Heat: most important and widely used. For sterilization one must consider the type of heat, and most importantly, the time of application and temperature to ensure destruction of all microorganisms. Endospores of bacteria are considered the most thermoduric of all cells so their destruction guarantees sterility.
Incineration: burns organisms and physically destroys them. Used for needles, inoculating wires, glassware, etc. and objects not destroyed in the incineration process.
Boiling: 100°C for 30 minutes. Kills everything except some endospores. To kill endospores, and therefore sterilize a solution, very long (>6 hours) boiling, or intermittent boiling is required (See Table 1 below).
Autoclaving (steam under pressure or pressure cooker)
Autoclaving is the most effective and most efficient means of sterilization. All autoclaves operate on a time/temperature relationship. These two variables are extremely important. Higher temperatures ensure more rapid killing. The usual standard temperature/pressure employed is 121°C/15 psi for 15 minutes. Longer times are needed for larger loads, large volumes of liquid, and more dense materials. Autoclaving is ideal for sterilizing biohazardous waste, surgical dressings, glassware, many types of microbiologic media, liquids, and many other things. However, certain items, such as plastics and certain medical instruments (e.g. fiber-optic endoscopes), cannot withstand autoclaving and should be sterilized with chemical or gas sterilants. When proper conditions and time are employed, no living organisms will survive a trip through an autoclave.
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Schematic diagram of a laboratory autoclave in use to sterilize microbiological culture medium. Sterilization of microbiological culture media is is often carried out with the autoclave. When microbiological media are prepared, they must be sterilized and rendered free of microbial contamination from air, glassware, hands, etc. The sterilization process is a 100% kill, and guarantees that the medium will stay sterile unless exposed to contaminants.
An autoclave for use in a laboratory or hospital setting.
Why is an autoclave such an effective sterilizer? The autoclave is a large pressure cooker; it operates by using steam under pressure as the sterilizing agent. High pressures enable steam to reach high temperatures, thus increasing its heat content and killing power. Most of the heating power of steam comes from its latent heat of vaporization. This is the amount of heat required to convert boiling water to steam. This amount of heat is large compared to that required to make water hot. For example, it takes 80 calories to make 1 liter of water boil, but 540 calories to convert that boiling water to steam. Therefore, steam at 100°C has almost seven times more heat than boiling water.
Moist heat is thought to kill microorganisms by causing denaturation of essential proteins. Death rate is directly proportional to the concentration of microorganisms at any given time. The time required to kill a known population of microorganisms in a specific suspension at a particular temperature is referred to as thermal death time (TDT). Increasing the temperature decreases TDT, and lowering the temperature increases TDT. Processes conducted at high temperatures for short periods of time are preferred over lower temperatures for longer times.
Environmental conditions also influence TDT. Increased heat causes increased toxicity of metabolic products and toxins. TDT decreases with pronounced acidic or basic pHs. However, fats and oils slow heat penetration and increase TDT. It must be remembered that thermal death times are not precise values; they measure the effectiveness and rapidity of a sterilization process. Autoclaving 121°C/15 psi for 15 minutes exceeds the thermal death time for most organisms except some extraordinary sporeformers.
Dry heat (hot air oven): basically the cooking oven. The rules of relating time and temperature apply, but dry heat is not as effective as moist heat (i.e., higher temperatures are needed for longer periods of time). For example 160°/2hours or 170°/1hour is necessary for sterilization. The dry heat oven is used for glassware, metal, and objects that won’t melt.
Irradiation: usually destroys or distorts nucleic acids. Ultraviolet light is commonly used to sterilize the surfaces of objects, although x-rays, gamma radiation and electron beam radiation are also used.
Ultraviolet lamps are used to sterilize workspaces and tools used in microbiology laboratories and health care facilities. UV light at germicidal wavelengths (two peaks, 185 nm and 265 nm) causes adjacent thymine molecules on DNA to dimerize, thereby inhibiting DNA replication (even though the organism may not be killed outright, it will not be able to reproduce). However, since microorganisms can be shielded from ultraviolet light in fissures, cracks and shaded areas, UV lamps should only be used as a supplement to other sterilization techniques.
An ultraviolet sterilization cabinet
Gamma radiation and electron beam radiation are forms of ionizing radiation used primarily in the health care industry. Gamma rays, emitted from cobalt-60, are similar in many ways to microwaves and x-rays. Gamma rays delivered during sterilization break chemical bonds by interacting with the electrons of atomic constituents. Gamma rays are highly effective in killing microorganisms and do not leave residues or have sufficient energy to impart radioactivity.
Electron beam (e-beam) radiation, a form of ionizing energy, is generally characterized by low penetration and high-dose rates. E-beam irradiation is similar to gamma radiation in that it alters various chemical and molecular bonds on contact. Beams produced for e-beam sterilization are concentrated, highly-charged streams of electrons generated by the acceleration and conversion of electricity.
e-beam and gamma radiation are for sterilization of items ranging from syringes to cardiothoracic devices.
Filtration involves the physical removal (exclusion) of all cells in a liquid or gas. It is especially important for sterilization of solutions which would be denatured by heat (e.g. antibiotics, injectable drugs, amino acids, vitamins, etc.). Portable units can be used in the field for water purification and industrial units can be used to “pasteurize” beverages. Essentially, solutions or gases are passed through a filter of sufficient pore diameter (generally 0.22 micron) to remove the smallest known bacterial cells.
This water filter for hikers and backpackers is advertised to “eliminate Giardia, Cryptosporidium and most bacteria.” The filter is made from 0.3 micron pleated glass fiber with a carbon core.
A typical set-up in a microbiology laboratory for filtration sterilization of medium components that would be denatured or changed by heat sterilization. The filter is placed (aseptically) on the glass platform, then the funnel is clamped and the fluid is drawn by vacuum into a previously sterilized flask. The recommended size filter that will exclude the smallest bacterial cells is 0.22 micron.
Chemical and gas
Chemicals used for sterilization include the gases ethylene oxide and formaldehyde, and liquids such as glutaraldehyde. Ozone, hydrogen peroxide and peracetic acid are also examples of chemical sterilization techniques are based on oxidative capabilities of the chemical.
Ethylene oxide (ETO) is the most commonly used form of chemical sterilization. Due to its low boiling point of 10.4°C at atmospheric pressure, EtO) behaves as a gas at room temperature. EtO chemically reacts with amino acids, proteins, and DNA to prevent microbial reproduction. The sterilization process is carried out in a specialized gas chamber. After sterilization, products are transferred to an aeration cell, where they remain until the gas disperses and the product is safe to handle.
ETO is used for cellulose and plastics irradiation, usually in hermetically sealed packages. Ethylene oxide can be used with a wide range of plastics (e.g. petri dishes, pipettes, syringes, medical devices, etc.) and other materials without affecting their integrity.
An ethylene oxide sterilization gas chamber.
Ozone sterilization has been recently approved for use in the U.S. It uses oxygen that is subjected to an intense electrical field that separates oxygen molecules into atomic oxygen, which then combines with other oxygen molecules to form ozone.
Ozone is used as a disinfectant for water and food. It is used in both gas and liquid forms as an antimicrobial agent in the treatment, storage and processing of foods, including meat, poultry and eggs. Many municipalities use ozone technology to purify their water and sewage. Los Angeles has one of the largest municipal ozone water treatment plants in the world. Ozone is used to disinfect swimming pools, and some companies selling bottled water use ozonated water to sterilize containers.
An ozone fogger for sterilization of egg surfaces. The system reacts ozone with water vapors to create powerful oxidizing radicals. This system is totally chemical free and is effective against bacteria, viruses and hazardous microorganisms which are deposited on egg shells.
An ozone sterilizer for use in the hospital or other medical environment.
Low Temperature Gas Plasma (LTGP) is used as an alternative to ethylene oxide. It uses a small amount of liquid hydrogen peroxide (H2O2), which is energized with radio frequency waves into gas plasma. This leads to the generation of free radicals and other chemical species, which destroy organisms.
An LTGP sterilizer that pumps vaporized H2O2 into the chamber.
We sterilize most media and supplies using a steam autoclave to produce moist heat. Other methods, including filtration, ethylene oxide, radiation, or ultraviolet light, may be necessary if components are heat-labile or materials are not heat-resistant.
An autoclave is designed to deliver steam into a pressure chamber, generating high heat and pressure at the same time. Heating media to above 121 degrees C for 4 to 20 min. destroys nearly all living cells and spores. High pressure (typically 20 lbs/sq. in) allows the temperature to exceed 100 degrees, which can’t be accomplished with steam at one atmosphere. We use an autoclave that starts timing when the temperature reaches 121 degrees, and exhausts the steam slowly after the prescribed time above 121 degrees (to prevent exploding bottles!). The autoclave is effectively a giant pressure cooker.
[ILLUSTRATION]
To properly use an autoclave
Know the instrument – some are fully automatic, some are fully manual
Prepare supplies properly – the more layers or greater the volume, the longer it will take for the interior to heat up
Check the steam pressure and ensure that the instrument is set for slow exhaust if liquids are to be sterilized
Ensure that the door is closed properly and securely
Check that the time and/or automatic cycle are set properly
Ensure that the temperature is well below 100 degrees before attempting to open the door
Crack the door to allow steam to vent, keeping face and hands well away from the opening
***CAUTION*** Exposing tightly stoppered bottles to variable pressures invites explosion and injury. When heating any liquids using any method, take care disturbing the flask or bottle. Material near the bottom may be superheated and boil over when moved. Stoppers, caps, covers, must be vented – never make them fit tightly.
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