Disinfectants in hospitals help prevent the risk of health care-associated infections. Disinfectant chemicals used in a health care setting are often commercial formulations that need to be cleared by the FDA or registered with the EPA.
These disinfectants have a specific purpose and must be used in a certain way, the Centers for Disease Control and Prevention explains. Therefore, it is important to choose the right disinfectant, use the proper concentration and use it in the intended manner.
Here are the top eight types of disinfectants used in hospitals:
1. Chlorine & Chlorine Compounds
The most commonly used chlorine disinfectant is hypochlorite, and sodium hypochlorite is EPA-registered and commercially available as household bleach. In hospitals, these compounds can be used to disinfect blood spills, bathrooms and food prep areas, especially on hard surfaces after all organic material has been cleaned and removed.
These products are often highly concentrated and require you to follow dilution protocols. Chlorine can cause eye and skin irritation, discolor clothing and be corrosive to metal, so it should be handled with care.
Hypochlorite substances are effective in killing viruses, bacteria and fungi. Chlorine-releasing agents destroy the cellular activity of proteins, such as those contained in blood.
2. Hydrogen Peroxide
The FDA approves disinfectant solutions containing 7.5% hydrogen peroxide for health care settings. Hydrogen peroxide is a great surface cleaner and is environmentally friendly. It works as a broad-spectrum disinfectant that works well on bacteria, viruses, spores and fungi.
Accelerated hydrogen peroxide is a blend of commonly used cleaning ingredients and hydrogen peroxide that is more stable than traditional hydrogen peroxide. It works quickly to disinfect surfaces, noncritical machinery and equipment in health care settings.
3. Peracetic Acid
Peracetic acid-based solutions are sporicidal, fungicidal, bactericidal and virucidal. They are generally more potent disinfectants than hydrogen peroxide. Peracetic acid-based solutions are used to disinfect medical devices, hemodialyzers and endoscopes.
When diluted, these solutions can become unstable and can corrode some metals, such as brass and copper. Peracetic acid is also used as a surface sterilant in health care settings.
4. Hydrogen Peroxide & Peracetic Acid
Several combination hydrogen peroxide/peracetic acid products are cleared by the FDA as disinfectants in health care settings. Combining peracetic acid with hydrogen peroxide increases its effectiveness, especially against glutaraldehyde-resistant mycobacteria.
Glutaraldehyde is another potent and high-level chemical disinfectant that has environmental concerns. It can cause skin irritation and pulmonary symptoms. Therefore, in health care associations, it is typically recommended to use a glutaraldehyde alternative. This can include both hydrogen peroxide and peracetic acid as well as hydrogen peroxide/peracetic acid combination products.
5. Ortho-Phthalaldehyde
OPA is considered a safer alternative to glutaraldehyde. It is cleared by the FDA as a high-level replacement disinfectant for endoscopes.
With excellent microbial activity, good sporicidal and bactericidal activity and even better mycobacterial activity than glutaraldehyde, OPA is more stable and has less exposure risk. It is also often more expensive upfront, but it may be more cost-effective because you do not need the same extensive ventilation system you do with glutaraldehyde.
6. Phenolics
Considered low- and intermediate-level disinfectants, phenolic disinfectants that are registered with the EPA are used to disinfect nonporous surface areas and noncritical items in health care settings. Phenolic disinfectants have been used in hospitals for a long time.
Phenolic disinfectants disrupt the cell membranes of microorganisms and are effective virucides, fungicides, bactericides and tuberculocides. However, these products are not effective against spore-forming bacteria.
7. Iodophors
Iodophors are iodine complexes combined with a solubilizing carrier or agent. Iodine is well known for its antiseptic properties, and it also has viricidal, fungicidal, bactericidal, tuberculocidal and sporicidal properties.
Iodophors, such as poloxamer-iodine and povidone-iodine, have better microbial action, are more stable and have less exposure risk than iodine solutions on their own. Iodophors are used to clean medical equipment such as thermometers and disinfect blood culture bottles in hospitals.
8. Quaternary Ammonium Compounds
Classified as low-level disinfectants, QACs are widely used for cleaning. QACs display both mycobacteriostatic and sporostatic activity, and they can be effective on bacteria, some fungi and enveloped viruses.
These products are used on hard surfaces as a last-line disinfectant in hospital rooms and for disinfecting medical equipment that comes in contact with nonbroken skin, such as blood pressure cuffs.
Factors to Consider When Choosing the Right Disinfectant
In a hospital setting, there will likely be several different types of disinfectants in use, and it is important to pick the right one for each specific job. For the prevention of HAIs, consider the following factors when choosing which disinfectant to use:
Safety: This involves environmental exposure risk to employees and patients.
Surface type: Whether the surface is porous, hard, cloth, metal or plastic will help determine which disinfectant to use.
Surface compatibility: Consider how well the disinfectant works on specific surfaces and materials.
Microbes being targeted: Certain microbes (such as HIV, hepatitis and C. difficile) may require different disinfectants.
Ease of use and cost: Both of these are major factors in choosing the right disinfectant for your hospital.
It is always vital to use products that are specifically designed and approved for the job at hand. Alsco can help with your health care cleaning and disinfectant needs. Reach out today and we can set you up on the right schedule with the right supplies for your hospital.
References
Disinfectant: Guideline for Disinfection and Sterilization in Healthcare Facilities. Centers for Disease Control and Prevention.
FDA-Cleared Sterilant and High-Level Disinfectants with General Claims for Processing Reusable Medical and Dental Devices. U.S. Food and Drug Administration. (September 2019).