Antisepsis, Disinfection, and Sterilization: Types, Action, and Resistance
Author: Gerald E. McDonnell1Basingstoke, Hampshire, United Kingdom
Category: Industrial Microbiology; Clinical Microbiology
The new title examines the various chemical and physical antisepsis, disinfection, and sterilization methods used for infection prevention and contamination control. Targeting microbiologists, chemists, facilities managers, health care professionals, infection and contamination control practitioners, application engineers, and students, Antisepsis, Disinfection, and Sterilization is a valuable reference written by an acknowledged expert working in the field.
The book provides descriptive background material covering the applications and various chemical and physical processes used for microbial control. An array of biocides is described, and the variables affecting their safe and effective use are detailed. The advantages, disadvantages, limitations, and correct applications of biocides and biocidal processes are discussed as well.
The mechanisms of biocidal action on microorganisms are investigated, including an examination of the less-studied intrinsic and acquired mechanisms of resistance in viruses, prions, protozoa, and fungi. Further considerations are given to the mechanisms on intrinsic and acquired resistance to biocides and biocidal processes, including cross-resistance to antibiotics in bacteria and novel mechanisms in extremophiles.
Digital Only, 361 pages, illustrations, index.
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Chapter 1 : Introduction
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Abstract:
Microorganisms play important roles in our lives. Of primary interest are those microorganisms that cause diseases under a variety of circumstances. Other issues include the economic aspects associated with microbial contamination, such as food spoilage, plant infections, and surface damage. This introductory chapter of Antisepsis, Disinfection, and Sterilization provides a brief description of the various types of target microorganisms, as well as a discussion of some key considerations for biocidal applications, including the evaluation of efficacy, formulation effects, and the importance of cleaning. It offers brief insights of the topics discussed in each chapter in the book. A section presents definitions of the biocidal applications consistent with international consensus documents.
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Chapter 2 : Physical Disinfection
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Abstract:
Disinfection is the antimicrobial reduction of the number of viable microorganisms on or in a product or surface to a level previously specified as appropriate for its intended further handling or use. This chapter considers the most widely used methods of physical disinfection, including heat (moist- and dry-heat methods), cold, radiation, and filtration. It discusses heat convection and conduction, with further consideration of radiation (for disinfection). Heat treatment leads to the release of dipicolinic acid and calcium from spores; dipicolinic acid and calcium are considered to play roles in protecting proteins in the inner core from heat damage and are examples of the multiple resistance mechanisms that protect spores from the effects of heat. Electromagnetic radiation is energy transmitted in the form of waves or rays, including X rays and UV and infrared (IR) radiation, which are considered to be within the electromagnetic spectrum. Nonionizing-radiation methods used for disinfection include UV and IR radiation and microwaves. Filtration is one of the oldest and most widely used physical methods for the removal of contaminants from liquids and gases. Filter types can also be classified as screen or depth filters.
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Chapter 3 : Chemical Disinfection
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Chemical biocides are used for various applications due to their ability to inhibit or inactivate microorganisms. In this chapter, biocides are classified according to their general chemical types, including alcohols, aldehydes, antimicrobial metals, and halogens. For each chemical group, the major types of biocides used are described, with consideration of their applications, spectra of activity, advantages, disadvantages, and what is known about their modes of action. A table presents examples of various guidelines and standards on the use and application of chemical disinfectants. Various types and sources of essential oils and oxygen- and hydrogen peroxide-releasing compounds are also tabulated.
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Chapter 4 : Antiseptics and Antisepsis
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Antiseptics are biocidal products used for antisepsis. They include washes (which contain soaps or other detergents and are used with water) and rubs (which are applied directly to the skin with no washing, e.g., tinctures and alcohols). Antiseptic hand washes or hand rubs for health care workers are fast acting, with minimal irritation, and designed for frequent use on the skin, particularly for the reduction of transient microorganisms. It should be remembered that the purpose of antiseptics is to reduce the level of contamination; although antiseptics can vary considerably in antimicrobial activity on the skin, they do not completely remove all transient and resident microorganisms. There are many reports of cross-transmission by pathogens from contaminated hands in these situations, and studies have shown that the use of antiseptics can reduce the risk of transmission; their effects vary from formulation to formulation, despite the presence of similar concentrations of various biocides. Hand washes include a range of biocides, usually in soap- or detergent-based formulations, such as chlorhexidine, triclosan, chloroxylenol, triclocarban, essential oils, benzalkonium chloride, and some iodophors. This chapter also discusses the biocides used as antiseptics and talks about the major types used in antiseptic skin washes and rinses.
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Chapter 5 : Physical Sterilization
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This chapter discusses the most widely used physical sterilization techniques and includes the use of moist heat, dry heat, and radiation. High-temperature steam (or steam under pressure) is the most widely used sterilization method. Steam is simply a gas that is produced by the heating of water and therefore can be explained by the gas laws that consider four variables: volume, temperature, pressure, and the amount of gas. Efficient air removal is essential to ensure steam sterilization, as air prevents the penetration of steam and leaves cold spots within the chamber/load that will not be adequately sterilized. Dry-heat sterilization methods include sterilization ovens and incineration. Incineration is essentially burning to ashes, which can be performed by passing material through a naked flame (for example, in microbiological manipulations by flaming) or in much larger scale applications in kilns or furnaces. For radiation sterilization, only high-energy or ionizing-radiation sources are utilized, due to their greater penetration and antimicrobial efficacy. Filtration methods can be used for sterilization of gas (such as air) and liquids, including water. The chapter also discusses developing methods, including plasma, pulsed-light applications, supercritical fluids, and pulsed electric fields.
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Chapter 6 : Chemical Sterilization
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This chapter provides an overview on chemical sterilization. Sterilization is a validated process that ensures that a surface or product is free from viable microorganisms, and evidence should be provided to support such a designation of a process. Despite the wide variety of chemical biocides, only a limited number have actually been developed for use in sterilization processes. They include the epoxides (particularly ethylene oxide (EO)), formaldehyde, hydrogen peroxide-based systems, and other oxidizing-agent-based liquid and gaseous processes. These systems are primarily used as alternatives to physical sterilization methods, particularly due to material compatibility concerns, for example, as alternatives to steam for the sterilization of temperature-sensitive materials. The type and application, spectrum of activity, advantages, disadvantages, and mode of action of each is discussed. EO is one of the most widely used products for industrial sterilization. Low temperature steam-formaldehyde (LTSF) systems are used for medical, dental, and some industrial sterilization processes. High-temperature formaldehyde-alcohol sterilization is a process that combines the biocidal activities of heat with those of formaldehyde and alcohol. Hydrogen peroxide solutions are not generally used in sterilization processes, but gaseous hydrogen peroxide is rapidly sporicidal at much lower concentrations and is considered significantly less damaging to surfaces. A section discusses other oxidizing agent-based sterilization processes that have been described or that are widely used.
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Chapter 7 : Mechanisms of Action
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Many compounds and processes have been identified as antimicrobial agents. For the purpose of this review, they are classified as anti-infective or biocides. Anti-infectives have been identified and developed for specific use in the control of microbial infections while having limited or no toxic effect on the host. This chapter considers, for comparison, the modes of activity of various anti-infectives, which are discussed as antibacterials (antibiotics), antiviral drug, antifungal drug, and antiprotozoal drug agents. The modes of action of biocides are discussed under four main classifications, based on their primary mechanisms of action: oxidizing agents, cross-linking or coagulating agents, and transfer-of-energy and other structure-disrupting agents. The antimicrobial effects of most biocides and biocidal processes are generally broad spectrum, with multiple effects on target microorganisms and their associated macromolecules. Further, in some cases, specific key targets for some biocides have been identified, and they are known targets for some antibacterial antibiotics (e.g., triclosan). The specific effects on microbial macromolecules are discussed in the consideration of heat. The biocides discussed in this chapter have been described as having as their primary mode of action the disruption of the structures and functions of lipid membranes. Until recently, it was widely considered that biocides had more nonspecific modes of action, in contrast to antibiotics and other anti-infective drugs.
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Chapter 8 : Mechanisms of Microbial Resistance
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This chapter discusses the various mechanisms of biocide resistance described in microorganisms. Resistance can be either a natural property of an organism (intrinsic) or acquired by mutation or by the acquisition of plasmids (self-replicating extrachromosomal DNA) or transposons (chromosomal or plasmid-integrating transmissible DNA cassettes). The biocide concentration is an important variable and must at least be at the MIC or, preferably, at the minimum biocidal concentration to have a significant effect. Mechanisms of intrinsic resistance are described with further consideration of the various types of bacteria. The first acquired resistance mechanisms reported were against mercury compounds and other metallic salts. In recent years, acquired mechanisms of resistance to other types of biocides have been observed, notably in gram-positive staphylococci. The proposed mechanisms of prion resistance are summarized. In comparison with bacteria, very little is known about the ways in which fungi can circumvent the actions of biocides and biocidal processes. As with bacteria, two general mechanisms of resistance can be identified: intrinsic resistance, a natural property or development of the organism during normal growth, and acquired resistance, with examples of both identified or proposed.
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Microbiology Today
14 August 2013
This book is unique in his field as it is pitched between a student hand book and a book for professionals. G.E. McDonnell manages successfully to combine in a clear readable manner basic information on a wide of micro-organisms and up-to-date practical information on disinfection, antisepsis and sterilization. The main chapters are structured in a logical way and include background information, practical information(such as current standard protocols) and theoretical information, which allow a clear understanding of the principles and usage of these processes. The last chapters on mechanisms of action and microbial resistance are more academic in nature, but reflect accurately the rapidly growing, and much needed, interests to understand better the interactions between antisepsis/disinfection/sterilization processes and microorganisms. This book will appeal to a broad audience, in particular to students and professionals that have an interest in antisepsis, disinfection and sterilization but have a limited knowledge of microbiology.
Society for General Microbiology: Microbiology Today
Reviewer: Jean-Yves Maillard, Cardiff University
Review Date: Unknown
Doody Enterprises
14 August 2013
At A Glance
This new title examines the various chemical and physical antisepsis, disinfection, and sterilization methods used for infection prevention and contamination control. Targeting microbiologists, chemists, facilities managers, health care professionals, infection and contamination control practitioners, application engineers, and students. Antisepsis, Disinfection, and Sterilization is a valuable reference written by acknowledged expert working in the field.
Description
This comprehensive review of the various chemical and physical antisepsis, disinfection, and sterilization methods discusses the current understanding of mechanisms of biocide action on microorganisms. The last and most lengthy chapter describes the current knowledge of biocide resistance in bacteria, and the less studied mechanisms of resistance in viruses, prions, fungi, and eukaryotes.
Purpose
The book is intended to provide a basic understanding of the various chemical and physical antisepsis, disinfection, and sterilization methods used for infection prevention and contamination control. The author succeeds in providing a comprehensive review of the types, actions, and practical uses of the available biocidal methods.
Audience
It is targeted at healthcare professionals involved in infection control and prevention, application engineers, facilities managers, microbiologists, chemists, and students. The author is an acknowledged expert working in the field.
Features
A general introduction provides a review of terminology, definitions, and a background of pertinent microbiology. An array of physical and chemical agents are described, including specific types, practical uses, spectrum of activity, and variables affecting their safe and effective use. The mechanisms of action of biocides are covered in four general groups: oxidizing agents, cross-linking agents, action by transfer of energy, and other structure-disrupting agents. Current knowledge of the natural and acquired mechanisms that microorganisms employ to resist the biocidal effects of chemical and physical processes is explored.
Assessment
Students and healthcare professionals of infection control, microbiology, and public health will be able to use this as a reliable reference for the various chemical and physical antisepsis, disinfection, and sterilization methods. The book will provide a greater understanding and appreciation of these technologies used in contamination and infection prevention. In return, this will help ensure their long-term safe and effective use.
Doody Enterprises
Reviewer: Robert Penn, MD (Nebraska Methodist Hospital)
Review Date: Unknown
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