Sterility indicators are crucial tools used to verify the effectiveness of sterilization processes.
These indicators ensure that sterilization has been achieved and provide assurance that items are free from viable microorganisms.
There are several types of sterility indicators, each with specific applications and mechanisms.
The main types include biological indicators, chemical indicators, and physical indicators.
Biological Sterility Indicators (BIs)
Principle:
Biological indicators contain highly resistant microorganisms, typically bacterial spores, which serve as a benchmark to test the sterilization process's efficacy.
If the sterilization process kills these resistant spores, it is assumed to be effective against all other microorganisms.
Procedure:
Placement: Place the biological indicator within the sterilization load, in the most challenging location for the sterilant to reach.
Sterilization: Run the sterilization cycle.
Incubation: After sterilization, incubate the indicator under conditions favorable for growth.
Observation: Check for any signs of growth (e.g., turbidity, color change).
No Growth: Indicates successful sterilization.
Growth: Indicates a failure in the sterilization process.
Examples:
Geobacillus stearothermophilus: Used for steam sterilization and hydrogen peroxide gas plasma.
Bacillus atrophaeus: Used for dry heat and ethylene oxide sterilization.
Chemical Sterility Indicators (CIs)
Principle:
Chemical indicators contain substances that change color or form when exposed to certain sterilization conditions.
They provide a visual confirmation that the sterilization process has reached specific parameters (e.g., time, temperature, presence of sterilizing agent).
Types:
Class 1 (Process Indicators): Indicate that the item has been exposed to the sterilization process (e.g., autoclave tape).
Class 2 (Specific Test Indicators): Used for specific tests, such as Bowie-Dick test packs for steam penetration.
Class 3 (Single Parameter Indicators): React to one critical parameter (e.g., temperature).
Class 4 (Multi-Parameter Indicators): React to two or more critical parameters (e.g., time and temperature).
Class 5 (Integrating Indicators): Designed to react to all critical parameters of a specific sterilization process.
Class 6 (Emulating Indicators): Precisely mimic the performance of a specified sterilization process cycle.
Procedure:
Placement: Place the chemical indicator inside or outside the sterilization pack or load.
Sterilization: Run the sterilization cycle.
Observation: Check the indicator for color change or other specified reactions.
Physical Indicators
Principle:
Physical indicators involve the monitoring and recording of the physical parameters of the sterilization process, such as time, temperature, and pressure.
Types:
Thermometers and Thermocouples: Measure temperature.
Pressure Gauges: Measure pressure.
Data Loggers: Record multiple parameters over time.
Procedure:
Setup: Install physical indicators on the sterilization equipment.
Monitoring: Continuously monitor and record data during the sterilization cycle.
Verification: Check recorded data against the sterilization cycle's required parameters to ensure they were met.