Related Experiment Videos
Disinfection and sterilization practices in Mexico
M Zaidi1, M Angulo, J Sifuentes-Osornio
1Departamento de Investigación, Hospital General O'Horán, Merida, Yucatan, Mexico.
Abstract:
We evaluated antisepsis, disinfection, and sterilization procedures at 22 hospitals in the state of Yucatan, Mexico, which provide services for approximately 80% of the population. The percentage of hospitals that followed standard recommendations for diverse antisepsis procedures were as follows: surgical scrub, 41%; surgical site preparation, 68%; central intravenous (iv) catheters, 61%; peripheral iv catheters, 86%; urinary catheters, 41%, and umbilical cord care, 5%. Inappropriate procedures typically involved the use of benzalkonium chloride and mercury compounds. Adequate sterilization procedures were observed for sharp surgical instruments in 9%, for blunt surgical instruments in 81%; for linen in 90%; for surgical brushes in 9%; for metal prostheses in 100%; for plastic prostheses in 57%; and for disinfection of endoscopes in 30%. The most common errors were the use of too short an exposure time in steam sterilizers or dry heat sterilizers, and the use of benzalkonium chloride as a sterilizing agent. Only 14% of hospitals used commercial spore preparations for autoclave monitoring. For the reuse of disposables, 50-94% of hospitals employed inappropriate sterilization or low-level disinfection procedures. Similar conditions are likely to exist in hospitals throughout the country. The establishment of strict regulations and hospital training programmes for disinfection and sterilization procedures, and the reuse of disposable devices is urgently needed in Mexico.
Insights
Hospital infection control in Mexico is lacking, with many facilities failing to follow standard antisepsis, disinfection, and sterilization procedures. Urgent improvements in regulations and training are needed to prevent patient harm from inadequate practices.
Area of Science:
- Healthcare quality and safety
- Infection prevention and control
- Medical microbiology
Background:
- Antisepsis, disinfection, and sterilization are critical for preventing healthcare-associated infections.
- Adherence to established protocols is essential for patient safety.
- Previous assessments of these practices in Mexico are limited.
Purpose of the Study:
- To evaluate the adherence to standard recommendations for antisepsis, disinfection, and sterilization procedures in hospitals in Yucatan, Mexico.
- To identify common errors and deficiencies in these critical healthcare processes.
- To highlight the need for improved regulatory oversight and training programs.
Main Methods:
- A cross-sectional study was conducted in 22 hospitals in Yucatan, Mexico.
- Data were collected on adherence to standard protocols for various antisepsis procedures (e.g., surgical scrub, catheter care).
- Sterilization practices for surgical instruments, linen, prostheses, and endoscopes were assessed, along with autoclave monitoring and disposable device reuse.
Main Results:
- Adherence to standard antisepsis recommendations varied widely, with low rates for surgical scrub (41%) and umbilical cord care (5%).
- Adequate sterilization of sharp surgical instruments (9%) and endoscopes (30%) was poor, with common errors including insufficient exposure times and use of inappropriate agents like benzalkonium chloride.
- Only 14% of hospitals used spore tests for autoclave monitoring, and 50-94% inappropriately reused disposable devices.
Conclusions:
- Significant deficiencies exist in antisepsis, disinfection, and sterilization practices in Yucatan hospitals, posing a risk of healthcare-associated infections.
- Inappropriate use of chemicals (benzalkonium chloride, mercury compounds) and inadequate sterilization times were prevalent issues.
- There is an urgent need for strict regulations, comprehensive training programs, and improved oversight for disinfection, sterilization, and the reuse of disposable medical devices in Mexico.