Occupational Exposure
Hospital Infections:
Disinfection of Patient Care Equipment
The following general principles apply to most questions CDC receives about
sterilization or disinfection of patient-care equipment in relation to HIV. However,
this information is not comprehensive. Therefore, it is advisable for you to obtain a
copy of the guidelines from which these statements have been derived.
- Commonly used chemical germicides at concentrations much lower than commonly used
in practice can rapidly inactivate HIV.
- Chemical germicides that are registered as "sterilants" with the U.S.
Environmental Protection Agency (EPA) and cleared for marketing as used on medical
devices by Food and Drug Administration (FDA) may be used either for sterilization or
highlevel disinfection of medical devices, depending on contact time.
- In general, reusable instruments or devices that enter sterile tissue including
the vascular system of any patient, and devices through which blood flows should be
sterilized before reuse.
- Reusable devices or items that contact intact mucous membranes should be
sterilized or receive highlevel disinfection before reuse.
- Medical devices that require sterilization or disinfection should be thoroughly
cleaned to reduce material/bioburden before being exposed to the germicide, and the
germicide and device manufacturers' instructions should be closely followed.
- Extraordinary attempts to disinfect surfaces such as walls, floors or other
environmental surfaces are not necessary. However, cleaning and removal of soil
should be done routinely. An inexpensive environmental surface germicide effective
against HIV is a solution of sodium hypochlorite (1 part household bleach to 99 parts
water or 1/4 cup bleach to 1 gallon of water) prepared daily. Bleach, however, is
corrosive to metals (especially aluminum), and should not be used to decontaminate
medical instruments with metallic parts.
Chemical germicides that are EPA-approved for use as "hospital
disinfectants" and are tuberculocidal/virucidal when used at recommended
dilutions and contact times can be used to decontaminate spills of blood or other
body fluids that contain blood in the following areas:
- In patient-care areas, visibly soiled areas should first be cleaned and then
chemically decontaminated. For disinfection, the precleaned areas should be
moistened with the appropriate germicide and allowed to airdry.
- With large spills of cultured or concentrated infectious agents in the
laboratory, the contaminated area should be flooded with a liquid germicide before
cleaning, then decontaminated with fresh germicidal chemical after organic material
has been removed. It is not necessary to flood spills of humansource material with
germicide before cleaning.
Gloves should always be worn during cleaning and decontaminating procedures.
If you have questions about a particular germicidal product, contact your local
or state health department, or the Antimicrobial Program Branch, Registration
Division, Environmental Protection Agency (EPA), telephone no. 703-305-7443.
The EPA is the federal regulatory agency for germicidal chemicals.
If you have questions about cleaning, disinfecting or sterilizing a particular
medical device, first contact the manufacturer of the device. If sufficient
information cannot be obtained in this manner, contact the Food and Drug
Administration (FDA) regional office or the FDA Center for Devices and Radiological
Health, Division of Compliance Program, telephone number 301-443-4690. FDA is the
federal regulatory agency for safe and effective use of medical devices, including
liquid chemical germicides used to disinfect or sterilize medical devices.
From the Centers for Disease Control and Prevention
