The Impact of Biofilms on Cleaning, Disinfection of Surfaces and Reprocessing of Reusable Medical Devices

A special issue of Hygiene (ISSN 2673-947X).

Deadline for manuscript submissions: closed (31 August 2023) | Viewed by 27117

Special Issue Editors

Surgical Infection Research Group, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney 2109, Australia
Interests: biofilms; decontamination; disinfection; medical devices; infection control; chronic infection
Special Issues, Collections and Topics in MDPI journals
1. Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
2. Faculty of Nursing, Universidade Federal de Goiás, Goiânia, Brazil
Interests: biofilms; decontamination; sterilization; disinfection; medical devices
School of Applied Sciences, Edinburgh Napier University, Scotland, UK
Interests: hospital cleaning; antimicrobial management; hospital-acquired infection and MRSA

Special Issue Information

Dear Colleagues,

Biofilms are an aggregation of microorganisms encased by extracellular polymeric substances adhered to surfaces, which protect them from detergent/disinfectant/sterilizing action. When formed on healthcare facility surfaces (dry-surface biofilm), and on reusable medical devices (build-up biofilm), this microbial consortium represents a great challenge for healthcare-associated infection control and prevention. Thus, evidence-based strategies and practices to prevent biofilm formation and the chemical fixation of existing biofilms, as well as to remove biofilms from environmental surfaces and reusable medical devices are required to minimize pathogen transmission and, therefore, to deliver safer care to the patients.

This Special Issue aims to address the improvement of cleaning, disinfection and sterilization at healthcare facilities by presenting evidence-based strategies and practices to prevent biofilm formation, chemical fixation, and to remove biofilms from environmental surfaces and reusable medical devices.

This Special Issue welcomes contributions that discuss, but are not limited to, the following topics:

  • The identification of dry-surface and/or build-up biofilm;
  • Strategies/practices/technologies for the prevention of dry-surface and/or build-up biofilm formation;
  • Strategies/practices/technologies for the prevention of dry-surface and/or build-up biofilm chemical fixation;
  • Strategies/practices/technologies for removing dry-surface and/or build-up biofilm.

Dr. Honghua Hu
Dr. Dayane de Melo Costa
Prof. Dr. Stephanie Dancer
Guest Editors

Manuscript Submission Information

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Keywords

  • biofilms
  • decontamination
  • cleaning
  • disinfection
  • sterilization
  • medical devices
  • healthcare facility surfaces
  • infection control
  • healthcare associated infection

Published Papers (8 papers)

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Editorial

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4 pages, 371 KiB  
Editorial
How Do Biofilms Affect Surface Cleaning in Hospitals?
Hygiene 2022, 2(3), 132-135; https://doi.org/10.3390/hygiene2030011 - 02 Sep 2022
Cited by 5 | Viewed by 1857
Abstract
The science of biofilms is progressing rapidly [...] Full article

Research

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9 pages, 2012 KiB  
Article
Manual Friction with Ethyl Alcohol at 70% (w/v) to Disinfect Three-Way Stopcocks
Hygiene 2023, 3(2), 197-205; https://doi.org/10.3390/hygiene3020014 - 16 May 2023
Viewed by 1471
Abstract
The disinfection procedures aim to reduce the microbial load, but there are doubts about the risks of contamination spreading into the lumens of devices, such as three-way stopcocks (3-WS). This study aimed at an in vitro evaluation of the antibacterial procedure of manual [...] Read more.
The disinfection procedures aim to reduce the microbial load, but there are doubts about the risks of contamination spreading into the lumens of devices, such as three-way stopcocks (3-WS). This study aimed at an in vitro evaluation of the antibacterial procedure of manual friction of 3-WS intentionally contaminated and to determine the solution dispersion into the lumens. Laboratory experiments were developed in two steps: evaluation of bacterial spread through intentional contamination with Staphylococcus aureus and Pseudomonas aeruginosa, and alcohol dispersion into the 3-WS lumens. After manual friction of the 3-WS with saline solution at 0.85% (w/v) [control group], S. aureus and P. aeruginosa were isolated in the lumens of 55.6% and 27.8% of the devices, respectively. However, after the disinfection of the 3-WS with ethyl alcohol at 70% (w/v), there was no bacterial contamination in the lumens of the 3-WS. On the other hand, the solution dispersion (dye) into the lumens was evidenced by two different techniques: Durham tubes (5.6%) and swabs (46.3%). The manual friction of the 3-WS with ethyl alcohol at 70% demonstrated antibacterial efficacy, but it refers to reflections on the risk of solution diffusion into the venous network and the inherent clinical practice situations and patient safety. Full article
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11 pages, 5604 KiB  
Article
Treatment with Gaseous Ozone Significantly Reduced the Number of Bacteria in Extended-Spectrum-β-Lactamase (ESBL)-Producing Escherichia coli Biofilm
Hygiene 2023, 3(2), 125-135; https://doi.org/10.3390/hygiene3020011 - 17 Apr 2023
Cited by 2 | Viewed by 1665
Abstract
Ozone is a triatomic allotropic modification of oxygen with very high oxidation potential and strong antimicrobial properties, and can be used as a disinfecting agent. The aim of this work was to investigate the effectiveness of gaseous ozone in reducing the number of [...] Read more.
Ozone is a triatomic allotropic modification of oxygen with very high oxidation potential and strong antimicrobial properties, and can be used as a disinfecting agent. The aim of this work was to investigate the effectiveness of gaseous ozone in reducing the number of bacteria and the total biomass of E. coli biofilm using different methods of quantification and detection. Biofilm of all tested clinical isolates and standard strain was grown on ceramic tiles with dimensions of 1.0 × 1.0 cm over 24 h. These plates were then treated with gaseous ozone for 1 h. After washing, CFU/cm2 was determined, ATP bioluminescence was measured with a luminometer, and the total biomass reduction was measured after crystal-violet staining. Gaseous ozone proved to be very effective in destroying the created bacterial biofilm on ceramic tiles. Treatment caused a reduction in total bacteria number of up to 2.00 log10CFU/cm2, followed by a reduction in total biomass of up to 61.40%. Inhibition rates varied from 35.80% to 99.41%, depending on the method of quantification used. All methods used in this study are effective in determining the anti-biofilm activity of gaseous ozone, but more research is needed. Full article
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8 pages, 5119 KiB  
Article
Evaluation of the Presence of Biofilms in Corrosive Points in Surgical Instruments after Reprocessing
Hygiene 2022, 2(4), 243-250; https://doi.org/10.3390/hygiene2040022 - 09 Dec 2022
Viewed by 1926
Abstract
Corrosive surgical instruments are routinely observed in central sterile services departments around the world. In addition to other risks, they can harbor microorganisms in the form of biofilms. Thus, this study aimed to evaluate whether biofilms intentionally formed at corrosion points on surgical [...] Read more.
Corrosive surgical instruments are routinely observed in central sterile services departments around the world. In addition to other risks, they can harbor microorganisms in the form of biofilms. Thus, this study aimed to evaluate whether biofilms intentionally formed at corrosion points on surgical instruments are removable by manual and automated cleaning followed by sterilization. Laboratory experiments were performed where samples of corroded surgical instruments in use in practice were evaluated for biofilm presence using a scanning electron microscope. No biofilms were observed in the samples subjected to manual and automated cleaning, nor in the samples in which there was no intentional biofilm formation. Residual organic matter without the presence of microorganisms was observed. Full article
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12 pages, 784 KiB  
Article
Efficacy of Ultraviolet Radiations against Coronavirus, Bacteria, Fungi, Fungal Spores and Biofilm
Hygiene 2022, 2(3), 120-131; https://doi.org/10.3390/hygiene2030010 - 12 Aug 2022
Cited by 11 | Viewed by 6380
Abstract
Ultra-violet (UV) C (200–280 wavelength) light has long been known for its antimicrobial and disinfecting efficacy. It damages DNA by causing the dimerization of pyrimidines. A newly designed technology (MUVi-UVC; Mobile UV Innovations Pty Ltd., Melbourne, VIC, Australia) that emits UVC at 240 [...] Read more.
Ultra-violet (UV) C (200–280 wavelength) light has long been known for its antimicrobial and disinfecting efficacy. It damages DNA by causing the dimerization of pyrimidines. A newly designed technology (MUVi-UVC; Mobile UV Innovations Pty Ltd., Melbourne, VIC, Australia) that emits UVC at 240 nm is composed of an enclosed booth with three UVC light stands each with four bulbs, and has been developed for disinfecting mobile medical equipment. The aim of this project was to examine the spectrum of antimicrobial activity of this device. The experiments were designed following ASTM E1052-20, EN14561, BSEN14476-2005, BSEN14562-2006 and AOAC-Official-Method-966.04 standards for surface disinfection after drying microbes on surfaces. The disinfection was analyzed using Staphylococcus aureus (ATCC 6538), Pseudomonas aeruginosa (6294), Candida auris (CBS 12373), spores of Aspergillus niger (ATCC 16404), coronavirus (SARS-CoV-2 surrogate ATCC VR-261) as well as a methicillin-resistant Staphylococcus aureus (SA31), a carbapenem- and polymyxin-resistant Pseudomonas aeruginosa (PA219), Escherichia coli K12 (ATCC 10798) and Salmonella typhi (ATCC 700730). The parameters of time, the number of lights and direction of the sample facing the lights were examined. The MUVi-UVC was able to kill 99.999% of all of the tested bacteria, fungi, coronavirus and bacteria in the biofilms if used for 5 min using all three lights in the setup with the glass slides in a vertical position. However, for fungal spores, 30 min were required to achieve 99.999% killing. There was a small but insignificant effect of having the surface horizontally or vertically aligned to the UV lights. Therefore, this UVC device is an effective technology to disinfect medical devices. Full article
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Review

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14 pages, 1818 KiB  
Review
The Use of 3D Printing and Nanotechnologies to Prevent and Inhibit Biofilms on Medical Devices
Hygiene 2023, 3(3), 325-338; https://doi.org/10.3390/hygiene3030024 - 19 Sep 2023
Viewed by 1020
Abstract
Biofilms remain one of the most pervasive complications of the medical field, representing 50–70% of all nosocomial infections and up to 80% of total microbial infections. Since biofilms contain intricately small matrices, different microenvironments, and accumulations of biodiverse microorganisms of different resistances, these [...] Read more.
Biofilms remain one of the most pervasive complications of the medical field, representing 50–70% of all nosocomial infections and up to 80% of total microbial infections. Since biofilms contain intricately small matrices, different microenvironments, and accumulations of biodiverse microorganisms of different resistances, these structures end up being difficult to target. As we review in this paper, 3D printing and nanotechnology help overcome these unique challenges of targeting biofilms, especially within the medical field. These technologies bring versatility and more precise control to personalized reusable medical device development and implants, with enhanced antimicrobial characteristics. They allow for decreased surface roughness of the implants, smaller pores, more targeted topography, and even added antibiotic or drug-releasing abilities for the medical devices. Furthermore, combining 3D with nanoparticles allows for the creation of anodized nanosurfaces of medical implants with increased osseointegration and reduced polymerization while promoting cost efficiency, durability, and biocompatibility. In this review, we explore the potentially valuable antimicrobial consequences of applying 3D technology and nanoengineering to dental and orthodontic implants, oral prostheses, hearing aids, joint replacements, catheters, stents, endotracheal tubes, prosthetics, and bone scaffolds. Full article
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22 pages, 8021 KiB  
Review
Antimicrobial Nanomaterials: A Review
Hygiene 2023, 3(3), 269-290; https://doi.org/10.3390/hygiene3030020 - 19 Jul 2023
Cited by 9 | Viewed by 4575
Abstract
Microbial colonization on various surfaces is a serious problem. Biofilms from these microbes pose serious health and economic threats. In addition, the recent global pandemic has also attracted great interest in the latest techniques and technology for antimicrobial surface coatings. Incorporating antimicrobial nanocompounds [...] Read more.
Microbial colonization on various surfaces is a serious problem. Biofilms from these microbes pose serious health and economic threats. In addition, the recent global pandemic has also attracted great interest in the latest techniques and technology for antimicrobial surface coatings. Incorporating antimicrobial nanocompounds into materials to prevent microbial adhesion or kill microorganisms has become an increasingly challenging strategy. Recently, many studies have been conducted on the preparation of nanomaterials with antimicrobial properties against diseases caused by pathogens. Despite tremendous efforts to produce antibacterial materials, there is little systematic research on antimicrobial coatings. In this article, we set out to provide a comprehensive overview of nanomaterials-based antimicrobial coatings that can be used to stop the spread of contamination to surfaces. Typically, surfaces can be simple deposits of nanomaterials, embedded nanomaterials, as well as nanotubes, nanowires, nanocolumns, nanofibers, nanoneedles, and bio-inspired structures. Full article
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9 pages, 4273 KiB  
Review
Providing Sterile Orthopedic Implants: Challenges Associated with Multiple Reprocessing of Orthopedic Surgical Trays
Hygiene 2022, 2(1), 63-71; https://doi.org/10.3390/hygiene2010005 - 14 Mar 2022
Cited by 1 | Viewed by 6912
Abstract
Orthopedic implants, such as screws, are provided in a non-sterile state and must be reprocessed before each use, therefore they may be subjected to multiple reprocessing cycles until they are implanted in the patient. The effect of these various reprocessing cycles on the [...] Read more.
Orthopedic implants, such as screws, are provided in a non-sterile state and must be reprocessed before each use, therefore they may be subjected to multiple reprocessing cycles until they are implanted in the patient. The effect of these various reprocessing cycles on the quality and safety of these implants has been a subject of concern and discussion around the world. In this narrative review, we discuss the four main challenges associated with supplying these non-sterile implants to the same standard, with respect to their quality and safety, as implants that are provided sterile: microbiological contamination (focusing on biofilm), non-microbiological contamination, surface damage, and their acquisition in surgical trays from loaner companies. Full article
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