Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-28T17:39:57.908Z Has data issue: false hasContentIssue false
  • English
  • Français

Is a reduction in viability enough to determine biofilm susceptibility to a biocide?

Published online by Cambridge University Press:  02 March 2021

Katarzyna Ledwoch Open the ORCID record for Katarzyna Ledwoch [Opens in a new window] ,
Maddalena Magoga ,
Dulcie Williams ,
Stefania Fabbri ,
James Walsh  and
Jean-Yves Maillard Open the ORCID record for Jean-Yves Maillard [Opens in a new window]
Katarzyna Ledwoch
Affiliation:
School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, United Kingdom GAMA Healthcare, Watford, United Kingdom
Maddalena Magoga
Affiliation:
School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, United Kingdom
Dulcie Williams
Affiliation:
School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, United Kingdom
Stefania Fabbri
Affiliation:
Perfectus Biomed Group, Cheshire, United Kingdom
James Walsh
Affiliation:
Department of Electrical Engineering and Electronics, School of Electrical Engineering, Electronics & Computer Science, University of Liverpool, Liverpool, United Kingdom
Jean-Yves Maillard*
Affiliation:
School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, United Kingdom
*
Author for correspondence: Prof Jean-Yves Maillard, E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

The abundance and prevalence of dry-surface biofilms (DSBs) in hospitals constitute an emerging problem, yet studies rarely report the cleaning and disinfection efficacy against DSBs. Here, the combined impact of treatments on viability, transferability, and recovery of bacteria from DSBs has been investigated for the first time.

Methods:

Staphylococcus aureus DSBs were produced in alternating 48-hour wet–dry cycles for 12 days on AISI 430 stainless steel discs. The efficacy of 11 commercially available disinfectants, 4 detergents, and 2 contactless interventions were tested using a modified standardized product test. Reduction in viability, direct transferability, cross transmission (via glove intermediate), and DSB recovery after treatment were measured.

Results:

Of 11 disinfectants, 9 were effective in killing and removing bacteria from S. aureus DSBs with >4 log10 reduction. Only 2 disinfectants, sodium dichloroisocyanurate 1,000 ppm and peracetic acid 3,500 ppm, were able to lower both direct and cross transmission of bacteria (<2 compression contacts positive for bacterial growth). Of 11 disinfectants, 8 could not prevent DSB recovery for >2 days. Treatments not involving mechanical action (vaporized hydrogen peroxide and cold atmospheric plasma) were ineffective, producing <1 log10 reduction in viability, DSB regrowth within 1 day, and 100% transferability of DSB after treatment.

Conclusions:

Reduction in bacterial viability alone does not determine product performance against biofilm and might give a false sense of security to consumers, manufacturers and regulators. The ability to prevent bacterial transfer and biofilm recovery after treatment requires a better understanding of the effectiveness of biocidal products.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 42 , Issue 12 , December 2021 , pp. 1486 - 1492
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Goodman, ER, Platt, R, Bass, R, Onderdonk, AB, Yokoe, DS, Huang, S. Impact of an environmental cleaning intervention on the presence of methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci on surfaces in intensive care unit rooms. Infect Control Hosp Epidemiol 2008;29:593–599.CrossRefGoogle ScholarPubMed
Dancer, SJ. Controlling hospital-acquired infection: focus on the role of the environment and new technologies for decontamination. Clin Microbiol Rev 2014;27:665–690.CrossRefGoogle ScholarPubMed
Weber, DJ, Rutala, WA, Miller, MB, Huslage, K, Sickbert-Bennett, E. Role of hospital surfaces in the transmission of emerging healthcare-associated pathogens: norovirus, Clostridium difficile, and Acinetobacter species. Am J Infect Control 2010;38:S25–S33.CrossRefGoogle Scholar
Doll, M, Stevens, M, Bearman, G. Environmental cleaning and disinfection of patient areas. Int J Infect Dis 2018;67:52–57.CrossRefGoogle ScholarPubMed
Holmes, A, Castro-Sánchez, E, Ahmad, R. Guidelines in infection prevention: current challenges and limitations. Br J Health Care Manag 2015;21:275–277.CrossRefGoogle Scholar
Iwami, M, Ahmad, R, Castro-Sánchez, E, Birgand, G, Johnson, AP, Holmes, A. Capacity of English NHS hospitals to monitor quality in infection prevention and control using a new European framework: a multilevel qualitative analysis. BMJ Open 2017;7:e012520.CrossRefGoogle ScholarPubMed
Hu, H, Johani, K, Gosbell, IB, et al. Intensive care unit environmental surfaces are contaminated by multidrug-resistant bacteria in biofilms: combined results of conventional culture, pyrosequencing, scanning electron microscopy, and confocal laser microscopy. J Hosp Infect 2015;91:35–44.CrossRefGoogle ScholarPubMed
Almatroudi, A, Gosbell, IB, Hu, H, et al. Staphylococcus aureus dry-surface biofilms are not killed by sodium hypochlorite: implications for infection control. J Hosp Infect 2016;93:263–270.CrossRefGoogle Scholar
Yezli, S, Otter, JA. Does the discovery of biofilms on dry hospital environmental surfaces change the way we think about hospital disinfection? J Hosp Infect 2012;81:292–294.CrossRefGoogle ScholarPubMed
Vickery, K, Deva, A, Jacombs, A, Allan, J, Valente, P, Gosbell, IB. Presence of biofilm containing viable multiresistant organisms despite terminal cleaning on clinical surfaces in an intensive care unit. J Hosp Infect 2012;80:52–55.CrossRefGoogle Scholar
Almatroudi, A, Hu, H, Deva, A, et al. A new dry-surface biofilm model: an essential tool for efficacy testing of hospital surface decontamination procedures. J Microbiol Methods 2015;117:171–176.CrossRefGoogle ScholarPubMed
Schultz, G, Bjarnsholt, T, James, GA, et al. Consensus guidelines for the identification and treatment of biofilms in chronic nonhealing wounds. Wound Rep Reg 2017;25:744–757.CrossRefGoogle ScholarPubMed
Han, Q, Song, X, Zhang, Z, et al. Removal of foodborne pathogen biofilms by acidic electrolyzed water. Front Microbiol 2017;8:988.CrossRefGoogle ScholarPubMed
Chowdhury, D, Tahir, S, Legge, M, et al. Transfer of dry surface biofilm in the healthcare environment: the role of healthcare workers’ hands as vehicles. J Hosp Infect 2018;100:e85–e90.CrossRefGoogle ScholarPubMed
Han, JH, Sullivan, N, Leas, BF, Pegues, DA, Kaczmarek, JL, Umscheid, CA. Cleaning hospital room surfaces to prevent health care-associated infections: a technical brief. Ann Intern Med 2015;163:598–607.CrossRefGoogle ScholarPubMed
Holah, JT, Taylor, JH, Dawson, DJ, Hall, KE. Biocide use in the food industry and the disinfectant resistance of persistent strains of Listeria monocytogenes and Escherichia coli . J Appl Microbiol 2002;92:111S–20S.CrossRefGoogle ScholarPubMed
Ledwoch, K, Said, J, Norville, P, Maillard, J.-Y. Artificial dry surface biofilm models for testing the efficacy of cleaning and disinfection. Lett Appl Microbiol 2019;68:329–336.CrossRefGoogle ScholarPubMed
ASTM Standard E2967-15. Standard test method for assessing the ability of pre-wetted towelettes to remove and transfer bacterial contamination on hard, nonporous environmental surfaces using the Wiperator. West Conshohocken, PA: ASTM International; 2015.Google Scholar
Modic, M, McLeod, NP, Sutton, JM, Walsh, JL. Cold atmospheric pressure plasma elimination of clinically important single- and mixed-species biofilms. Int J Antimicrob Agents 2017;49:375–378.CrossRefGoogle ScholarPubMed
BS EN 13697:2015+A1:2019 Standard. Chemical disinfectants and antiseptics—Quantitative non-porous surface test for the evaluation of bactericidal and/or fungicidal activity of chemical disinfectants used in food, industrial, domestic and institutional areas—Test method and requirements without mechanical action (phase 2, step 2). London: The British Standards Institution; 2019.Google Scholar
The National Specifications for Cleanliness in the NHS: A Framework for Setting and Measuring Performance Outcomes. London: National Patient Safety Agency; 2007.Google Scholar
Ramphal, L, Suzuki, S, McCracken, IM, Addai, A. Improving hospital staff compliance with environmental cleaning behavior. Proc (Bayl Univ Med Cent) 2014;27:88–91.CrossRefGoogle ScholarPubMed
Otter, JA, Yezli, S, Salkeld, JAG, French, GL. Evidence that contaminated surfaces contribute to the transmission of hospital pathogens and an overview of strategies to address contaminated surfaces in hospital settings. Am J Infect Control 2013;41:S6–S11.CrossRefGoogle Scholar
Tahir, S, Chowdhury, D, Legge, M, et al. Transmission of Staphylococcus aureus from dry surface biofilm (DSB) via different types of gloves. Infect Control Hosp Epidemiol 2019;40:60–64.CrossRefGoogle ScholarPubMed
Ledwoch, K, Dancer, SJ, Otter, JA, et al. Beware biofilm! Dry biofilms containing bacterial pathogens on multiple healthcare surfaces; a multicentre study. J Hosp Infect 2018;100:e47–e56.CrossRefGoogle Scholar
Siani, H, Maillard, J-Y. Best practice in healthcare environment decontamination. Eur J Clin Microbiol Infect Dis 2015;34:1–11.CrossRefGoogle ScholarPubMed
Sattar, SA, Maillard, J-Y. The crucial role of wiping in decontamination of high-touch environmental surfaces: review of current status and directions for the future. Am J Infect Control 2013;41:S97–S104.CrossRefGoogle ScholarPubMed
Wesgate, R, Robertson, A, Barrell, M, Teska, P, Maillard, J-Y. Impact of test protocols and material binding on the efficacy of antimicrobial wipes. J Hosp Infect 2019;103:e25–e32.CrossRefGoogle ScholarPubMed
Chapter, Sandle T. 17—Assessing, controlling, and removing contamination risks from the process. In: Sandle T. Biocontamination Control for Pharmaceuticals and Healthcare. London: Elsevier; 2019:287–314.CrossRefGoogle Scholar
Moore, G, Dunnill, CW, Wilson, APR. The effect of glove material upon the transfer of methicillin-resistant Staphylococcus aureus to and from a gloved hand. Am J Infect Control 2013;41:19–23.CrossRefGoogle ScholarPubMed
Supplementary material: File

Ledwoch et al. supplementary material

Figures S1-S3

Download Ledwoch et al. supplementary material(File)
File 29.3 MB