Gerald E. McDonnell - Antisepsis, Disinfection, and Sterilization

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GERALD E. McDONNELL, B.SC., PH.D.

Vice President of Research and EMEA Affairs

STERIS Limited

Basingstoke, Hampshire, United Kingdom

Address editorial correspondence to ASM Press, 1752 N St. NW, Washington, DC 20036-2904, USA

Send orders to ASM Press, P.O. Box 605, Herndon, VA 20172, USA

Phone: (800) 546-2416 or (703) 661-1593

Fax: (703) 661-1501

E-mail: books@asmusa.org

Online: estore.asm.org

Copyright © 2007 ASM Press

American Society for Microbiology

1752 N St. NW

Washington, DC 20036-2904

Library of Congress Cataloging-in-Publication Data

McDonnell, Gerald E.

Antisepsis, disinfection, and sterilization : types, action, and resistance / Gerald E. McDonnell.

p. ; cm.

Includes bibliographical references and index.

ISBN-13: 978-1-55581-392-5 (hardcover)

ISBN-10: 1-55581-392-5 (hardcover)

1. Sterilization. 2. Asepsis and antisepsis. 3. Disinfection and disinfectants. I. Title. [DNLM: 1. Antisepsis. 2. Disinfection. 3. Sterilization. WA 240 M478a 2007]

QR69.S75M33 2007

614.4′8—dc22 2006031854

All Rights Reserved

Cover photo:Scanning electron micrograph of a mixed biofilm of yeast and bacteria on an indwelling silicone rubber voice prosthesis after 3 to 4 months in a laryngectomized patient. Courtesy of Henny C. van der Mei and Henk J. Busscher (Department of Biomedical Engineering, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands).

Dedicated to the memory of Professor A. Denver Russell

The control of microorganisms and microbial growth is an important consideration in medical, veterinary, dental, industrial, pharmaceutical, environmental, and food processing settings. This book has been developed to provide a basic understanding of the various chemical and physical antisepsis, disinfection, and sterilization methods used for infection prevention and contamination control. Disinfection and sterilization technologies are used for the control of microorganisms on surfaces, in products, or in air, while antisepsis is particularly associated with microbial reduction on the skin or mucous membranes. These varied applications play important roles in our daily lives, including the provision of safe drinking water, production and preservation of products, sterilization of medical devices, and decontamination of surfaces. The benefits of microbial control have been appreciated since ancient times—for example, in the use of heating, salts, and metals for preservation and wound treatment—despite the absence of any pure understanding of microbiology. Over the last 200 years, we have gained a greater appreciation of microorganisms and their roles in contamination and infection. In parallel, various chemical (referred to as “biocidal”) and physical antisepsis, disinfection, and sterilization methods have been developed and are widely used to render surfaces and products safe for use. Despite these advancements, microbial control issues continue to challenge us. Recent examples include the aftermath of the bioterrorism attacks in the United States; the alarming spread of viral and reemerging bacterial infections such as influenza viruses and tuberculosis, respectively; the more recent identification of newer infectious agents (notably prions and viroids); and the continuing concern of anti-infective (including antibiotic)-resistant microorganisms in hospitals and the general community.

As a background to this subject, an introduction to microbiology is provided, including a discussion of the spectrum of action, determination of efficacy, and common variables that affect the performance of antisepsis, disinfection, and sterilization methods. Disinfection and sterilization are considered as either chemical (biocide) or physical technologies. Chemical biocides include aldehydes, halogens, and phenolics, while physical processes include the use of heat, filtration, and radiation. For each biocide class or process, the various types are discussed, along with their applications, spectrum of activity, advantages, and disadvantages and a brief description of their modes of action. A wider range of methods is used for disinfection and antisepsis applications. Many of these are required to reduce the number of microorganisms, or even the number of certain types of microorganisms, to an acceptable level. In contrast, only a limited number of technologies are utilized for sterilization, which has the ultimate goal of rendering a surface, area, or substance free of all viable microbial contamination. For this reason, disinfection and sterilization methods are considered separately, with a specific chapter dedicated to the various biocides used as antiseptics and in antisepsis applications.