HSM 2433 Mikrobiologi, Penyakit Berjangkit dan .“Prinsip Sterilisasi ... Contaminated solids...

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Transcript of HSM 2433 Mikrobiologi, Penyakit Berjangkit dan .“Prinsip Sterilisasi ... Contaminated solids...

  • HSM 2433

    Mikrobiologi, Penyakit Berjangkit dan Kesihatan Pekerjaan

    Prinsip Sterilisasi

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  • Pengenalan Terma-terma

    Teknik Pensterilan satu teknik untuk membunuh SEMUA mikroorganisma pada sesuatu bahan/permukaan objek (termasuk endospora)

    Dperlukan utk smua peralatan/cecair yg dmasukkan kdlm badan

    Teknik Disinfektan satu teknik untuk MENGURANGKAN BILANGAN mikroorganisma pada sesuatu bahan (tidak termasuk endospora) yg bertujuan mengurangkan jangkitan.

    Antiseptik: agen kimia yg digunakan pada TISU HIDUP

    Agen Disinfektan: agen kimia/fizikal yg dgunakan utk objek BUKAN HIDUP seperti lantai, peralatan hospital dll.

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  • Cleaning/pbersihan Mbuang semua bhn asing (i.e., dirt, body fluids,

    lubricants) pd sesuatu objek dgn mgunakan air + pluntur/ sabun mlalui teknik pcucian (washing) / pberusan (scrubbing)

    WAJIB dlakukan sblm mlakukan teknik disinfeksi atau pensterilan supaya bhn asing pd sesuatu objek tiada sms proses disinfeksi/ pensterilan dilakukan.

    Pasteur Teknik utk mbuang/ mgurangkan patogen termasuk

    mikrob) terutama dlm pyediaan susu dan jus buah.

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  • Teknik Aseptik teknik yg mhalang kontaminasi, terutama mlibatkan

    Peralatan pembedahan,

    Kakitangan perubatan,

    Pesakit semasa pembedahan,

    Penyediaan ubat-ubatan,

    Industri makanan.

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  • DISINFEKTAN

    Mbuang mikrob, ttp tidak sesempurna dlm pensterilan

    Mgunakan kaedah fizikal atau kimia Mudah digunakan Tidak merbahaya kpd peralatan/ kakitangan/ psakit. Tidak mhakis/ mengewap (volatile) Tiada bau busuk

    Cecair Disinfektan: Applied to inanimate objects (bukan hidup) spt alkohol, gluteraldehyde

    Antiseptic: Applied to living tissue

    Pgunaan kaedah mgikut arahan pengeluar sesuatu peralatan/ prosedur prubatan yg ingin dilakukan

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    CECAIR DISINFEKTAN

  • Tahap teknik disinfektan tbahagi kpd 3 kump mgikut prosedur kpd psakit

    High level (Kritikal): mbunuh smua jenis mikrob (endospora, virus, fungus, bakteria tmasuk Mycobacteria) kecuali endospora tertentu = mcapai kesan pensterilan

    Intermediate level (semi- kritikal): menyahaktif/ mbunuh Mycobacteria, bakteria, virus, fungus ttp tidak mbunuh endospora

    Low level (tidak kritikal): mbunuh kbanyakan bakteria, virus dan fungus ttp tidak berupaya pada Mycobacteria/ spora bakteria

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  • Pbezaan tahap disinfektan berasaskan;

    Kepekatan

    Masa dedahan

    Suhu

    Bhn organik tertentu

    pH

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  • Critical

    Enters Sterile tissue or Vascular System

    Examples: Implants, Scalpels needles, surgical and dental equipments, endoscopic accessories

    PROCESS: Sterilization & High level disinfection

    Sterilization: (follow manuf. Instructions for cycle/time)

    Autoclave

    Dry heat

    ETOgas

    Chemical gas sterilizers

    High level disinfection : (pbezaan kepekatan)

    Gluteraldehyde 2%

    Hydrogen peroxide 6% Paracetic acid

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  • Semi-critical

    myentuh membran mukosa or kulit tbuka/ luka:

    Examples: gastroscopy, endoscopy, termometer (do not mix oral and rectal thermometers)

    Process: intermediate level disinfection (exposure time =/

  • Non-Critical

    Touches intact skin Ex: Stethoscopes, tabletops, floors, bedpans,

    furniture Process: low level disinfection (exposure time

  • PENSTERILAN

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  • PENSTERILAN

    Proses yg membunuh semua mikroorganisma termasuk endospora

    Mgunakan kaedah fizikal/ kimia

    Dgunakan bg semua peralatan yg memerlukan kmasukan kdalam badan yg steril, spt darah

    Sblm dilakukan, semua peralatan perlu dibersihkan (cleaning) dan dibungkus utk mmastikan kesterilan dan diletakkan pita pnunjuk (biological indicator tape) bg mmastikan kaedah djalankan dgn sempurna.

    Bungkusan yg TKOYAK, BASAH atau ROSAK dianggap TIDAK STERIL.

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  • Alat pbungkus (kalis dgn kaedah yg ingin digunakan) Kertas tertentu

    Plastik polyethylene dan polypropylene (mgunakan bhn kimia etylene oksida)

    Kain bukan tenunan yg pakai buang

    Botol kaca (steril cecair)

    Smua peralatan yg disteril perlu diletakkan tarikh teknik dilakukan

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  • Teknik sterilisasi

    Fizikal Permanasan basah: Autoklaf (121oC slm 30 min)

    Permanasan kering: utk peralatan perubatan yg bsalur (160oC slm 120 min)

    Radiasi: Gamma & UV

    Penurasan/ filtration

    Suhu rendah (plasma sterilization)

    Chemicals (in liquid or gaseous phase) Liquid: gluteraldehyde, Peracetic acid

    Gas: Ethylene oxide, Formaldehyde

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  • Autoklaf

    Direct exposure to steam (wet) at the required temperature and pressure for

    a specific time: 30 min

    121o C - 123o C (250o F - 254o F)

    Bhn yg boleh diautoklaf

    Culture and stocks of infectious agents (bacteria, mold, viruses)

    Contaminated solids (paper towel, cloth, plastic pipette tips, glassware)

    Discarded live and attenuated vaccines

    Bhn yg x boleh diautoklaf

    Cecair yg mhakis, volatile

    Radioactive material

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  • Kimia Utk bhn yg tidak boleh diautoklaf: sensitif dgn pemanasan

    Material biologi (tisu-tisu kultur)

    Fiber optics

    Plastik

    Mgunakan fasa cecair/ gas

    Gas etelena oksida: most common sterilization method, used for over 70% of total sterilizations, and for 50% of all disposable medical devices.

    Glutaraldehyde and formaldehyde solutions: tisu manusia

    volatile, and toxic by both skin contact and inhalation.

    Many vaccines, such as the original polio vaccine, are sterilized with formaldehyde.

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    http://en.wikipedia.org/wiki/Glutaraldehydehttp://en.wikipedia.org/wiki/Formaldehyde

  • Radiasi Mgunakan radiasi mlli electron

    beams, X-rays, gamma rays, or subatomic particles.

    Gamma rays: disposable medical equipment, such as syringes, needles, cannulas and IV sets.

    Electron beam processing: medical device sterilization.

    Ultraviolet light : useful only for sterilization of surfaces and some transparent objects..

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  • Disinfectants that Inactivate Hepatitis B Virus (HBV)

    The following common disinfectants have been shown to inactivate HBV:

    glutaraldehyde (2%),

    glutaraldehyde-phenate (0.13% glutaraldehyde/.44% phenol),

    iodophor,

    isopropyl alcohol (70%), and

    sodium hypochlorite

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  • Disinfectants that Inactivate Human Immunodeficiency Virus (HIV)

    The following common disinfectants have been shown to inactivate HIV:

    glutaraldehyde (2%),

    hydrogen peroxide (.3%),

    ethyl alcohol (50%),

    isopropyl alcohol (70%),

    phenolics, and

    sodium hypochlorite (50 ppm).

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  • Disinfection-Hand Washing

    Handwashing frequently is called the single most important measure to reduce the risks of transmitting organisms from one person to another or from one site to another on the same patient.)

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  • Dishes, Glasses, Cups, and Eating Utensils

    No special precautions are needed for dishes, glasses, cups, or eating utensils. Either disposable or reusable dishes and utensils can be used for patients on isolation precautions. The combination of hot water and detergents used in hospital dishwashers is sufficient to decontaminate dishes, glasses, cups, and eating utensils.

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  • Pengendalian Bahan Buangan

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  • Cultures and stocks of microorganisms and biologicals

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  • Human Blood & Blood Products

    All human blood (wet or dried)

    Products from human blood.

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  • Pathological Waste

    Human pathological wastes - tissues, organs, body parts, containers of body fluids

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  • Sharps

    Any article that can puncture or cut, and have been used in animal/human patient care or treatment

    Examples: needles, syringes, scalpel blades, razors, forceps

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  • Animal Waste

    Contaminated animal carcasses, body parts, animal bedding known to have been exposed to infectious agents during research

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  • Sekian, terima kasih

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