소독제의 종류와 특성 - gie.or.kr

1 The Korean Journal of Gastrointestinal Endoscopy Room C .. Characteristics and Types of Dysinfectants Hyun-Soo Kim Department of Internal Medicine, Chonnan Naional University Medical School, Gwangju, Korea ..2 Glutaraldehyde .. , pH 2%.. , ( ) .. Glutaraldehyde .. , 1 2 . 3. (semicritical) . Glutaraldehyde , . ethylene oxide ( ) . 2% , . , , .. o , 20 35 C 20 . ( 10 20 , Mycobacteria 20 45 , . 6 10 ), .. Glutaral- dehyde .. glutaraldehyde, or- . thophthaldehyde, peracetic acid/hydrogen peroxide, supero- . Glutaraldehyde , , , . xidized water, peroxygen compounds, alcohol, chlorine.

2 Dioxide . FDA glutaraldehyde, peracetic glutaraldehyde . 4. acid, hydrogen peroxide, peracetic acid/hydrogen peroxide, 35% . orthophthaldehyde 5 , . , , . 1.. 1. Glutaraldehyde , , . Glutaraldehyde 5 2 , , . Glutaraldehyde . 1908 Harries 1974 Azon (Table 1).. Cidex Widex . Cidex . 198 The Korean Journal of Gastrointestinal Endoscopy .. 4. Table 1. Advantages and Disadvantages of Glutaraldehyde Advantages Disadvantages In-use solution stable for 14 days Slow action against bacterial spores and mycobacteria at 25oC. (28 days for one product) (product-specific data) Sensitizing, irritant to skin, eyes and respiratory tract; stains skin.

3 Excellent compatibility with materials: does not damage ventilation is recommended Adverse effects for patients after insufficient rinsing of devices Fixative, tends to create residue film; thorough cleaning is essential Environmental health and safety measures are expensive 4. Table 2. Advantages and Disadvantages of Ortho-phthaldehyde Advantages Disadvantages In-use solution is stable for 7 14 days Slow action against bacterial spores Excellent compatibility with materials; does not damage Irritant to eyes and respiratory tract; stains skin; ventilation is recommended Little data on hazards of long-term exposure and on safe exposure levels "Anaphylaxis-like" reactions after repeated use have been reported in other endoscopy application areas Little data on fixation behavior 1 l g.

4 Widex 2% glutaraldehyde 1/20 . ( , 3 ) 5 l 15 g . glutaraldehyde . pH .. , , .. 2. 2. Ortho-phthaldehyde 3 .. orthophthaldehyde 2 .. 5 . orthophthaladehyde . , , .. Ortho-phthaldehyde (Table 2).. orthophthaldehyde Cidex-OPA .. 3. Peracetic acid/Hydrogen peroxide . 5 glutaraldehyde Peracetic acid hydrogen peroxide . 7% peracetic acid 1 . , , B C 5 hydrogen peroxide .. Peracetic acid (CH3 COOH) . Orthophthaldehyde 1 . 14 ( ) . 5.. , , . , .. glutaraldehyde . glutaraldehyde .. Vol. 41 (Suppl 2), 2010 (198-201) 199.. 900 ml . Scoterin . biofilm . 4 l 90 ml . 5 4 , 80.

5 Peracetic acid . 4. Electrolyzed acid water .. Peracetic acid glutaraldedyde , , , .. pH . ( NaCl) .. pH (H ), (Cl2), (HClO) .. Glutaraldehyde .. pH pH .. Peracetic acid , , . (Table 3).. Perasafe , Perescope , Acecide , Scoterin 2 .. Perasafe . 7 .. o .. 35 C 1 l Perasafe g 24 . 15 .. Perescope . base 1 4,750 ml 2 .. 250 ml . Acecide .. 1 50 ml, 2 50 ml . 4. Table 3. Advantages and Disadvantages of Paracetic Acid Advantages Disadvantages Fast high level disinfection and sporicidal activity Depending on pH value, irritant to skin eyes and respiratory tract;. Preferably single-shot use strong odor of vinegar; ventilation is recommended Depending on formula, in-use solutions are stable for Material compatibility depends on the pH value and temperature.

6 1~14 days endorsement of compatibility with endoscopes and processor is Environmentally friendly substance required No chemical cross-linking of protein residues Acid-related coagulation of proteins is possible, depending on pH. value 4. Table 4. Advantages and Disadvantages of Electrolytically Generated Disinfectants Advantages Disadvantages Fast high level disinfection and sporicidal activity Fast deactivation of in-use solution where residual organic load is present In-use solution is reusableas long as the generator Endorsement of material compatibility with endoscopes is required works (an additional coating might be required with some types of endoscopes In-use solution is nonirritant to skin, eyes, and manufacturer-specific).

7 Respiratory tract Acid-related coagulation of proteins is possible, depending on pH value Waste water restriction for chlorine compounds in some countries 200 The Korean Journal of Gastrointestinal Endoscopy .. 4. Table 5. Advantages and Disadvantages of Chlorine Dioxide Advantages Disadvantages Fast high level disinfection and sporicidal activity Irritant to skin, eyes, and respiratory tract; strong odor of chlorine;. In-use solution stable for 7~14 days ventilation is recommended Damage to endoscopes has been reported; endorsement of compatibility with endoscopes is required (an additional coation might be required with some types of endoscopes - manufacturer specific Waste water restriction for chlorine compounds in some countries.)

8 Electrolyzed acid water 8. Peroxygen compounds (Table 4). glutaraldehyde . Mycobacteria, Enterovirus .. Hicro-S .. Virkon .. Medilox Cleantiop .. 5. Chlorine dioxide . 2 .. , . Chlorine dioxide . (Table 5). , , . 6.. 1.. 2010;. 40:50-52.. 2. , .. , 2005. 7. 3.. 2007;. 34:223-226. Ethyl isopropyl 70% 4. Beilenhoff U, Neumann CS, Rey JF, et al. ESGE-ESGENA gui- . , deline: Cleaning and disinfection in gastrointestinal endoscopy Update 2008. Endoscopy 2008;40:939-957. , . 5.. 2009;39:97-100. Vol. 41 (Suppl 2), 2010 (198-201) 201.