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Special Problems Related to Some of the Emerging Pathogens and Best Practices

While most of the microorganisms listed above can be controlled with appropriate cleaning techniques and chemical disinfectants or sterilants, there are some pathogens that are resistant to these techniques. These pathogens are Cryptosporidium and H. pylori.

Cryptosporidium is resistant to chlorine at the normal concentrations found in potable water. It is also resistant to ethyl alcohol, glutaraldehyde, 5.25% hypochlorite, peracetic acid, and phenols. The only thing that works as a disinfectant or sterilant is 6% or 7.5% hydrogen peroxide used after thorough cleaning of the area. Sterilization using steam, ethylene oxide gas, or hydrogen peroxide gas plasma will fully deactivate the Cryptosporidium and spores.

H. pylori is resistant to formalin and cleaning with soap and water as well as ethanol. Mechanically washing endoscopes and disinfecting with 2% glutaraldehyde for 20 minutes is effective.

Rotaviruses may be resistant to quaternary ammonium chloride compounds. After proper cleaning and rinsing, 2% glutaraldehyde, 800 ppm free chlorine, and sodium hypochlorite and certain phenol- based compounds can decontaminate surfaces and destroy the rotavirus. On skin, the rotavirus can be destroyed with 95% ethanol.

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