In a recent report published by the CDC, it is estimated that healthcare-associated infections (HAIs) directly cost U.S. hospitals an estimated $35.7 to $45 billion. With this statistic in mind, choosing the appropriate surface disinfectant is critical to protect your patients, staff and budget.

Because no product is alike, evaluating the main active ingredient of a disinfectant will help you determine the best solution for your healthcare environment.

Cone Instruments carries a wide variety of hospital grade disinfectants containing Quaternary Ammonium Chloride, Alcohol, or Phenol their main active ingredients. While all are effective disinfectants, there are advantages and disadvantages to each that must be considered.

Quaternary Ammonium Chloride (“Quats”)

Quat-based hospital disinfectants are generally fungicidal, bactericidal, and virucidal against lipophilic (enveloped) viruses such as HIV, RSV and hepatitis B. They are not sporicidal, and generally not tuberculocidal or virucidal against hydrophilic (non-enveloped) viruses such as poliovirus, rhinovirus and hepatitis A**.

In addition to serving as disinfectants, quats are also excellent cleaners – making them ideal for ordinary sanitization of non-critical surfaces such as floors, furniture and walls. It is less corrosive than other disinfectant bases, non-carcinogenic and maintains efficacy for extended periods of time, even in the presence of a high soil load.

However, studies have shown that microbicidal properties are reduced when quat-based disinfectants are combined with hard water, or materials such as cotton or gauze pads.

Kill claims vary widely among quat-based disinfectants, so be sure to check kill time before purchasing.

Alcohol

Alcohol-based disinfectants typically come in two forms, ethyl alcohol and isopropyl alcohol. They are bactericidal (rather than bacteriostatic) against vegetative forms of bacteria. They are also tuberculocidal, fungicidal and virucidal, but do not destroy bacterial spores. Depending on the alcohol content, they are highly effective against lipophilic viruses, but isopropyl is ineffective against hydrophilic viruses.

These disinfectants are not as easy to use as quat-based, but are considered easier to use than phenol and chlorine based. Many alcohol-based disinfectants offer a broad spectrum of kill claims, but the rapid evaporation rate can make exposure time difficult.

Concentrations of alcohol vary with the disinfectants on the market. Those with a higher concentration are flammable, cannot be shipped by air (expedited shipping) and must be stored in cool and well-ventilated area. Furthermore, gloves should be worn when handling, because of its tendancy to open up pores and dry skin.

Lower concentrations of alcohol are compatible with most medical device material, and are safe to use on non-porous sufaces, even in high-risk medical environments such as neonatal and infant care areas.

Alcohol-based disinfectants are not recommended for porous surfaces typically found in healthcare facilities such as rubber, plastic tubing and shellac mounting of lensed instruments. Consult your equipment representative to ensure that the disinfectant you choose is safe with their line of equipment.

Phenol

Phenol is one of the oldest known disinfectants and is available in both consumer and hospital-grade strengths.

Commercial-grade phenols are tuberculocidal, fungicidal and virucidal but not sporicidal. They are recommended for use on laboratory surfaces and non-critical medical and surgical items. Due to a toxic residue, phenol-based disinfectants cannot be used on food contact surfaces, or in neonatal or infant care units.

Wearing goggles, gloves, and other PPE equipment is recommended when handling hospital grade phenol-based products; skin and eye irritation has been known to occur.

Cone Instruments is your source for a complete array of surface disinfection products plus a wide range of high-level disinfection solutions, and personal protective equipment. Keep your facility safe with Cone Instruments.

**According to the EPA, the following efficacy claims are defined as follows:

Sporicide/Sterilant - An agent intended to inactivate all living microorganisms, especially bacterial spores (a bacteria that, because of its thick outer wall, is easily able to survive in hostile environments otherwise not conducive to bacterial growth and reproduction).

Tuberculocide - An agent intended to inactive mycobacteria. Tuberculocidal efficacy assumes inactivation of all viruses, fungi and vegetative bacteria (bacteria in growth and reproductive phase).

Virucide - An agent intended to destroy viruses. Virucidal efficacy may vary in regard to lipophilic and hydrophilic viruses.

Fungicide - An agent that inactivates fungi, including fungal spores.

Bactericide - An agent that inactivates vegetative bacteria but not bacterial spores.

The above information should only be used as a guideline of common disinfectants available for hospital-grade use. Each facility is unique; please refer to your facility’s infection control plan, or consult with infection control personnel, for variances specific to your organization.

EPA.gov

Scott RD II. The Direct Medical Costs of Healthcare-Associated Infections in U.S. Hospitals and the Benefits of Prevention. Centers for Disease Control, March 2009

Rutala WA, Weber DJ, HICPAC. Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008. Centers for Disease Control, 2008

Rutala WA. APIC Guideline for Selection and Use of Disinfectants. Association for Professionals in Infection Control and Epidemiology, Inc., August 1996.

Kyle D. Choosing a Disinfectant for Hospital Environments. TGHospital.com. March 2010