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82 Cards in this Set

  • Front
  • Back
Define Sterile/Sterilization
ABSENCE of any life form/processes.

Must kill those motherfucking SPORES!!!!!!
Define Disinfection
FREE from infection

Kills bacteria/Inactivates virus

Does not necessary kill spores
Define Antiseptic
Substance that OPPOSES growth/action of microorganisms

Either be killing or inhibiting them
Define Sanitize
REDUCTION of microbial contaminants to "safe levels" as determined by the public health requirements
Define "-cide"
Kill microbes
Inactivates virus/spores
Define "-static"
Arrests growth of microbes
Inhibits viral replication
What is the most effective and practical method of sterilization used primarily in most hospitals?
Autoclaving with MOIST HEAT
Moist Heat:

- duration
- killing agent
- killing process x2
- container effect
- sharp edge effect


Coagulation/denaturing protein
Destroy DNA

Container should be open

Dulls sharp edges
Dry Heat:

- duration
- killing agent
- killing process
- container effect
- sharp edge effect
Longer than steam

Dry heat

oxidation/denaturing protein

Container may be closed

Does NOT dull sharp edges
UV is what kind of radiation?
Give 2 examples of ionizing radiation.
Beta rays

Gamma rays
UV radiation:

- Sterilizer?
- Method of killing
- Most effective against?
- Disadvantage?

Destroys/inhibits DNA via pyrimidine dimer

Airborne microorganisms

Poor penetrance due to low energy.
Beta/Gamma rays:

- Sterilizer?
- Method of killing
- Advantage?

"Chain reaction" where bacterial/viral cell component absorbs electrons then gives off high energy electrons, thus disrupting cell components.

Can penetrate barriers

- Sterilizer? why or why not?
- Useful for?
Not really b/c does not filter some small viruses

Heat labile solutions
How does Hydrogen peroxide (or plasmas) kill?
How does Chloride Dioxide kill?
How does ethylene oxide kill?
How does Paracetic Acid kill?
Critical items:

- Define
- How to handle?
Anything that enters tissue/blood

Always sterilize
Semi-critical Items:

- Define
- How to handle
Items that come into contact with mucous membranes

Sterilize or high level disinfectant
Non-critical item:

- Define
- How to handle
May come into contact with INTACT skin

Low or Medium level disinfectant
T/F - High level disinfectants are not always sporicidal.

All high level methods are sporicidal.

- kills how?
- inhibited by?
Denatures proteins

Sodium Hypochlorite (Bleach):

- inhibited by?
alkaline pH (i.e.-alkaline detergent)
Give an example of low level disinfectant.
Quatenary Amine Compound

These are cationic detergents
What is the most dominant gram positive species causing nosocomial infection?

What comes second most common?
Staphylococcus Aureus

Enterococcus Faecalis
Enterococcus Faecium
What is the most common gram negative bacteria causing nosocomial infections? x2
E. coli

Pseudomonas Aeruginosa
What is the most common spore forming bacteria causing nosocomial infections?
Clostridium Difficile
What are two common viruses causing nosocomial infections?

What is the most common fungus causing nosocomial infections?
Candida Albicans
T/F - Gloves can be a substitute for hand antisepsis.
False. It is not a substitute

- killing mechanism
- advantage
- disadvantage
Disrupts membrane/lipids

Killing activity persists after drying

Poor killing activity against:
Enterococcus species
Staphylococcus species

- killing mechanism
- disadvantage x2
Inhibits enoyl-acyl protein carrier reductase

Unknown effect on viruses
Unknown effect clinically/households
What is the most common ingredient in antibacterial soap/products?
What is the best choice for routine hand antisepsis? and why? x4

fast acting
broad killing spectrum
increases compliance over handwashing
decreases NI
What is the best combo for most effective treatment in hand antisepsis?
Chlorhexidine combined with alcohol
What is the gold standard in eliminating harmful pathogenic microorganisms?

(b/c it kills spores)
What is the FIRST choice method of sterilization used in hospitals?
Moist Heat (AUTOCLAVE)
What is the major disadvantage of Moist Heat Sterilization?
Non-applicable to Heat-Labile substances

(i.e. - antibiotics, ..)
UV (non-ionizing) radiation is often used to prevent?
Airborne spread of bacteria
Sterilization of sutures, plastic tubing, plasticware can be done via?
Ionizing radiation (beta/gamma rays)
When do you use Filtration techniques?
Heat Labile solutions

whose efficacy/safety is compromised by chemicals or heat
(antibiotics/antibiotic solutions)
What are ALL the actions mechanism-wise for Chemical Agents?
(one or more of following)

Disruption of cell
Oxidation of cell

Modification of cell permeability
Inactivation of viral enzymes
(by Alkylation)
Denaturing of protein
When using chemical agents, what properties are dependent on the chemical agent type?
Effectiveness against different life forms

Time to sterilize/disinfect
Which chemical agent works really fast?
Peracetic acid
In terms of chemical agents that Sterilize, what is "plasma?"
Hydrogen Peroxide plasma that has been microwaved

(to increase Oxygen radicals)
What sterilizing chemical agent was used to decontaminate building where anthrax attacks occured?
Chlorine Dioxide GAS
Which sterilizing chemical agents kill via Oxidizing? x3
Hydrogen Peroxide
Peracetic acid
Chlorine Dioxide
Which sterilizing chemical agents kill via Alkylating? x2
Glutaraldehyde (liquid soln 2%)

Ethylene Oxide (gas & slow)
Glutaraldehyde is inhibited by?
Which sterilizing chemical agents are used for delicate instruments , optics?
Ethylene oxide gas
Which sterilizing chemical agents are the Preferred method of sterilizing Heat-SENSITIVE instruments at LSUHSC-S?
Peracetic acid (liquid)
Which sterilizing chemical agents are limited to instruments that will be used immediately (b/c objects come out wet)?
Peracetic acid (liquid)
Which sterilizing chemical agent is known to be slow?
Ethylene oxide (gas)
Which sterilizing chemical agent is known to be fast?
Peracetic acid (liquid)
Which sterilizing chemical agents have been recently curtailed due to its toxicity?
Ethylene oxide
Peracetic acid sterilizer equipment is manufactured by?
What are the Physical Evaluations of Sterilization? x2

Pressure gauges
What are the Biological Evaluations of Sterilization?
Which chemical agents are used in High Level? x4

Which one is TOXIC!
Which one BURNS?
Hydrogen Peroxide (>10%)

Peracetic Acid (0.2%)

Chlorine Dioxide -- TOXIC

Glutaraldehyde (2%) -- BURNS
Which chemical agents are used in Intermediate Level? x3

Iodophor compounds

Sodium Hypochlorite
Sodium Hypochlorite is used at what Level of Disinfection?

What inhibits Sodium Hypochlorite (bleach)?

What makes it stronger?

Alkaline pH

High concentration
Alcohol is effective Disinfection agent at intermediate level and utilizes what killing mechanism?
Denatures Proteins
Iodophor compounds are effective Disinfection agent at intermediate level and utilizes what killing mechanism?
Denatures / Oxidizes proteins
Iodophor compounds are effective Disinfection agent at intermediate level and have what advantage? disadvantage?
NOT influenced by pH

Inhibited by dirt
What is the killing mechanism of action for quaternary amine compounds?
Denatures cell membranes

Precipitates biological molecules
Which disinfection chemical agents can also be used as antiseptics? x3

Iodophor compounds

Quarternary Amine compounds
Which disinfection chemical agents can also be used as both a low and high level disinfectant?
Sodium Hypochlorite
Which Disinfection Chemical Agent is a Cationic Detergent?
Quaternary Ammonium compounds
What are the factors affecting Killing Dynamics of chemical agents? x9
Number of microorganisms
Nature of Microbial population

Composition of agent
Concentration of agent


Extraneous material (dirt w/ EtOH)
(bleach effectiveness decreases as pH increases)
Amount of NI in US annually?
2 million
List the Antiseptics. x3


What is the BEST choice for ROUTINE hand antisepsis?
What must be required when using the Hand Antisepsis Alcohol?
Hands need to be Free of Dirt BEFORE using
What Hand Antisepsis treatment is most effective such that is is used in Surgical Scrubs?
Chlorhexidine handwash


Alcohol rub
What hand antisepsis agent is particularly effective in having residual activity?

(Chlorhexidine > Triclosan (?) > Iodophors)
Upon IMMEDIATE CONTACT which hand antisepsis agent is LESS EFFECTIVE in killing microbes
Chlorhexidine, Triclosan, & Iodophors

less effective than EtOH

Immediate Contact
A glove is NOT a substitute for Hand Antisepsis, BUT it does decrease what?
Transmission of infection rates
When using gloves, what is a concern?

(18% occurence rate)
(83% not detected by worker)
(common invisible perforations)
When using gloves, when do you perform Hand Antisepsis?
AFTER removing gloves
Which chemical agents are inhibited by dirt?

Iodophore compounds
Which chemical agents have a mechanism of action involving disruption of cellular membrane/lipids?
Quarternary Ammonium compounds