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William A. Rutala

Wherever patient care is provided, strict adherence to evidence-based infection prevention guidelines is essential to ensure that all care is safe care.

Healthcare-associated infections (HAIs) are infections caused by a wide variety of common and unusual bacteria, mycobacteria, fungi, and viruses during the course of receiving medical care. Medical advances have brought lifesaving care to patients in need, yet many of those advances come with a risk of HAI. Overall there are an estimated 1.7 million HAIs each year in the United States that cost an estimated $40 billion. These infections related to medical care can be devastating and even deadly. As our ability to prevent HAIs grows, these infections are increasingly unacceptable. Wherever patient care is provided, strict adherence to evidence-based infection prevention guidelines is essential to ensure that all care is safe care.

Each year in the United States there are 46 million procedures performed on hospital inpatients and an estimated 53.3 million surgical and nonsurgical procedures performed during ambulatory surgery visits. For example, there are at least 10 million gastrointestinal endoscopies per year. Each of these procedures involves contact by a medical device or surgical instrument with a patient’s sterile tissue or mucous membranes. A major risk of all such procedures is the introduction of infection. Failure to properly disinfect or sterilize equipment carries not only the risk associated with breach of the host barriers but the additional risk of person-to-person transmission (e.g., hepatitis B virus) and transmission of pathogens that contaminate the environment (e.g., Clostridium difficile).

Achieving disinfection and sterilization through the use of disinfectants and sterilization practices is essential for ensuring that medical and surgical instruments do not transmit infectious pathogens to patients. Because it is unnecessary to sterilize all patient-care items, healthcare policies must identify whether cleaning, disinfection, or sterilization is indicated based primarily on the items’ intended use.

Multiple studies in many countries have documented lack of compliance with established guidelines for disinfection and sterilization. Failure to comply with scientifically-based guidelines has led to numerous outbreaks. The information on this website is maintained by William A. Rutala to assist health care professionals in their judicious selection and proper use of disinfection and sterilization processes and help move health care systems toward elimination of HAIs associated with medical and surgical instruments. It is based on well-designed studies assessing the efficacy (via laboratory investigations) and effectiveness (via clinical studies) of disinfection and sterilization procedures.