CURRENT STERILIZATION PROCEDURES ACCOMPLISHED BY LIQUID CHEMICALS : Presented at the Twentieth Anniversary Symposium of the Research Committee on Sterilization of Medical Products The Medical Instrument Society of Japan-November, 1987
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概要
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A major strategy in the control of hospital-acquired infections in the U.S. is the effective use of antiseptics, disinfectants and sterilization procedures. In hospitals physical agents such as steam sterilizers and dry hear sterilizers are the most frequently used procedures for sterilizing fluids and medical devices. Ethylenen oxide gas is also used but in recent years the frequency with which items are sterilized by EO has decreased. There are a number of liquid chemical germicides that have been approved by the U.S. Environmental Protection Agency for purposed of sterilization. However, these chemical germicides are used primarily for the purposes of disinfection rather than sterilization of medical devices. Infections transmitted to patients that are the result of inadequate disinfection procedures most often are due to procedural errors made by hospital personnel rather than problems associated with the potency and efficacy of the chemical germicide. There is a trend in the U.S., with certain types of critical medical devices such as endoscopes and other lensed instruments as well as hemodyalyzers, to perform high-level disinfection rather than sterilization procedures. When these high-level disinfection procedures are performed adequately, there appears to be no associated infection transmission problems. However, it is easier to make procedural errors which can result in infection transmission. The reuse of disposable medical devices has incerased in the U.S. For example, the disposable hemodialyzer is reused on the average approximately 10 times. In 1987 63% of U.S. dialysis centers reprocessed hemodialyzers which represented 69% of the dialysis patient population.In the U.S. the Environmental Protection Agency approves the use of chemical germicides used as disinfectants and sterilants. On the ther hand the Food and Drug Administration categorizes antimicrobial agents that are used as antiseptics, surgical scrubs and in handwashing preparation. There are a number of research studies and policy changes that are needed for the future. The standaard tests to determine the efficacy of chemical germicides need to be improved. A simplified method is needed to allow health care workers to make judgements on the current use of chemical germicides that are sold in the U.S. Currently, there are approximately 300 active ingredients that have been registered with the EPA and approved for use in chemical germicides. About 14 of them are in 92% of the registered products and there are approximately 14,000 products.
- 日本医療機器学会の論文
- 1988-07-01