Modern disinfectants. The main groups of disinfectants and antiseptic substances, the mechanism of their antibacterial action. Disinfectants, their characteristics and rules of use.

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The chemical disinfection method is most often used to combat hospital infections. The corresponding preparations are available in the form of soluble granules, tablets, powders, concentrates, emulsions, pastes, and aerosols. The active compounds included in the composition remove and devitalize most pathogenic microorganisms, bringing their number to an acceptable level.

There are several types of products (depending on which chemical is used as the main disinfectant).

1. Halogen-containing, iodine, bromine. They have a diverse spectrum of antimicrobial action, but have a strong irritating effect on the respiratory system and eyes, are toxic, and if not disposed of correctly, are harmful to the environment, provoke corrosion, and have a persistent odor. Despite a number of disadvantages, the products of this group (Chloramine, Chloreffekt, DP-2T, Monochloramine, Chlorine, Calcium Hypochlorite) are often used in medical organizations. They are accessible and effective, but require strict adherence to the rules of use and disposal.

2. Preparations based on oxygen (as well as hydrogen peroxide, ozone, perborates) are low-toxic, safe for the natural environment, do not have a specific odor, and are active against most pathogenic microorganisms and pathogens. Their main disadvantage is their high corrosion activity, so they are not suitable for processing metal tools and equipment. Drugs of this group are often used in neonatal departments and obstetric hospitals.

3. Disinfectants based on aldehydes (formaldehyde, glyoxal, glutaric and orthophtholic aldehyde). They have a complex bactericidal, sporicidal, virucidal effect, have high antimicrobial activity against all types of microorganisms, but have an irritating effect on the respiratory system and cannot be used in the presence of people. Suitable for disinfection of equipment, including those with a complex configuration (for example,). This group of drugs includes Glutaral, Bianol, Lysoformin.

4. Preparations based on alcohols (ethanol, isopropanol, propanol) are effective against most microorganisms. At sufficient concentration (at least 60%), they provide rapid fungicidal, virucidal, bactericidal and bacteriostatic effects. However, they are helpless against spores and vegetative forms of microorganisms. Suitable for sanitation, scissors, rectal. Alcohol treatment of endoscopes, surgical materials, and instruments is not effective enough and creates a risk of spreading infections. Alcohols are often included in aerosols in combination with aldehydes. Like aldehydes, alcohols fix blood, mucus, and other organic contaminants, so before using them, thorough pre-cleaning of equipment with detergents is necessary.

5. Cationic surfactants (Biodez-extra, Veltolen, Vapusan) act due to the quaternary ammonium compounds, amines, and ampholytic surfactants they contain. They do not have a pungent odor, are inert to metals, but are effective only against a limited number of pathogens. Sometimes they provoke the emergence of resistant strains. Due to its high cleaning properties, this group is successfully used at the stages of pre-sterilization cleaning in combination with primary disinfection. FAs and tertiary amines do not damage equipment, are low-toxic, do not irritate mucous membranes and the respiratory system, and can be used in the presence of patients and personnel.

6. Guanidine-containing preparations based on polyhexamethylene guanidine and chlorhexidine (Polysept, Demos, Bior) also have a narrow spectrum of bactericidal activity and a fixing effect. Their characteristic feature is a long period of action due to the formation of a bactericidal film on treated surfaces. Combining low toxicity and gentle action on equipment, they are among the most promising drugs.

7. Phenolic-based disinfectants (Amocid, etc.) are used as antimicrobial agents, but are useless in the fight against viruses and spore forms of bacteria.

8. Organic acids are used in medical institutions to disinfect hemodialysis machines. Currently, scientists are studying the antimicrobial properties of peroxyacids - at low concentrations, drugs based on them exhibit high bactericidal properties.

Today there are no comprehensive universal solutions for chemical disinfection. Each group of funds is a combination of strengths and weaknesses that must be taken into account and correlated with the intended area of application.

Alexandra Abramova Leading Specialist

Disinfection is an integral part of activities carried out in medical and industrial institutions in order to prevent the spread of infection. It is aimed at destroying microorganisms found on the surfaces of objects, furniture, equipment, tools, hands, and in water.

The most common decontamination method is chemical disinfection. Experts identify the following classification of products used as the main disinfectant.

Disinfectants for medical institutions. Main groups.

Halogen-containing

These are products based on the use of iodine, bromine, and chlorine. They effectively destroy microorganisms, but irritate the mucous membranes and affect the respiratory system. Treatment with Chloramine, Chloreffect, Bleach, and Chlorhexidine is common in medical organizations (hospitals, clinics).

Preparations based on oxygen

These are low-toxic substances that are safe for humans and the environment and effectively destroy pathogens and microorganisms. The main disadvantage is increased corrosive activity, which is why they cannot be used for processing tools made of metal.

Disinfectants based on aldehydes

They have an active antimicrobial effect and effectively destroy bacteria. They are a common chemical method for pre-sterilization treatment of medical equipment. Due to excessive irritant effects on the respiratory system, they are restricted for use in the presence of people.

Alcohol preparations

They have a bactericidal effect on most microorganisms, but are weak against spores. Together with aldehydes, they are part of aerosols and are used to clean stethoscopes and scissors.

Cationic substances

They do not have a corrosive effect on metals, are odorless, but are effective against a certain number of pathogens. Most often used at the stage of primary disinfection.

They have a long duration of action, since after their use a bactericidal film appears on the surface. Due to their quality, they are considered the most promising drugs.

Disinfectants based on phenols

They are effective in disinfecting the action of microbes, but are not useful in the fight against viruses and bacterial spores.

Requirements for disinfectants

In the process of using disinfection solutions, the following requirements for them were developed:

Maximum safety for human health. If chlorine disinfection solutions or others are too toxic, the manufacturer must indicate this on the packaging of the product.
Increased antimicrobial activity. In their action, the products must destroy harmful microorganisms to the maximum.
Can be used in the presence of patients and staff. This requirement for tablets and solutions is optional - some substances are best used in the absence of strangers in the room.
Multifunctionality. The disinfectant must not only clean the surface from germs and harmful microorganisms, but also from contaminants.
Harmless to the surface being treated. Disinfectants should not harm both objects and people. If there is one, the manufacturer is obliged to indicate this on the packaging of the product.
Comfort. The products should be easy to use.
Ready solubility in water. One of the main qualities of chemical preparations for disinfection is their complete solubility.
Long term use of solutions and concentrates.
Description of common means for chemical disinfection

Aquaminol Forte

This is an effective concentrate that looks like a transparent yellow liquid with a slight fragrance odor. The product mixes well with water. Using the product allows you to get rid of pathogens of dangerous infections, viruses, and carry out antimicrobial cleaning.

The disinfectant is intended for individual use in laboratories, hospitals, and clinics. It can be used to treat the surface of outpatient equipment, devices, to disinfect drains, instruments, and suction elements of dental machines.

An important feature of Aquaminol Forte is its suitability even after freezing and subsequent thawing. The processing time varies depending on the concentrate and can range from 15 to 120 minutes.
The product is sold in liter containers. It can be either sprayed using Quasar or applied using a piece of fabric.

Aquaminol

Sold in 1 liter containers. The concentrate has the appearance of a transparent blue-green liquid. Like Aquaminol Forte, it mixes well with water. The disinfectant fights fungi well and has an antimicrobial effect. Can also be used as a detergent. Intended for use in hospitals, various laboratories, and places of focal infection.

Using Aquaminol and hydrogen peroxide, you can sanitize rugs and rubber shoes, various types of dishes, clean cleaning equipment, and disinfect instruments. The application mode varies depending on the subject and the quality of the solution and can reach 120 minutes.

Alaminol

Available in the form of a bright blue concentrate with virtually no odor. There are no contraindications for use. According to the instructions, the disinfectant is used to treat instruments, medical equipment, napkins, and dressing materials. Also, Alaminol solution can be successfully used during cleaning in medical and public institutions, as well as in public utilities during seasonal exacerbation of diseases.

There are different strengths of Alaminol concentrates: from 1 to 10%. The “strongest” solution is used to disinfect medical items.

Alaminol Plus

It is an antiseptic that has a powerful effect against tuberculosis pathogens, viruses, and harmful microorganisms. The shelf life of the product is 3 years, and the working solution can be stored for 14 days.

Alaminol Plus is intended for use in medical institutions, educational institutions and utility companies. It can be applied either with a napkin or with a spray on surfaces, cleaning equipment, laboratory glassware, shoes, and medical instruments. The solution concentration rate is 0.5% for purification from pathogens of viral infections.

Alpinol

An effective disinfectant that is used in hospitals, clinics, various types of laboratories, places of infectious disease, cultural and educational institutions.

Alpinol is a transparent yellow liquid with a light fragrance. The product mixes well with water and removes dirt well. It is best used for processing furniture, appliances, tools, rubber products, and medical waste. You can apply the product either by aerosol or by immersing things in the solution. It is easy to prepare the product: just follow the simple algorithm found on the product packaging.

Alpinol is a low-hazard product for the skin and mucous membranes and can be stored for 3 years. Its solution retains its cleaning properties for two weeks.

Bianol

An effective disinfectant. Intended for sterilization of medical instruments, rubber, plastic, glass products, processing of plumbing equipment, and cleaning.

Bianol can also be used in veterinary institutions for the treatment of containers, halls, and vehicles transporting animals. The product has good bactericidal properties and effectively destroys viruses (HIV) and fungi.

A weak solution of the drug does not cause irritation to the skin. A 20% solution may cause redness of the dermis. The mucous membrane is irritated regardless of the concentration of the solution.

Maxi-Dez

A disinfectant that has a good bactericidal effect and perfectly destroys fungus. It is used in the processing of dishes, linen, furniture, sanitary and medical instruments. Can act as a replacement for chloramine and has a good cleaning effect.

The packaging of the product contains a manual dispenser, which ensures convenient preparation of working solutions and eliminates contact of medical staff with the concentrate. It’s easy to prepare the solution: just press the dispenser and dilute it in 5 liters of water. This will be enough to prepare a solution with a concentration of 0.5%.

Maxi-Dez M

A disinfectant used in general cleaning and used in the cleaning process of medical devices. Effectively removes fungus, cleans passenger vehicles, disinfects premises in public utilities, markets, educational and cultural institutions.

Maxi-Dez M is a non-hazardous substance if it comes into contact with the skin and a moderately dangerous substance if it gets ingested. To prepare the working solution, you must use glass or plastic containers.

Maxi-Sept Aqua

A good disinfectant intended for treating the hands of doctors, medical staff, laboratory employees, specialists in perfume production and beauty salons, and the elbow joints of donors. Using Maxi-Sept Aqua effectively destroys harmful microorganisms, viruses, and fungi.

Maxi-Steril

This is a very economical drug that has an immediate effect on the surface being treated. Due to its characteristics, it is characterized by low toxicity and environmental safety.

Maxi-Steril effectively destroys germs and bacteria that spread tuberculosis and dangerous infections. The product is used in the process of disinfection of medical instruments, endoscopes, and equipment.

Aquaminol Spray

The disinfectant is used in the process of rapid cleaning of small and hard-to-reach surfaces, furniture, medical instruments, and door handles. Aquaminol Spray can be used in medical institutions, educational and cultural institutions, public utilities, and crowded places.

Maxi-Sept

An effective aerosol skin antiseptic used in disinfection and treatment of the hands of medical staff, donors, surgeons, and patients. The product can be used in everyday life, treating hard-to-reach surfaces and small objects. The product is easy to use and quickly removes dirt.

Proper chemical disinfection will effectively eliminate harmful microorganisms from the surfaces of objects and skin. This is a guarantee of human health and an obstacle to the spread of infection.

Disinfectants are divided into 4 groups based on toxicity.

Drugs of the 2nd toxicity group should be used with protective equipment for personnel and in the absence of patients;

Drugs of the 3rd group - toxicity should be used without protective equipment in the absence of patients; .

Drugs of toxicity group 4 should be used without protective equipment in the presence of patients.

Disinfectants are classified into various chemical groups depending on the active substances (AS) included in their composition.

Halogen-containing disinfectants. For disinfection, chlorine-containing preparations are often used, for example, Javelion, Javel-salid, Purzhavel, Javel-kleid etc. Release form: tablets. According to the regime of viral infections, 0.1% solutions are used (7 tablets per 10 liters of water). To wipe the surfaces of oilcloths and wash floors, use a 0.015% solution of these drugs (1 tablet per 10 liters of water). This group also includes Chlormix, Aquatabs, DeochlorLumax-chlor. Sulfochloranthine 0.5% used for single-use medical devices, 0,2% - for surface treatment.

Aldehyde-containing disinfectants- This Lysoformin, Alaminol, Desoform, Decoiex, used in different concentrations and exposures depending on the type of infection. The main disadvantage of these drugs is the formation of a film on medical devices and surfaces, so medical devices must be thoroughly rinsed with running water before disinfection.

· Oxygen-containing disinfectants. More often used hydrogen peroxide 3% or 6%, which even has sporicidal properties. They are used as part of a complex cleaning solution for reusable PSO medical devices, as well as for general cleaning of health care facilities, disinfection of care items and household items.

· Surfactants (surfactants)- these are substances, for example, “Nika”, “Samarovka”, Diamond etc. The main advantage of these drugs is the formation of a bactericidal film on medical devices cleaned of contaminants, which is effective for several hours. But these drugs have a narrow spectrum of antimicrobial action.

· Guanidine-containing disinfectants. These include Lisetol, Demos, Dezin etc. The advantage of these drugs is that they form a film on the surfaces being treated, which provides a long-term residual antimicrobial effect. Among them are skin antiseptics (Plivasept), but all drugs have a narrow spectrum of antimicrobial action.

· Acid-based disinfectants. Inorganic acids have a wider spectrum of antimicrobial action, but are currently not used for disinfection in health care facilities. There are few disinfectants based on organic acids. For example, Diasteril, Citrosteril used for disinfection of hemodialysis machines. Surfanius- for disinfection of surfaces and plumbing equipment. These agents are active against bacteria, mycobacteria, spores, viruses, and Candida fungi.

PRECAUTIONS WHEN WORKING WITH DISINFECTANTS AND DETERGENTS

1. Supplies of drugs are stored in places inaccessible for public use, in dark containers, in a dark, dry and cool place. All disinfectants, detergents and their solutions must have labels indicating the concentration. In medical, preventive and children's institutions, disinfectants and their calculations are stored under lock and key in places inaccessible to children and persons not involved in disinfection, separately from medicinal preparations.

2. The safety of using chemicals for pre-sterilization cleaning of medical devices for patients and personnel is guaranteed by observing precautionary measures.

3. Persons at least 18 years of age who have received appropriate instruction on production duties, safety precautions and precautions when working with chemicals are allowed to work. The person responsible for the instruction is the chief physician of the institution and an administrative person specially appointed by order.

4. Medical staff undergo preliminary and periodic (once a year) medical examinations. Persons with hypersensitivity to the detergents used are not allowed to work with them.

5. It is necessary to strictly follow the sequence and accurately carry out all stages of disinfection and cleaning, systematically monitor their quality and the completeness of the alkaline components of detergents, ensuring maximum removal of their residues from the objects being treated.

6. Packaging and preparation of working solutions of formaldehyde, hydrogen peroxide, dezoxon-1, chloramine should be carried out in a fume hood or, as a last resort, in a separate ventilated room.

7. All work with disinfectants and detergents is carried out in rubber gloves, sealed goggles (PO-2, PO-3) and a four-layer gauze mask or dust or universal respirators. At the end of the work, wash your hands and lubricate them with cream.

8. In the presence of patients, do not use the method of irrigation, spraying, and when using the wiping method, do not use products that have an irritating effect on the upper respiratory tract or an allergic effect.

METHODS OF DISINFECTION OF VARIOUS OBJECTS

According to MU 287/113-98, disinfection is carried out according to five modes, depending on the type of infection, using third-generation disinfectants.

· The double wiping method is carried out using disinfectant solutions and rags at intervals of 15 minutes.

ü Oxygen cushion

ü Oilcloth linings, oilcloth aprons

ü Couches

ü Stretchers, gurneys ,

ü Manipulation tables

ü Dining tables

ü Warmers, ice packs

ü Esmarch mug

ü Tourniquet and injection roller

ü Infusion stand

The method of immersion in disinfectant solutions of different concentrations depending on the degree of contamination and type of infection.

ü Thermometers

ü Single-use instruments

ü Tableware and laboratory utensils .

ü Enema tips

ü Bed and underwear

ü Rubber balloon

ü Cleaning rags

ü Medical gloves

A method of irrigation with special disinfectants without subsequent wiping of surfaces.

ü Dinnerware

ü Spatulas, enema tips

ü Bed linen

AIR DISINFECTION

The bactericidal irradiator is intended for air disinfection in the premises of medical institutions (operating rooms, dressing rooms, maternity wards), as well as for disinfecting the surfaces of equipment located in the room.

This irradiator can be used to quickly disinfect the air in rooms where large numbers of people gather (schools, preschool institutions, cinemas, concert halls, etc.), as an effective means for the prevention of ARVI.

Security measures:

1. Work with the irradiator only in protective glasses that do not transmit ultraviolet rays.

2. Treatment of premises is carried out only by medical staff.

4. Moisture must not get inside the device.

5. All work related to the repair of the irradiator should be carried out in a workshop or by specialists with sufficient qualifications.

6. The irradiator is turned on by pressing one of the keys. Restarting can be done after cooling for 5-10 minutes.

7. To reduce the concentration of ozone generated during operation of the irradiator, the room must be ventilated.

Healthcare disinfectants are used to kill pathogens.

These are highly active and aggressive chemicals, so they pose a certain danger to humans, hospital facilities and the environment.

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The main thing in the article

The article discusses modern disinfectants based on active chlorine and oxygen, cationic surfactants, aldehydes, alcohols, phenols, acids and alkalis.

Additionally, the features of using disinfectants depending on the chemical group are described.

Many manufacturing companies try to present their products as universal and multifunctional.

However, practice shows that there are still some restrictions on their use - some drugs are more effective in certain situations, others have a greater degree of aggressive effect on surfaces, and others can be harmful to human health.

Chloroactive compounds

Compounds based on active chlorine are divided into:

inorganic (calcium hypochlorite, bleach, etc.);
organic (chloramines, derivatives of hydantoin and cyanuronic acids);
chlorinated derivatives of isocyanuronic acid (DCCA, TCCA, etc.);
hydantoin derivatives (dichlorodimethylhydantoin).

Preparations using active chlorine are active against all forms and types of pathogens - bacteria (including Mycobacterium tuberculosis), viruses, fungi and their spores.

These disinfectants are extremely effective, and therefore are used to destroy pathogens of particularly dangerous infections (for example, anthrax spores).

In addition, chloroactive disinfectants have bleaching and deodorizing properties, and also have a homogenizing effect on the organic substrate.

The disadvantages of chlorine-based products include:

Strong unpleasant odor.
Irritating effect on the upper respiratory tract and mucous membranes of the eyes.
Damaging effect on various materials - metal, some types of fabrics, etc.
Low degree of solubility in water (for bleach and calcium chlorite).
Low storage stability.

Due to the irritating properties of chloroactive compounds, it is recommended that all work with them be carried out using personal protective equipment - goggles, rubber gloves, respirators.

treatment of non-residential premises, cesspools, waste collection areas, outbuildings;
disinfection of biological substances, laboratory glassware, food debris, plumbing fixtures, medical waste, cleaning equipment;
carrying out general cleaning and final disinfection.

To reduce the harmful effects of chlorine on the human body and give drugs additional properties, composite drugs are created in safer and more hygienic forms - gels, tablets, granules.

List of chloroactive disinfectants for medical institutions

Most often, granules and tablets using the sodium salt of dichloroisocyanuric acid are used in medical institutions:

These drugs have a lower impact on the human body at the time of preparation of the working solution in comparison with conventional products with an active substance - chlorine.

Chloramines and combinations of chlorine with surfactants and other components are also common:

"Sporox";
"Domestos";
"Clorilly";
drugs from the Sulfochloranthin series.

Oxygen-active compounds

The most common preparations based on active oxygen are:

hydrogen peroxide;
chlorine dioxide;
perborates;
persulfates;
perphosphates;
percarbonates;
Potassium fluoride peroxohydrate.

These compounds have a wide spectrum of antimicrobial activity. However, most of them exhibit it only at high concentrations of the active ingredient, even against low-resistant microorganisms.

Preparations that use active oxygen are safe for the environment and humans (due to rapid decomposition into water and oxygen) and do not irritate the respiratory tract. For this reason, their use is permissible for treating objects surrounding the patient (up to maximum permissible concentrations_.

Among the disadvantages are:

intense irritant effect on the skin and mucous membranes;
low stability;
inconvenience of use (most products are in liquid form);
aggressive effect on treated surfaces.

The introduction of corrosion inhibitors, activators and other additives into the composition of such disinfectants increases their antimicrobial effectiveness, makes them more stable and reduces toxicity and aggressiveness for humans and treated surfaces.

Names of oxygen-active disinfectants

The list of disinfectants for medical institutions, which use active oxygen as an active component, includes the following items:

The first two names are in liquid form, the rest are in solid form.

When active oxygen combines with acids, peracids are obtained, the most common of which is peracetic (PAA). It has a high degree of activity against all forms and types of pathogens.

However, its disadvantages are low stability, aggressiveness towards some materials, a pungent odor and a strong irritant effect on mucous membranes, skin and upper respiratory tract. These effects are eliminated by introducing special additives into the drug formulation.

Preparations containing NAA and hydrogen peroxide-based products have similar qualities. They are used for processing and sterilization of medical devices, including endoscopes and their components. However, it is not advisable to use NAA for disinfecting surfaces.

Cationic surfactants

Cationic surfactants include:

quaternary ammonium compounds (QAC);
guanidine derivatives (PHMG-x, PHMG-f);
tertiary amines.

Advantages of cationic surfactants:

remain stable for a long time;
dissolves well in water;
do not damage surfaces;
have good cleaning properties.

QAC and guanidine derivatives are active against gram-negative and gram-positive microorganisms, but show weak activity against tubercle bacilli, non-enveloped viruses and spores.

Tertiary amines exhibit high activity against Mycobacterium tuberculosis and various viruses, however, like other cationic surfactants, they do not have a sporicidal effect.

Preparations containing QAC as the main component retain their properties on surfaces from several hours to several months, depending on the type and concentration of the chemical compound.

Cationic surfactants are non-volatile, non-toxic when inhaled, and do not have a strong odor, so rinsing them off the treated objects and ventilating is not required. Their good cleaning properties make it possible to combine disinfection and cleaning, as well as disinfection and pre-sterilization cleaning of medical devices.

KPAV: list of disinfectants

Names of disinfectants for medical institutions based on cationic surfactants:

"Katamin AB";
"Dezin";
"Septabik".

They are used to treat indoor surfaces, plumbing fixtures, dishes, and patient care items.

Combinations of cationic surfactants with alcohols, aldehydes and some other components are more widely used:

These preparations are used for disinfection and pre-sterilization cleaning of medical devices and various materials, including endoscopes and dental instruments.

Aldehydes

Aldehydes include:

formaldehyde;
orthophthalic;
glutaric, etc.

They are active against all forms and types of pathogens and are compatible with most materials. Aldehydes are used for disinfection (including high levels) and sterilization of medical devices, including endoscopes and instruments for them.

Names of disinfectants with aldehydes

The list of aldehyde-based disinfectants for medical institutions includes the following drugs:

"Glutaral";
"Glutaral N";
"Sidex";
"Steranios 20%" and others.

Aldehydes have a strong fixing effect, so medical products are washed in running water before being treated with them.

Aldehydes are very toxic and have fixing properties, so they are not recommended for treating linen, dishes and indoor surfaces. In addition, they are absorbed by surface materials and then released into the atmosphere over time.

Therefore, after exposure, prolonged ventilation of the room and thorough washing of surfaces and other objects with clean water are required.

More widely used are products containing, in addition to aldehydes, QAS, nonionic surfactants, guanidines and other components:

"Alaminol";
"Bianol";
"Lysoformin 3000";
"Deconex 50FF".

The combination of various components in these preparations is mutually reinforcing, due to which it is possible to reduce the concentration of the active substance in the working solution. In addition, additives contribute to the appearance of detergent properties in the products and reduce the sorbing and fixing effect.

Alcohols

Most often, ethyl and isopropyl alcohols are used in medical institutions. In high concentrations (60-95%) they are active against bacteria, viruses, fungi and mycobacterium tuberculosis.

However, alcohols are ineffective against spores, and isopropyl alcohol is also ineffective against hydrophilic viruses. 70% alcohols are most effective.

Disadvantages of alcohols:

Aggressive to surfaces made of organic glass, rubber, linoleum and surfaces coated with paint or varnish.
Organic substances are fixed, as a result of which antimicrobial activity is reduced and subsequent cleaning of the surface is difficult.
They are flammable and easily ignite, as a result of which they are allowed to treat a small surface area (no more than 1/10 of the part).

Due to their pronounced fixing properties, alcohols are used only for treating surfaces without visible contamination.

As a rule, alcohols are used in the form of sprays, in combination with cationic surfactants or other components that enhance the antimicrobial properties of the drug. They are also used as impregnation of antibacterial wipes for treating small surfaces.

Phenols

Phenol preparations include:

orthophenylphenol;
orthobenzylparachlorophenol.

They are active against bacteria (including tuberculosis bacillus), fungi, and viruses. Some phenol-containing drugs do not show activity against resistant viruses that do not have an envelope. In addition, phenols are ineffective in killing spores and have no cleaning properties.

Phenol products are poisonous and are not used for treatment in children's institutions and neonatal units in maternity hospitals.

Porous surfaces absorb phenol-containing preparations, resulting in a persistent unpleasant odor. Due to toxicity and the need to wash surfaces for a long time and thoroughly with clean water after disinfection with these disinfectants, they are extremely rarely used in Russian medical institutions.

Acids and alkalis

Preparations based on acids and alkalis have weak antimicrobial properties, but severely damage surface materials, and therefore are used in strict accordance with the manufacturer’s recommendations - most often as part of household chemicals and for treating specific objects.

For example, acids are used to remove limescale from plumbing fixtures, and alkalis are used to remove grease from kitchen equipment. After use, these products must be neutralized, and the object is thoroughly washed from its residues.

Use of disinfectants depending on chemical group

The areas of application of disinfectants depending on the chemical group are presented in the table below:

Essay

"modern disinfectants »

1st year student

Group 131

specialties: General Medicine

Fedin A.D.

teacher

Panasenkova T.S.

Introduction

Classification of disinfectants

Modern range of disinfectants

Production control

experimental part

List of sources used

Introduction

Disinfection (French des - from, and late Latin infectio - infection) are measures aimed at the complete destruction of vegetative and dormant forms of pathogenic and opportunistic microorganisms on environmental objects (including medical products) in order to prevent transmission pathogen from an infected organism to a healthy organism (breaking the epidemic chain).

Disinfection methods:

1) physical - boiling, hot air treatment, steam under pressure, ultrasound treatment;

2) chemical - the use of chemicals for the purpose of processing pathological material, utensils, tools, equipment.

Types of disinfection:

1) focal;

2) preventive.

Preventive disinfection is carried out if the source of infection has not been identified, but its occurrence is possible. It is carried out in places where there is a probable source of infection: in medical institutions, in communal facilities (swimming pools, bathhouses, hairdressers), in transport, in children's institutions, etc.

Focal disinfection is carried out in the presence of the patient (source of infection) at the source of the infectious disease.

There are two types of focal disinfection: current and final.

Current is called disinfection, which is carried out repeatedly in the outbreak during the entire time the source of infection is in it.

Final disinfection is carried out in the outbreak after removal of the source of infection (hospitalization, departure, recovery, death) once.

The actual chemical method of disinfection consists of the use of chemicals that have a detrimental effect on pathogens of infectious diseases. Today, people use a huge variety of chemical compounds as disinfectants, but do not stop there. The search for new chemical disinfectants is carried out in two main directions:

1) search for fundamentally new substances;

2) search for new biocidal mixtures.

Since chemical science has made great progress over the last century and one cannot expect the emergence of new biocides, all scientific enthusiasm comes down to the search for new mixtures of known disinfectants.

Why is so much attention paid to the chemical method of disinfection, the search for new drugs for disinfection, why is disinfection so important in general? To answer these questions, you must first determine the meaning of disinfection in the modern world. Firstly, disinfection is vital for institutions where the risk of infection spread is high, i.e., primarily for healthcare institutions. Currently, despite the expansion of the range of disinfectants, the problem of nosocomial infections is still acute. Why are hospital-acquired infections such a significant problem? Hospital patients are particularly susceptible to infectious diseases due to weakening of the body as a result of general illness, injury or as a result of surgery, as well as due to reduced body resistance in children and the elderly. An increase in the number of bacteria with increased resistance to antibiotics, crowding of weakened patients in a relatively small area, difficulties in cleaning and cleaning modern complex equipment are also factors that contribute to the development and spread of infection in hospitals. In addition, according to epidemiological studies, 5% of all hospitalized patients develop infectious diseases. The risk of hospital-acquired infections increases dramatically as a result unless the right measures are taken to prevent their spread. And the development of nosocomial infection leads to additional costs for effective antibiotics and other therapeutic drugs, to additional costs for hospital beds, to additional suffering of patients from deterioration of their condition, the development of postoperative suppuration and, ultimately, to a decrease in the effectiveness of treatment. Secondly, regular disinfection can significantly reduce the risk of epidemics. But recently the whole world has been shaken by epidemics of previously unknown infections, causing people to feel close to panic and forcing them to run to the pharmacy. By lining up for medicines, they, without knowing it, contribute to the spread of infection, creating a vicious circle. Meanwhile, in conditions of an epidemic threat, we must try to avoid crowds of people. And in those places where they are unavoidable, regularly carry out preventive measures. The most effective of them is disinfection. Thirdly, regular disinfection and ventilation of premises can significantly reduce the incidence of illness among enterprise employees. This, in turn, will ensure that staff performance is maintained at a high level. Ultimately, the costs of these activities will be guaranteed to be lower than paying for the forced absence of employees and losses from unfulfilled work. Fourthly, regular disinfection is necessary to comply with the requirements of sanitary legislation. For pharmacy organizations, this is primarily Order of the Ministry of Health of the Russian Federation No. 309 “On approval of instructions on the sanitary regime of pharmacy organizations (pharmacies).” Also, Article 11 of the Federal Law of March 30, 1999 No. 52-FZ “On the Sanitary and Epidemiological Welfare of the Population” establishes the responsibilities of legal entities and individual entrepreneurs to comply with the requirements of sanitary legislation. In particular, they are required to exercise production control, including through laboratory research and testing, over compliance with sanitary rules and sanitary and anti-epidemic (preventive) measures when performing work and providing services, as well as during the production, transportation, storage and sale of products . To fulfill this requirement, the Decree of the Chief State Sanitary Doctor dated July 13, 2001 No. 18 approved SP 1.1.1058-01 “Organization and conduct of production control over compliance with sanitary rules and implementation of sanitary and anti-epidemic (preventive) measures.” Clause 4.1 of this regulatory document states that when carrying out pharmaceutical activities and activities related to the provision of medical care to the population, in order to prevent infectious diseases, including hospital-acquired ones, it is necessary to provide for monitoring compliance with sanitary and anti-epidemic requirements, disinfection and sterilization measures in in accordance with regulatory documents issued by the Ministry of Health of the Russian Federation, state and industry standards, sanitary rules and hygienic standards.

From the above it follows that disinfection measures can significantly reduce the risk of infectious diseases, the damage from eliminating their consequences, and that they are necessary for the proper organization of the work of an enterprise, including a pharmacy. Moreover, the most accessible, simplest and most universal is the chemical method of disinfection. Physical methods of disinfection, such as the use of high temperature, steam under pressure, boiling, UV radiation, ultrasound, require special equipment, specially trained personnel, a lot of time, are often unsafe for human health and must be carried out in their absence. Modern disinfectants used for chemical disinfection are safe for humans, do not damage the surfaces being treated, have a pleasant odor and a cleaning effect. This means that their use can be carried out in the “background” and allows you to combine room cleaning with disinfection. Of course, it is necessary to take into account that infectious agents can change, increasing their resistance, so manufacturers are constantly developing new disinfectants.

Classification of disinfectants

To disinfect products, disinfectants of domestic and foreign production from the following main chemical groups are allowed for use: chlorine-containing, active oxygen-based, alcohol-based, aldehyde-based, cationic surfactants (QAS). In addition, products based on guanidines and tertiary amines have recently appeared.

They have long been used for disinfection and in the recent past they were widely used for almost all disinfection objects. They have a wide spectrum of antimicrobial action, are inexpensive, have a relatively low exposure, and are compatible with soaps. However, their high corrosion activity allows them to be used only for corrosion-resistant surfaces and products. In addition, chlorine-containing preparations cause discoloration and damage to tissues, and have an irritating effect on the mucous membranes of the respiratory and visual organs. When working with high concentration solutions, the use of protective equipment is required. If improperly disposed of, drugs from this group have an adverse effect on the environment and do not meet modern environmental safety requirements.

2. Disinfectants based on active oxygen.

Preparations based on hydrogen peroxide, peroxide compounds, and superacids are the safest for the environment; they decompose into oxygen and water. The wide spectrum of action allows the use of some drugs from this group not only for disinfection, but also for sterilization. The products are low toxic, without a specific odor, and can be used in the presence of people, which is why they are used in obstetric hospitals and newborn departments for treating incubators. New drugs from this group are also used for previous sterilization cleaning, since components with detergent properties have been added to the formulation. Available in the form of powder or granules, which simplifies use, storage and transportation.

3. Disinfectants based on cationic surfactants.

Quaternary ammonium compounds are currently the most widely used. They have cleaning properties and are used for sterilization cleaning of medical products, including combined with disinfection. When using CHAS for routine and general cleaning, surfaces are simultaneously washed and disinfected. Products from this group do not damage instruments and equipment, are low toxic, do not have an irritating effect, and do not have strong odors, therefore they are used for disinfection in places where personnel and patients are constantly present. Disadvantages include the possibility of the emergence of resistant strains of microorganisms.

4. Disinfectants based on tertiary amines (amphotensides).

A completely new type of disinfectants, interest in which is due to their high microbiological activity - they are active against bacteria (including mycobacteria), fungi and viruses, have low toxicity and good cleaning properties. A feature of tertiary alkylamines is that they combine the properties of surfactants and, under certain conditions, the properties of quaternary ammonium salts. And due to the presence of free amino groups and a tertiary nitrogen atom, an alkaline environment is formed, which helps to increase their antimicrobial activity, especially in composition with other substances.

5. Alcohol-based disinfectants. Alcohol-based products based on ethanol, propanol and isopropanol are mainly used as skin antiseptics. To disinfect skin, 70% alcohol is used, because 96% denatures proteins. In addition, it is used in combination with QAS, aldehydes in the form of aerosols to treat small, hard-to-reach surfaces without leaving marks. All alcohols have a broad antimicrobial spectrum (except for spores), evaporate quickly, and leave no traces when evaporated. Products containing alcohols fix organic contaminants, so preliminary cleaning from blood, mucus, pus, or a combination with components with detergent properties is necessary. It is recommended to disinfect metal products with ethyl alcohol. Alcohol-based preparations have been developed to disinfect some dental instruments. Disadvantages include fire and explosion hazards.

6. Aldehyde-based disinfectants.

Aldehyde-containing products based on glutaric, succinic, and orthophthalic aldehydes have a number of advantages: they act on all types of microorganisms, including spores, and do not damage the products being processed, which makes it possible to use them to disinfect equipment of complex configurations. Aldehyde-containing drugs are the drugs of choice when processing endoscopic equipment: high-level disinfection, sterilization of flexible endoscopes and instruments for them. A wide spectrum of antimicrobial action allows their use in departments and offices that require aseptic working conditions and a low level of microbial contamination. However, they are highly toxic, which precludes their use in the presence of patients, and their ability to capture organic contaminants requires careful pre-cleaning of contaminated products.

7. Guanidine-based disinfectants. Guanidines are one of the promisingly developing groups of modern disinfectants with low toxicity, high stability and a gentle effect on objects. Products containing guanidines have a so-called residual effect, that is, they form a bactericidal film on the surface. The low level of toxicity allows the use of hand disinfectants in the food industry. Varnishes and paints with antimicrobial properties have been developed based on guanidines. Disadvantages of guanidine-containing products: their solutions fix organic contaminants, the film is sticky and difficult to remove from surfaces.

8. Phenolic-based disinfectants. One of the first disinfectants, but nowadays they are practically not used in their pure form due to their high toxicity. A special feature of phenols is their ability to create a residual film on disinfected surfaces. Preparations containing phenol derivatives are used to disinfect surfaces and are used in cosmetology and technical fields as preservatives. The drug "Amocid" - a concentrate based on a phenol derivative, is an active tuberculocide. Therefore, it is recommended for use primarily in anti-tuberculosis dispensaries and in centers of tuberculosis for disinfection of surfaces, linen and patient secretions, and for carrying out current and final disinfection.

9. Combined disinfectants. Modern disinfectants are multicomponent formulations, often including several different active ingredients. They also contain solvents, corrosion inhibitors, thickeners, antioxidants, dyes, and fragrances. A huge variety of drugs allows them to be used for various purposes.