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Disinfectants for surfaces and floors
Often, the transmission of infections that is directly related to the provision of medical care is carried out with close contact of the infected surface with the human palm. In practice, this is possible if the health worker's hand touches the area contaminated with microorganisms. This species is a direct causative agent of infections and reproduces superbly on various objects, whether it is a piece of furniture or an attribute of medical equipment.
The closer to the patient is the surface infected with bacteria, the more likely the infection. In this regard, carrying out disinfecting works in rooms and on objects of a hospital interior, in fact - important and obligatory procedure.
According to the information prescribed in SanPiN / 2.1.3.2630-10 “Sanitary and epidemiological requirements for enterprises engaged in medical practice” / preventive disinfection can be of several types:
well-established disinfection
disinfection according to indications (epidemiological and / or sanitary and hygienic)
Preventive measures (routinely) are carried out permanently in health care facilities, but only if no nosocomial infection was detected, that is, a breeding ground for bacteria, like the provoker itself, was not detected, with the aim of
reducing the number of microbial organisms (in nosocomial conditions)
prevent the emergence of a breeding ground for bacteria
prevent the transmission of bacterial organisms through medical devices, skin of medical staff and patients
At the time of the implementation of planned disinfection in health care facilities, they disinfect all the existing surfaces inside the hospital, which allows for maximum death of various types of microbacteria, and also significantly reduces contamination of various objects with microbacteria. This means that harmful bacterial organisms are released into oxygen, household items, cutlery, tools and other hospital attributes.
The implementation of preventive measures for disinfection according to epidemiological indications is carried out taking into account the characteristics of a particular type of infection identified in the nosocomial room. A number of factors are also taken into account:
incubation period
microorganism resistance
the duration of the survival of the pathogen on objects
Quite a different situation if disinfection takes place (for the purpose of prophylaxis) according to sanitary and hygienic indications. The range of such actions is carried out as a one-time event and it is in those premises / enterprises whose condition leaves much to be desired and unsatisfactory appraisal judgments have been received from specialized specialists.
The use of detergent disinfectants for current and general cleaning
Scheduled regular room disinfection procedure is divided into daily and general.
General cleaning is done with the intention to get rid of sewage and reduce the number of infectious bacteria in the building. During the main cleaning, all surfaces are completely washed out, cleaned and disinfected (taking into account places that are difficult to penetrate), furniture, doorways, installations and devices (including lamps and chandeliers) with the use of soap and processing agents, and airspace disinfection.
General cleaning of functional rooms, medical rooms and hospital wards is done on a schedule at least every four weeks; operating rooms, dressing rooms and procedures and manipulations, delivery rooms, places allocated for sterilization - once every seven days.
During the main cleaning, the order of use of disinfecting solutions is calculated with deduction of the stationary profile and bacterial contamination.
In accordance with SanPiN 2.1.3.2630-10 “Sanitary and epidemiological requirements for organizations engaged in medical activity”, the stages of the main clean-ups consist of:
Preparing the rooms and preparing the staff for cleaning (they should have special clothes and protective personal belongings - a bathrobe, cloth covering the head and covering the face, rubberized gloves and an apron, etc., signed cleaning equipment and sterile textile rags);
Washing and disinfecting all surfaces with a floor disinfectant / sprinkling / cleaning (walls - at least two meters; fully operational;);
Washing the disinfectant for cleaning with a sterile textile cloth, using ordinary water at the end of the disinfection prevention, only after changing the workwear.
* Extract from the plan of the updated SanPiN 10.15.
During the implementation of the main cleaning of the premises, the disinfecting solution is coated on the walls by sprinkling or rubbing at a height of at least two meters (fully operational), frames, doorways, all surfaces and devices. At the end of the disinfection procedure (the staff is obliged to change the form), each surface is wiped with sterile textile rags, using ordinary water (not counting the solutions, the instructions for which indicate that they do not require washing), after which the air in the rooms is filtered.
Chemicals for disinfecting activities. The sequence of applications on various surfaces of medical devices (surgical, obstetric and dental category)
The sequence of applications of a chemical preparation for various surfaces is determined by the unity of this kind of interrelated aspects:
Profile direction of a room
The category of the probability of infection and the microbial variety of microbial contamination
Specific features of the medical activity
In accordance with SanPiN 2.1.3.2630-10, disinfection of surgical and obstetric profile objects is carried out as follows:
According to the information from the clinical guidelines (at the federal level) on the choice of disinfecting chemicals for surface sterilization, which are used in medical institutions ”(FKR), (M., 2015, 67 p., Approved at the All-Russian Scientific and Practical Conference of Infections Control Specialists, related to the provision of medical care on November 19-21, 2014, at the General Meeting of Members of NP NASKI (Protocol No 6 of November 19, 2014) and agreed by the Profile Commission of the Ministry of Health of the Russian Federation on Epidemiology (Protocol No 4 of November 20, 2014 ), reviewed and accepted by the principal supernumerary employee profile epidemiologist Health Ministry Briko NI) p. 6.6. In specialized medical institutions of the infectious profile, they use such chemicals for disinfecting action that are effective against the respective types of microorganisms:
tubal dispensaries / where there is a component that has a tuberculocidal effect with a mandatory mention in the instructions for the drug that this drug has been tested for "Mycobacterium terrae" /
mycological / constituent component capable of exerting a fungicidal effect on fungal bacteria of the genus Trichophyton.
Chemicals used for disinfecting measures must meet a number of requirements:
High drug efficacy
The drug must be safe
Ideal physical and chemical functionality
Antibacterial action should be maintained at the proper level (in the presence of various kinds of organic substances)
Lack of the fixing effect of pollution on a subject
No repellent odor
The absence of components that provoke the appearance of allergic reactions in humans
Low toxicity of the drug
The presence of detergent components in disinfectants with detergent effect
Compatible with other types of detergents
Do not cause damage to the surface of the material that can be processed
The main substances in the composition of the means for disinfection, recommended for use:
Cationic surfactants - Quaternary ammonium compounds (QAC), guanidine derivatives and tertiary amines are actively used in medical institutions for sterilization because of their advantages over other similar substances:
do not require special storage conditions and are highly soluble in water;
keep the quality of processed items;
contain the washing element, therefore, there is no need to use the special separate washing substances;
have a neutral odor, are not volatile and toxic when inhaled by personnel;
quickly erode and wash off, leaving no residue or odor on the surfaces;
According to FKR p.5.5. Quaternary ammonium compounds are not effective in combating bacteria that cause tuberculosis. Derivatives of guanidines are not as such; therefore, it is not necessary to choose and use QAC compositions with these substances. In accordance with the FCR p.5.7. they possess minimal sporicidal activity; therefore, the agents whose key substances are QAS, guanidines, amines and compositions of these compounds, regardless of their amount in the solutions used, are ineffective in the fight against microbial spores. Means based on the substances described above are not allowed to use for disinfection of objects affected by spores, the TLD of medical devices and the disinfection of medical devices.
Oxygenated components are represented by such compounds:
peroxide;
potassium fluoride peroxyhydrate;
perborate;
percarbonate.
Possess the following actions:
tremendous antibacterial activity
do absolutely no harm to others (due to the rapid decomposition into 2 elements: oxygen and water)
there is no need for long-term ventilation and washing of the treated item
Chlorine-active chemical compounds include increased antimicrobial activity in relation to all existing varieties of microbacteria, including the well-known bacterial spores.
To the above, we can add that the existing restrictive framework in relation to the conduct of disinfectant measures on various surfaces and objects, with the use of chlorine-containing drugs, is associated with the presence of a strong odor. The repellent fragrance has a somewhat negative effect on the mucous membranes of the eyes and respiratory tract, as well as on the treated surfaces, the appearance of corrosion and discoloration.
Today, the least dangerous forms of drugs containing chlorine-active ingredients are tablets and granules.
Aldehydes, as well as bacterial spores, are characterized by a wide spectrum of antimicrobial activity; they are able to interact with various types of surfaces. However, they are not used as disinfectors for indoor surfaces for the following reasons:
due to the absorption of aldehyde surfaces, they are released into the air for a long time, causing a harmful effect on the human body. It takes a long time to ventilate the room and clean the surfaces with running water;
have a fixing effect, resulting in organic matter remains on the surface, which is not effective disinfection.
Minimizing the disadvantages of aldehyde, it is used for disinfection of areas not contaminated with organic matter. Combined preparations, the components of which are aldehydes and QAS, are used to disinfect surfaces. Due to the synergistic effect, these two compounds disinfect the surface, destroying microbes and are used as a detergent disinfectant.
It is no secret that all the microorganisms in the world are arranged in such a way that they adapt very easily to various environmental conditions, in particular, to the effects of antibacterial drugs, which include various types of antibiotics, detergents and skin antiseptics known to us.
Conditions that fully influence the formation of biocide resistance require the most accurate and versatile approach and analysis of the information received, as well as explanations from a scientific point of view and reasoned evidence of evidence based on the experiment.
I would like to separately note a scientifically proven fact regarding the resistant resistance of bacteria to various drugs: the active influence of low, ineffective concentrations of various disinfectants to clean objects.
To date, there is an established list of disinfectants recommended for cleaning and destroying bacteria from various objects. The presence of minimal concentrations of various solutions is guaranteed to lead to the elimination of bacteriophages.
According to the data of their current SanPiN / 2.1.3.2630-10 "Sanitary and epidemiological requirements for organizations engaged in medical practice" p. 1.9. / established methods to promote the rotation of disinfecting solutions in various medical institutions. The most important task is to prevent (at the maximum level) the probable appearance of various strains of microbacteria that are resistant to antibacterial drugs.
It is extremely important to carry out permanent monitoring of the factor of resistance of hospital strains to actual disinfectants (with their subsequent rotation).
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