High-Level Disinfection


 Infections from pathogens being transmitted from medical instruments and equipment is a very real risk that must be dealt with very seriously. The protocols and products used must be carefully considered and selected with a full understanding of their strengths and weaknesses to keep patients safe.

There's a number of medical instruments and equipment that cannot be cleaned and sterilized utilizing heat. The answer for most of these situations including most endoscopes is the use of a high-level disinfectant.

You might be asking what "high-level disinfection" actually means. Well arguably the two best definitions might come from the CDC and the FDA. The CDC indicates that "complete elimination of all microorganisms in or on an instrument, except for small numbers of bacterial spores". The FDA's definition indicates "a sterilant used for a shorter contact time to achieve a 6-log10 kill of an appropriate Mycobacteriumspecies."

There are several classification categories used to identify the infectious risk level that you're dealing with. The highest level is "Critical".

Critical items are the items or equipment that come into contact with sterile human tissue (e.g. body cavities) or the blood stream. Some examples outlined by the CDC are: surgical instruments, implants, ultrasound probes, and cardiac and urinary catheters.

The second category is "SemiCritical". The semi-critical category deals with items and equipment that come into contact with mucous membranes or non-intact skin. Some endoscopes fall under the semicritical category, but be sure to check with the manufacturer of your endoscope to be sure.

Noncritical items and equipment may come into contact with skin but don't come into contact with mucous membranes.

In 1999 the FDA approved OPA (ortho-phthalaldehyde) to be used as a high-level disinfectant. It was quickly adopted as the standard globally due to its "excellent microbiocidal activity in vitro studies". Here at MedServiceRepair.com we currently carry two OPA solutions, Rapicide and MetriCide. 

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