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2, 4, 5, 6, 7, 8 In this chapter, which is an update of previous chapters, 9, 10, 11, 12, 13 a pragmatic approach to the judicious selection and proper use of disinfection and sterilization processes is presented, based on well-designed studies assessing the efficacy (via laboratory investigations) and effectiveness (via clinical studies) of disinfection and sterilization procedures. 3, 4 Failure to comply with scientifically based guidelines has led to numerous outbreaks of infectious diseases. Multiple studies in many countries have documented lack of compliance with established guidelines for disinfection and sterilization. Because it is unnecessary to sterilize all patient care items, health care policies must identify whether cleaning, disinfection, or sterilization is indicated based primarily on the item's intended use. Failure to properly disinfect or sterilize equipment carries not only the risk associated with breach of the host barriers but also the additional risk for person-to-person transmission (e.g., hepatitis B virus) and transmission of environmental pathogens (e.g., Clostridium difficile).Īchieving disinfection and sterilization through the use of disinfectants and sterilization practices is essential for ensuring that medical and surgical instruments do not transmit infectious pathogens to patients.

A major risk of all such procedures is the introduction of infection. 2 Each of these procedures involves contact by a medical device or surgical instrument with a patient's sterile tissue or mucous membranes.

1 For example, there are at least 10 million gastrointestinal endoscopies per year. Each year in the United States there are approximately 53 million outpatient surgical procedures and 46 million inpatient surgical procedures.

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