Decontamination: a microbiologist's perspective

The primary objective of decontamination is to protect healthcare workers who handle medical devices from infectious diseases that may be present on those devices. Ideally, the decontamination process should provide both cleaning and biocidal activity. A wide range of equipment, from automatic washer/sterilizers to semi-automated washer/sanitizers are commercially available to satisfy this need. The primary difference between these pieces of equipment, from a microbiology perspective, is in the level of safety they provide. A summary comparison of the decontamination methods is shown in Table 1. Without a doubt, steam sterilization as a method of decontamination provides a greater safety level than may be required. However, the question is, "Do disinfection and sanitization provide an adequate safety level?" Although items do not necessarily need to be sterile to be safe to handle, sterilization processes provide the greatest margin of safety because of the significant microbial lethality and the ability to effectively monitor the process via biological indicators. Sterilization effectively eliminates the concern regarding the nearly unanswerable question of bioburden. Unfortunately, not all items are capable of being processed through a washer/sterilizer. Therefore, consideration must be given to the process compatibility of each device. Disinfection processes provide the next level of safety. Unfortunately, there is no recognized or accepted method for quantitatively describing or monitoring a thermal disinfection process. As is the case with sterilization consideration must be given to the process compatibility of each device. Sanitization provides the lowest level of safety for the decontamination process.(ABSTRACT TRUNCATED AT 250 WORDS)