Biological monitoring verifies sterilization by confirming that all spore-forming microorganisms have been destroyed.

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Biological monitoring relies on using spores of hardy, spore-forming microorganisms as the test organisms. The basic idea is that if a sterilization cycle can destroy these highly resistant spores, it should kill most other microbes too, ensuring sterility of the load. After a cycle, the spores in a biological indicator are incubated to see if any growth occurs; no growth means the cycle was effective at achieving sterility.

This is different from other checks. Non-spore-forming organisms are not reliable proof of sterilization because they’re killed more easily and don’t challenge the process. Recording how long a cycle runs tells you exposure time, not whether all microbes were destroyed. Checking the chemical potency of sterilants verifies the presence and activity of the chemical, but doesn’t prove that any microorganisms were killed.