Final answer:
If too many microorganisms remain after high-level disinfection, the risk of disease transmission remains high, because the item is not sterile. High-level germicides are typically effective, but their efficiency can be reduced by various factors, including insufficient concentration and exposure time.
Step-by-step explanation:
When high-level disinfecting a device, if too many microorganisms remain on an item after the cleaning process, the risk of transmission remains high, even after cleaning. High-level germicides are designed to kill a wide range of microorganisms, including vegetative cells, fungi, viruses, and endospores, which can lead to sterilization. However, the effectiveness of a disinfectant can be compromised by factors such as insufficient length of exposure, inadequate concentration of disinfectant, temperature, and the presence of organic matter.
Furthermore, it's important to note that certain pathogens, like endospores from bacteria such as Clostridium botulinum, are particularly resistant to microbial control protocols. To ensure that disinfection is effective, the appropriate level and duration of disinfectant exposure must be used for the specific pathogens involved, in combination with other methods such as heat or high pressure, when necessary.