Selection of Disinfection or Sterilization

Here is a chart which identifies different types of equipment and indicates the level of disinfection or sterilization needed. [1,2] Editor's note: The following chart was originally published in Preventing Infection in Ambulatory Care, the quarterly e-publication from APIC.


Level of


or Sterilization





Procedure Needed






Critical devices

Instruments or objects introduced directly into the body either through the bloodstream or sterile areas of the body

Sterilization High risk of transmission of infection

Kill all microorganisms including spores

Surgical instruments, needles, transfer forceps, inner surfaces of heart-lung machine, blood oxygenators, and blood compartments of hemodialyzers

Semicritical devices

Contact intact mucous membranes or non-intact skin

Sterilization, if possible, or at a minimum, meticulous physical cleaning and high-level disinfection

All microorganisms except large number of spores

Noninvasive, flexible and rigid fiberoptic endoscopes, endotrachael and aspirator tubes, bronchoscopes, laryngoscopes, respiratory therapy equipment, cystoscopes, vaginal specula, and urinary catheters

Non-critical devices

Contact only intact skin

Detergent and warm water

Removal of pathogenic organisms

Surgical facemasks, blood pressure cuffs, neurologic and cardiac diagnostic electrodes, surfaces of radiology machines

Environmental surfaces

Surfaces that usually do not contact patients or if do, only intact skin

Soap and water


Germicidal detergent


Soap and water, followed by low to intermediate-level disinfection


Water and detergent, or a hospital-grade disinfectant-detergent designed for housekeeping

Removal of pathogenic organisms

Medical equipment surfaces


Housekeeping surfaces



1. Association for the Advancement of Medical Instrumentation. Comprehensive

guide to steam sterilization and sterility assurance in health care facilities. ANSI/AAMI ST79:2006, A1:2008 and A2:2009.


2. The Centers for Disease Control and Prevention 2. (CDC) Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008.


Read more from APIC:


- Updating Our Understanding of "Flash" Sterilization: The Need to Improve Practices


- Understanding and Controlling the Hazards of Surgical Smoke


- APIC Announces 2011 Recipient of Carole DeMille Achievement Award

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