the type of microorganisms the source of infection may
be Humans, animals, inanimate objects and plants.
• The infectious process consists of:
– Agents
– Reservoir host
– Susceptible host
– Ways of transmission
– Portal of entry
– Portal of exit

Chain of Infection

Host-parasite interaction Host-parasite interaction

– The agent • Carrier can be classified as:

• Etiology of a certain disease ranges from the smallest – Incubatory carrier-transmit the disease during the
virus particle to complex multicellular organism
incubation period
– Reservoir
– Convalescent carrier-transmit the disease during the
• It is an organism or habitats, in which the infectious
convalescent period
organism normally lives, transform, develop and
multiply. – Asymptomatic carrier-transmit the disease without
• A person who does not have apparent clinical disease, ever showing its symptoms
but can be a potential source of infection to other – Chronic carrier-transmit the disease for a long period
people are called carrier

Host-parasite interaction Host-parasite interaction

• Portal of exit • Method of spread or mode of transmission

– All micro-organisms need a mode of transmission.
– The way that the agent leaves the reservoir Hands play a big part in spreading infection
– All body secretion, discharge, mucus, saliva, Brest – The modes of transmission include:
• Aerosol
milk, vagina and tissue, cervical discharge, excretions
• Droplet
(faces, urine) and blood. • Faecal – oral
• Direct contact (person to person)
– All micro-organisms need an exit point, for instance:
• Transplacental-from mother to fetus
• Salmonella bacteria are excreted through faeces • Indirect contact (food, water, fomites, environment)
• Tuberculosis bacterium uses the same entry and exit points • Blood and body fluid
(lungs, mouth and nose) • Vector borne

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Host-parasite interaction Host-parasite interaction

• Susceptible host
• Portal of entry
– For infection to occur once micro-organisms have reached their ‘target’, the person
– Site where agents can enter in to the body such as must be at risk of infection.

nasal mucosa, respiratory, anal, vaginal – Factors that affect a person’s susceptibility to infection include:
• Age (the very young and very old are more susceptible)

– All micro-organisms need a point of entry, for instance: • Immune status

• Physical well-being
• The mouth for the salmonella bacteria
• Psychological well-being
• The Nose and mouth for the micro-organisms causing • Hygiene

tuberculosis, which then make their way to the lungs • Underlying or chronic diseases or medical conditions

• Other existing infections

• The bloodstream until the liver for the hepatitis B virus • Medical interventions/Medical therapies

• A catheter if poorly cared for can lead to urinary tract infections. • Cultural behaviors

• Sexual behaviors

Host-parasite interaction Host-parasite interaction

• Prevention and control of infectious disease • Isolation

– There are different ways of controlling or limiting the – Requires that a patient infected with a communicable
spread of communicable diseases. disease be prevented from making contact with the
general public.
– These methods include
• Isolation, quarantine, and vector control. • Quarantine
• Public sanitation measure – Enforced isolation of people or animals that may have
• Vaccination / immunization, been exposed to a contagious or infectious disease,
• Sterilization and disinfection e.g. when entering a country
• Chemotherapeutic agent

Host-parasite interaction

• Vector control
– Is a good way of controlling the spread of infectious disease
when the vector, such as rodents or insects, is identified.
Principle of disinfection and
– This vector’s habitats and breeding grounds can be treated with Sterilization
insecticides and poisons.

– Also, barriers such as window screens, netting, and repellents

can provide protection against bites and infection.

• Immunization
– Is an effective means of controlling the spread of communicable
diseases by the use of safe vaccines

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Principle of disinfection and Sterilization Principle of disinfection and Sterilization

• Learning Objectives • Controlling microorganisms

– Methods of controlling microorganisms outside the
• At the end of this chapter the students body result in
• Sterilization is the destruction of all microbial life
will be able to
• Disinfection destroys most microbial life, reducing
– Explain sterilization, disinfection, antisepsis contamination on inanimate surfaces
– Describe the mechanism of action • Antisepsis (also called degermation) is the same as
– Describe the preparation of disinfectants and disinfection except a living surface is involved.

antiseptics, application • Decontamination (also called sanitization) is the mechanical

removal of most microbes from an animate or inanimate
surface.

Principle of disinfection and Sterilization Principle of disinfection and Sterilization

• Relative Resistance of
Microbial Forms
– The type of microorganisms,
quantity, and application of the
item being disinfected determine
the strength of disinfectant
needed

– Levels of disinfection

• Low-Level disinfection

• Intermediate-Level
disinfection

• High-Level disinfection

Principle of disinfection and Sterilization Principle of disinfection and Sterilization

• The Effects of Agents on the Cell Wall

• How Antimicrobial Agents Work: Their Modes
– Several types of chemical agents damage the cell wall

of Action by blocking its synthesis, digesting it, or breaking down

its surface

– Cellular targets of physical and chemical agents • How Agents Affect the Cell Membrane

fall into four general categories: – Surfactants bind to the lipid layer and penetrate the
internal hydrophobic region of membranes
1. The cell wall
• Agents That Affect Protein and Nucleic Acid
2. The cell or cytoplasmic membrane Synthesis
– Inhibited from forming proteins, preventing both
3. Cellular synthetic processes (DNA, RNA)
transcription and translation
4. Proteins • Agents That Alter Protein Function
– Disrupt, or denature, proteins

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Principle of disinfection and Sterilization Principle of disinfection and Sterilization

• Methods of Physical Control • Mode of Action and Relative Effectiveness of

Heat
– Heat
– Moist heat and dry heat differ in their modes of
• Temperatures as microbicidal and microbiostatic action and efficiency
• Can be applied in either moist or dry forms • Moist heat
– Operates at lower temperatures and shorter exposure
• Moist heat occurs in the form of hot water, boiling times

water, or steam (vaporized water) [60°C to 135°C] – Main effect is coagulation and denaturation of proteins

• Dry heat
• Dry heat denotes air with a low moisture content that
– Dehydrates the cell, and it denatures proteins
has been heated by a flame or an electric heating coil – Very high temperatures, dry heat oxidizes cells, burning
them to ashes
[>160°C ]

Principle of disinfection and Sterilization Principle of disinfection and Sterilization

• Heat Resistance and Thermal Death: Spores and Vegetative Cells Common Methods of Dry heat Control
– It is less efficient and requires high temperature and long period
– Endospore with high resistance heating than moist heat

– Vegetative bacteria for moist health ranges from from 50°C for 3 A. Incineration
• It is an efficient method of sterilization (800°C to 6,500°C.)
minutes (N. gonorrhoeae) to 60°C for 60 minutes (S. aureus)
• Needles, syringes and cover slips

– Viruses are resistant to heat, with a tolerance range extending from B. Flaming
• Inoculating wires loops and points of forceps (flame of a Bunsen burner
55°C for 2 to 5 minutes (adenoviruses) to 60°C for 600 minutes
until turn red hot)

(hepatitis A virus) • The flame of a Bunsen burner reaches 1,870°C at its hottest point

• Scalpels , neck of flasks, bottles and tubes (uncertain efficacy)

– All non-heat-resistant forms of bacteria, yeasts, molds, protozoa,
C. Hot air sterilizer (hot air oven/ dry oven)
worms, and viruses are destroyed by exposure to 80°C for 20 minutes • It is essential that hot air should circulate between the objects being
sterilized (loosely packed and adequate air space)

• At 140-160 0C for 45 to 60 min or 180 0C for 30 minutes

• Usually used to sterilize glass wares and metallic objects.

Principle of disinfection and Sterilization Principle of disinfection and Sterilization

• Common Methods of Moist Heat Control Temperature below 100 0c

1. Boiling water – Pasteurization
• At 62 0C for 30 minutes (or 720C for 15 seconds)
2. Pasteurization followed by rapid cooling to discourage bacterial growth
• This is sufficient to kill the vegetative cells of the milk-borne
pathogens, e.g., Mycobacterium bovis, Salmonella, Streptococcus,
3. Non-pressurized steam
Listeria, and Brucella, but not to sterilize the milk

• Pasteurization of milk (disinfecting milk)

4. Steam under pressure • Preparation of bacterial vaccines

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Principle of disinfection and Sterilization Principle of disinfection and Sterilization

Temperatures around 100 oC Temperature above 100oC

A. Boiling- (Hot water boilers) Moist Heat sterilization (Autoclaving)
• At 100oC (not kill all the spores), but for 20 minute exposure all – It is based on the principle that when microorganism is boiled at
vegetative forms of bacteria and viruses can be destroyed (cleaning
increased pressure (in closed container), hot saturated steam will
enhance it)
be formed which penetrates and gives up its latent heat when it
B. Tyndallization condenses on objects
• Intermittent steaming
– Moist heat sterilizes at a lower temperature than dry heat,
• Steaming of the material is done at 100 ○C for 30 minutes for three
because
consecutive days
• It destroys bacterial endospores and vegetative cells
• The principle is that spores which survived the heating process would
– Sterilize solid and fluid culture media, gowns, medical and surgical
germinate before the next thermal exposure and then would be killed
equipment

Principle of disinfection and Sterilization

Principle of disinfection and Sterilization
Table: Time-Temperature-Pressure Level Relationship in
Methods of Controlling Sterilization
moist heat sterilization (Autoclaving)
Complete sterilization can be checked by

Temperature Time Pressure level 1. Heat-sensitive autoclave tape

• Fixed to the outside of each pack

• Color change of autoclave tape from blue to brown-black indicates

1210c 15 minutes 15 lb/inch2 complete sterilization

1260c 10 minutes 20 lb/inch2 2. Biological indicator

• Use of paper strips impregnated with spores of Bacillus

1340c 3 minutes 30 lb/inch2 thermophilus

• Put the paper strip in the culture medium

• After autoclaving observe for germinating bacteria to check for growth

N.B: Most autoclave work by 1210C
,15 minutes and 15 lb/inch2 • In a complete sterilization there should not be bacterial growth
(temperature, time and pressure respectively)

Principle of disinfection and Sterilization Principle of disinfection and Sterilization

Other methods using low temperature Filtration

– Useful for removing bacteria and fungi from air or
A. Freezing (At 0 oC or less temp)
from solutions with heat-sensitive components
• Is inactivation of living bacteria by cold
– Liquids and gases can be sterilized by passing them
• It prevents active multiplication of bacteria by decreasing the
through filters
metabolic activity of bacteria
– Filters (e.g. 0.45 µm) that have pores smaller than
• Is more of preservative than disinfectant
the size of the microbes: retain micro-organisms
B. Lyophilization (Freeze-drying)
– The filter acts as a strainer, a microbial sieve
• Is a process which involves rapid freezing with subsequent
– Uses for preparing heat-labile culture media
drying
components, pharmaceuticals and biological
• Use for preservation of microbial cultures and vaccines
solutions, and microbial evaluation of water purity
Figure: Micropore filter apparatus

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Principle of disinfection and Sterilization Principle of disinfection and Sterilization

Radiation Ultraviolet Radiation

– Radiation that kills microorganisms (sterilizing radiation) is of – It damages the DNA of exposed cells
two types: ionizing and non ionizing
– As a result, DNA replication is inhibited and the organism cannot
– Ionizing radiation
grow
• Gamma rays, X rays, or high-energy electron beams
• Has a wavelength shorter than that of nonionizing radiation, less than – The greatest antimicrobial activity of UV light occurs at 250–260
about 1 nm
nm, which is the wavelength region of maximum absorption by
• Therefore, it carries much more energy
the purine and pyrimidine bases of DNA
– Nonionizing radiation
• Has a wavelength longer than that of ionizing radiation, usually greater
– It is used in hospitals to kill airborne organisms, especially in
than about 1 nm operating rooms when they are not in use
• The best example of nonionizing radiation is ultraviolet (UV) light

Principle of disinfection and Sterilization Principle of disinfection and Sterilization

X-rays • Chemical agents

– X-rays have higher energy and penetrating power than UV – Act primarily by one of the three mechanisms
radiation
• Disruption of the lipid-containing cell membrane
• Kill mainly by the production of free radicals

• Another mechanism is a direct hit on a covalent bond in DNA • Modification of proteins

– X-rays kill vegetative cells readily, but spores are remarkably • Modification of DNA
resistant • Some of the chemicals agents act by more than one
– Used for sterilization of heat-sensitive items, such as sutures mechanism
and surgical gloves, and plastic items, such as syringes

Principle of disinfection and Sterilization Principle of disinfection and Sterilization

• Alcohol
• Chlorine and Chlorine Compounds
– Ethyl alcohol and isopropyl alcohol
– Hypochlorites, as liquid (e.g., sodium hypochlorite) or solid (e.g., calcium
– With germicidal characteristics (Tuberculocidal, fungicidal, and virucidal hypochlorite)

but do not destroy bacterial spores) – A 1:10–1:100 dilution of 5.25%–6.15% sodium hypochlorite (i.e., household

– Optimum bactericidal concentration is 60%–90% solutions in water bleach)

(cidal activity drops sharply when diluted below 50% concentration) – Mode of Action
• Decreased uptake of nutrients
– Mode of Action: denaturation of proteins • Inhibition of protein synthesis
• Breaks in DNA
– Oral and rectal thermometers, hospital pagers, scissors , and • Depressed DNA synthesis

stethoscopes – For decontaminating blood spills on noncritical surfaces, and water treatment

(Chlorine )

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Principle of disinfection and Sterilization Principle of disinfection and Sterilization

• Formaldehyde • Glutaraldehyde

– Disinfectant and sterilant (liquid and gaseous) – Wide acceptance as a high-level disinfectant and chemical sterilant

– 37% formaldehyde by weight is formalin – Aqueous solutions, acidic (not sporicidal) and alkaline) (become

– Bactericide, tuberculocide, fungicide, virucide and sporicide (the aqueous

sporicidal)

solution) – Mode of Action

• Alkylation of sulfhydryl, hydroxyl, carboxyl, and amino groups -----> alters RNA,
– Potential carcinogen, asthma-like respiratory problems and skin irritation (risk)
DNA, and protein synthesis
– Mode of Action
– Endoscopes, spirometry tubing, and dialyzers (high-level disinfectant)
• Inactivates microorganisms by alkylating the amino and sulfhydral groups of proteins

and ring nitrogen atoms of purine bases

– Not be used for cleaning noncritical surfaces because it is too toxic and
expensive
– Chemical sterilant (Formaldehyde-alcohol) and high-level disinfectant

(formaldehyde)

Principle of disinfection and Sterilization Principle of disinfection and Sterilization

• Hydrogen Peroxide
• Iodophors
– Effectively kills
– Iodine solutions or tinctures
• Most bacteria at a concentration of 3% to 6%
• Used primarily as antiseptics on skin or tissue
• All organisms, including spores, at higher concentrations (10% to
25%) – Iodophors
– Mode of Action • Used both as antiseptics and disinfectants
• By producing destructive hydroxyl free radicals that can attack • Are complexes of iodine with detergents that are frequently used to
membrane lipids, DNA, and other essential cell components prepare the skin prior to surgery
– Used – Iodine Tincture: 2% iodine and 70% ethanol
• To disinfect plastic implants, contact lenses, and surgical prostheses
– Mode of Action
• As an antiseptic
• Iodine can penetrate the cell wall of microorganisms quickly
• Disruption of protein and nucleic acid structure and synthesis

Principle of disinfection and Sterilization Principle of disinfection and Sterilization

• Phenolics • Quaternary Ammonium Compounds

– Phenol is highly effective in Gram positive bacteria – e.g benzalkonium chloride and cetylpyridinium chloride

– Has poor activity against non-lipid containing viruses – Mode of Action

• Inactivation of energy-producing enzymes, denaturation of
– Mode of Action:
essential cell proteins, and disruption of the cell membrane
• Act by disrupting lipid-containing membranes, resulting in leakage of

cellular contents – Used in ordinary environmental sanitation of noncritical

• Penetrating and disrupting the cell wall and precipitating the cell proteins surfaces, such as floors, furniture, and walls
• Are rarely used as disinfectants

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Principle of disinfection and Sterilization Principle of disinfection and Sterilization

Dyes
Heavy metals
– A variety of dyes not only stain microorganisms but also inhibit
– Mercury and silver, are the most widely used in medicine
their growth
– When the metal ions combine with the sulfhydryl groups
– Their mechanism of action is through modification of nucleic
on cellular proteins, denaturation results acids
– A combination of silver and the drug sulfadiazine, – Example: Malachite green, Brilliant green, Crystal violet/gentian
silversulfadiazille, is the most common formulation violet
• It is available as a topical cream for use on burns – Uses:
– Silver can also be incorporated into indwelling catheters, • Highly selective for Gram-positive bacteria.

• For treatment of dermatological lesions.

and in wound dressings
• For formulation of selective culture media.

Principle of disinfection and Sterilization Principle of disinfection and Sterilization

• Factors Affecting the Efficacy of Disinfection and

Ethylene oxide
Sterilization
– Is the most commonly used gas vapor sterilant.
– Number and Location of Microorganisms
– Used to sterilize medical-surgical devices that would be – Innate Resistance of Microorganisms
damaged by heat.
– Concentration and Potency of Disinfectants
– It is toxic and explosive in its pure form, so it is usually – Physical and Chemical Factors (temperature, pH, relative
mixed with a nonflammable gas, such as carbon humidity, and water hardness)
dioxide. – Organic and Inorganic Matter
– Among its advantages is that it carries out sterilization at – Duration of Exposure
ambient temperatures and it is highly penetrating – Biofilms (tightly attached to surfaces)

Principle of disinfection and Sterilization Principle of disinfection and Sterilization

• A rational approach to disinfection and • Critical items

– Confer a high risk for infection if they are contaminated with any
sterilization microorganism
– Objects that enter sterile tissue or the vascular system
• Instruments and items for patient care were
• Surgical instruments, cardiac and urinary catheters, implants, and
categorized according to the degree of risk for ultrasound probes

infection involved in use of the items – Most of the items in this category (sterilization)
• Should be purchased as sterile or
 Critical items
• Be sterilized with steam if possible
 Semi-critical items • Or Heat-sensitive objects can be treated with ethylene oxide, hydrogen
peroxide gas plasma; or by liquid chemical sterilants
 Non-critical items

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Principle of disinfection and Sterilization Principle of disinfection and Sterilization

• Semi-critical items • Non-critical items

– Are those that come in contact with intact skin but not
– Contact mucous membranes or nonintact
mucous membranes
skin (e.g. lungs and the gastrointestinal tract)
– Noncritical patient care items
• Respiratory therapy and anesthesia equipment, • Bedpans, blood pressure cuffs, crutches and computers
esophageal manometry probes, cystoscopes – Noncritical environmental surfaces

– Minimally require high-level disinfection • Bed rails, some food utensils, bedside tables, patient
furniture and floors
using chemical disinfectants
– Low-level disinfection

Summary questions
1. What is the difference between sterilization, disinfection,
antisepsis, decontamination, and cleaning?
2. What are the 3 levels of disinfection?
3. What are the chemical means for Disinfection and
Sterilization?
4. What are the physical means for Disinfection and
Sterilization?
5. What are the Factors Affecting the Efficacy of Disinfection
and Sterilization?
6. What is the rational approach for disinfection and
sterilization of patient care items?

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