Factors Affecting Bacterial Adhesion on Selected Textile Fibres

Clinical study of antibacterial medical textiles containing polyhydroxyalkanoate oligomers for reduction of hospital-acquired infections

INTRODUCTION

The prevention and control of hospital-acquired infections remain a significant challenge worldwide, as textiles used in hospital wards are highly involved in transmission processes. This paper reports a new antibacterial medical fabric used to prepare hospital pillowcases, bottom sheets and quilt covers for controlling and reducing hospital-acquired infections.

METHOD

The medical fabric was composed of blended yarns of staple polyester (PET) and degradable poly(3-hydroxybutyrate co-3-hydroxyvalerate) (PHBV)/polylactic acid (PLA) fibres, which were coated with polylactide oligomers (PLAO), which are environmentally friendly and safe antimicrobial agents with excellent thermal stability in high-temperature laundry. A clinical trial was conducted, with emphasis on the bacterial species that were closely related to the infection cases in the study hospital.

RESULT

After 7 days of use, 94% of PET/PHBV/PLA-PLAO fabric retained <20 colony-forming units/100 cm2 of the total bacterial amount, meeting hygiene and cleanliness standards.

CONCLUSION

This study demonstrates the potential of fabrics containing polyhydroxyalkanoate oligomers as highly effective, safe and long-lasting antimicrobial medical textiles that can effectively reduce the incidence of hospital-acquired infections.

Factors affecting biofilm formation by bacteria on fabrics

Fabrics act as fomites for microorganisms, thereby playing a significant role in infection transmission, especially in the healthcare and hospitality sectors. This study aimed to examine the biofilm formation ability of four nosocomial infection-causing bacteria (Acinetobacter calcoaceticus, Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus) on cotton, polyester, polyester-cotton blend, silk, wool, viscose, and nylon, used frequently in the healthcare sector, by qualitative and quantitative methods. The impact of temperature, pH, and relative humidity (RH) on biofilm formation was also assessed. P. aeruginosa and S. aureus were strong biofilm producers, while E. coli produced weak biofilm. Wool (maximum roughness) showed the highest bacterial load, while silk (lowest roughness) showed the least. P. aeruginosa exhibited a higher load on all fabrics, than other test bacteria. Extracellular polymeric substances were characterized by infrared spectroscopy. Roughness of biofilms was assessed by atomic force microscopy. For biofilm formation, optimum temperature, pH, and RH were 30 °C, 7.0, and 62%, respectively. MgCl2 and CaCl2 were the most effective in removing bacterial biofilm. In conclusion, biofilm formation was observed to be influenced by the type of fabric, bacteria, and environmental conditions. Implementing recommended guidelines for the effective disinfection of fabrics is crucial to curb the risk of nosocomial infections. In addition, designing modified healthcare fabrics that inhibit pathogen load could be an effective method to mitigate the transmission of infections.

Biohybrids: Textile fibres provide scaffolds and highways for microbial translocation

Introduction: Living materials (biohybrids, textile-microbial hybrids, hybrid living materials) have gained much attention in recent years with enormous potential for applications in biomedical science, the built environment, construction and architecture, drug delivery and as environmental biosensors. Living materials contain matrices which incorporate microorganisms or biomolecules as the bioactive components. A cross-disciplinary approach, operating at the intersection of creative practice and scientific research, incorporated textile technology and microbiology to demonstrate textile fibres providing microbial scaffolds and highways during this study. Methods: The study evolved from previous research which showed bacteria utilising the water layer surrounding fungal mycelium for motility, termed the 'fungal highway', which led to the investigation of the directional dispersal of microbes across a range of fibre types (natural and synthetic). The application of the study centred around the potential for biohybrids to be used as a biotechnology to improve oil bioremediation through seeding of hydrocarbon-degrading microbes into polluted environments via fungal or fibre highways, therefore treatments in the presence of crude oil were tested. Furthermore, from a design perspective, textiles have huge potential to act as a conduit for water and nutrients, essential to sustain microorganisms within living materials. Using the moisture absorption properties of natural fibres, the research explored how to engineer variable liquid absorption rates using cellulosics and wool to produce shape-changing knitted fabrics suitable for adaptation to oil spill capture. Results: At a cellular scale, confocal microscopy provided evidence to show that bacteria were able to utilise a water layer surrounding the fibres, supporting the hypothesis that fibres can aid bacterial translocation through their use as 'fibre highways'. A motile bacterial culture, Pseudomonas putida, was shown to translocate around a liquid layer surrounding polyester, nylon, and linen fibres, yet no evidence of translocation was apparent on silk or wool fibres, suggesting microbes elicit different responses to specific fibre types. Findings showed that translocation activity around highways did not diminish in the presence of crude oil, known to contain an abundance of toxic compounds, in comparison to oil-free controls. A design series demonstrated the growth of fungal mycelium (Pleurotus ostreatus) through knitted structures, highlighting the ability for natural fabrics to provide a scaffold to support microbial communities whilst retaining the ability to undergo environmentally responsive shape-change. A final prototype, Ebb&Flow, demonstrated the potential to scale up the responsive capacities of the material system using locally produced UK wool. The prototype conceptualised both the uptake of a hydrocarbon pollutant by fibres, and the translocation of microbes along fibre highways. Discussion: The research works towards facilitating the translation of fundamental science and design into biotechnological solutions that can be used in real world applications.

Textiles as fomites in the healthcare system

Nosocomial infections or healthcare-associated infections (HAIs) are acquired under medical care in healthcare facilities. In hospital environments, the transmission of infectious diseases through textiles such as white coats, bed linen, curtains, and towels are well documented. Textile hygiene and infection control measures have become more important in recent years due to the growing concerns about textiles as fomites in healthcare settings. However, systematic research in this area is lacking; the factors contributing to the transmission of infections through textiles needs to be better understood. The review aims to critically explore textiles as contaminants in healthcare systems, and to identify potential risks they may pose to patients and healthcare workers. It delineates different factors affecting bacterial adherence on fabrics, such as surface properties of bacteria and fabrics, and environmental factors. It also identifies areas that require further research to reduce the risk of HAIs and improve textile hygiene practices. Finally, the review elaborates on the strategies currently employed, and those that can be employed to limit the spread of nosocomial infections through fabrics. Implementing textile hygiene practices effectively in healthcare facilities requires a thorough analysis of factors affecting fabric-microbiome interactions, followed by designing newer fabrics that discourage pathogen load. KEY POINTS: • Healthcare textiles act as a potential reservoir of nosocomial pathogens • Survival of pathogens is affected by surface properties of fabric and bacteria • Guidelines required for fabrics that discourage microbial load, for hospital use.

Occurrence and size distribution study of microplastics in household water from different cities in continental Spain and the Canary Islands

The purpose of this study was to investigate the occurrence of microplastics (MPs) in drinking water in Spain by comparing tap water from different locations using common sampling and identification procedures. We sampled tap water from 24 points in 8 different locations from continental Spain and the Canary Islands by means of 25 μm opening size steel filters coupled to household connections. All particles were measured and spectroscopically characterized including not only MPs but also particles consisting of natural materials with evidence of industrial processing, such as dyed natural fibres, referred insofar as artificial particles (APs). The average concentration of MPs was 12.5 ± 4.9 MPs/m³ and that of anthropogenic particles 32.2 ± 12.5 APs/m³. The main synthetic polymers detected were polyamide, polyester, and polypropylene, with lower counts of other polymers including the biopolymer poly(lactic acid). Particle size and mass distributions were parameterized by means of power law distributions, which allowed performing estimations of the concentration of smaller particles provided the same scaling parameter of the power law applies. The calculated total mass concentration of the identified MPs was 45.5 ng/L. The observed size distribution of MPs allowed an estimation for the concentration of nanoplastics (< 1 µm) well below the ng/L range; higher concentrations are not consistent with scale invariant fractal fragmentation. Our findings showed that MPs in the drinking water sampled in this work do not represent a significant way of exposure to MPs and would probably pose a negligible risk for human health.

Monitoring Growth and Removal of Pseudomonas Biofilms on Cellulose-Based Fabrics

Biofilms are often tolerant towards routine cleaning and disinfection processes. As they can grow on fabrics in household or healthcare settings, resulting in odors and serious health problems, it is necessary to contain biofilms through eradication strategies. The current study proposes a novel test model for the growth and removal of biofilms on textiles with Pseudomonas fluorescens and the opportunistic nosocomial pathogen Pseudomonas aeruginosa as model organisms. To assess the biofilm removal on fabrics, (1) a detergent-based, (2) enzyme-based, and (3) combined formulation of both detergent and enzymes (F1/2) were applied. Biofilms were analyzed microscopically (FE-SEM, SEM, 3D laser scanning- and epifluorescence microscopy), via a quartz crystal microbalance with mass dissipation monitoring (QCM-D) as well as plate counting of colonies. This study indicated that Pseudomonas spp. form robust biofilms on woven cellulose that can be efficiently removed via F1/2, proven by a significant reduction (p < 0.001) of viable bacteria in biofilms. Moreover, microscopic analysis indicated a disruption and almost complete removal of the biofilms after F1/2 treatment. QCM-D measurements further confirmed a maximal mass dissipation change after applying F1/2. The combination strategy applying both enzymes and detergent is a promising antibiofilm approach to remove bacteria from fabrics.

Preparation of Cotton-Zinc Composites by Magnetron Sputtering Metallization and Evaluation of their Antimicrobial Properties and Cytotoxicity

The aim of this investigation was to evaluate the biological properties of cotton-zinc composites. A coating of zinc (Zn) on a cotton fabric was successfully obtained by a DC magnetron sputtering system using a metallic Zn target (99.9%). The new composite was characterized using scanning electron microscopy/energy-dispersive X-ray spectroscopy (SEM/EDS), UV/Vis transmittance, and atomic absorption spectrometry with flame excitation (FAAS). The composite was tested for microbial activity against colonies of Gram-positive (Staphylococcus aureus) and Gram-negative (Escherichia coli) bacteria and antifungal activity against Aspergillus niger and Chaetomium globosum fungal mold species as model microorganisms. Cytotoxicity screening of the tested modified material was carried out on BALB/3T3 clone mouse fibroblasts. The SEM/EDS and FAAS tests showed good uniformity of zinc content on a large surface of the composite. The conducted research showed the possibility of using the magnetron sputtering technique as a zero-waste method for producing antimicrobial textile composites.

Plastic Debris As a Vector for Bacterial Disease: An Interdisciplinary Systematic Review

Pathogens and polymers can separately cause disease; however, environmental and medical researchers are increasingly investigating the capacity of polymers to transfer pathogenic bacteria, and cause disease, to hosts in new environments. We integrated causal frameworks from ecology and epidemiology into one interdisciplinary framework with four stages (colonization, survival, transfer, disease). We then systematically and critically reviewed 111 environmental and medical papers. We show 58% of studies investigated the colonization-stage alone but used this as evidence to classify a substratum as a vector. Only 11% of studies identified potential pathogens, with only 3% of studies confirming the presence of virulence-genes. Further, 8% of studies investigated μm-sized polymers with most (58%) examining less pervasive cm-sized polymers. No study showed bacteria can preferentially colonize, survive, transfer, and cause more disease on polymers compared to other environmental media. One laboratory experiment demonstrated plausibility for polymers to be colonized by a potential pathogen (Escherichia coli), survive, transfer, and cause disease in coral (Astrangia poculata). Our analysis shows a need for linked structured surveys with environmentally relevant experiments to understand patterns and processes across the vectoral stages, so that the risks and impacts of pathogens on polymers can be assessed with more certainty.

Periodontal Pathogen Adhesion, Cytotoxicity, and Surface Free Energy of Different Materials for an Implant Prosthesis Screw Access Hole

Background and Objectives: Oral implant restorations are an excellent treatment option for edentulous patients; however, periodontopathogenic bacteria have been found in the microgaps between implant−abutment junctions. Implant designs to limit the microgaps have been extensively studied. However, studies have shown microgaps continue to exist, allowing for the leakage of bacteria into the implant system. Screw access hole materials are used to fill the access hole void. The use of materials with beneficial properties could provide bacterial leakage prevention. The aim of this study was to examine the surface free energy, cytotoxicity, and bacterial adhesion of selected screw access hole materials such as cotton, polytetrafluoroethylene (PTFE) tape, paraffin wax−polyolefin thermoplastic (PF), paraffin wax (Wax), gutta-percha (GP), and caviton EX (CE). Materials and Methods: A sessile drop test was performed to observe the contact angle and calculate the surface free energy of each material in order to determine the level of hydrophobicity. Cytotoxicity was examined in a mouse gingival epithelial cell line for day 1 and day 3. Bacterial adhesion was tested with Porphyromonas gingivalis, Fusobacterium nucleatum, and Aggregatibacter actinomycetemcomitans. Results: PTFE, PF, and wax presented low surface free energies of 19.34, 23.041, and 24.883 mN.m-1, respectively. No cytotoxicity was observed, except for GP and CE. Concurrently, the bacterial adhesion was also the lowest in PTFE and PF. Conclusion: Within the limits of this study, PTFE and PF showed an excellent biocompatibility with few bacterial adhesions. These materials could be potential screw access hole materials in clinical settings.

Porous surfaces: stability and recovery of coronaviruses

The role of indirect contact in the transmission of SARS-CoV-2 is not clear. SARS-CoV-2 persists on dry surfaces for hours to days; published studies have largely focused on hard surfaces with less research being conducted on different porous surfaces, such as textiles. Understanding the potential risks of indirect transmission of COVID-19 is useful for settings where there is close contact with textiles, including healthcare, manufacturing and retail environments. This article aims to review current research on porous surfaces in relation to their potential as fomites of coronaviruses compared to non-porous surfaces. Current methodologies for assessing the stability and recovery of coronaviruses from surfaces are also explored. Coronaviruses are often less stable on porous surfaces than non-porous surfaces, for example, SARS-CoV-2 persists for 0.5 h-5 days on paper and 3-21 days on plastic; however, stability is dependent on the type of surface. In particular, the surface properties of textiles differ widely depending on their construction, leading to variation in the stability of coronaviruses, with longer persistence on more hydrophobic materials such as polyester (1-3 days) compared to highly absorbent cotton (2 h-4 days). These findings should be considered where there is close contact with potentially contaminated textiles.

The Bacterial Life Cycle in Textiles is Governed by Fiber Hydrophobicity

Colonization of textiles and subsequent metabolic degradation of sweat and sebum components by axillary skin bacteria cause the characteristic sweat malodor and discoloring of dirty clothes. Once inside the textile, the bacteria can form biofilms that are hard to remove by conventional washing. When the biofilm persists after washing, the textiles retain the sweat odor. To design biofilm removal and prevention strategies, the bacterial behavior needs to be understood in depth. Here, we aim to study the bacterial behavior in each of the four stages of the bacterial life cycle in textiles: adhesion, growth, drying, and washing. To accomplish this, we designed a novel in vitro model to mimic physiological sweating in cotton and polyester textiles, in which many of the parameters that influence bacterial behavior could be controlled. Due to the higher hydrophobicity, polyester adhered more bacteria and absorbed more sebum, the bacteria's primary nutrient source. Bacteria were therefore also more active in polyester textiles. However, polyester did not bind water as well as cotton. The increased water content of cotton allowed some species to retain a higher activity after the textile had dried. However, none of the textiles retained enough water upon drying to prevent the bacteria from adhering irreversibly to the textile fibers. This work demonstrates that bacterial colonization of textiles depends partially on the hydrophobic and hygroscopic properties of the textile material, indicating that it might be possible to direct bacterial behavior in a more favorable direction by modifying these surface properties. IMPORTANCE During sweating, bacteria from the skin enter the worn textile along with the sweat. Once inside the clothes, the bacteria produce sweat malodor and form colonies that are extremely hard to remove by washing. Over time, this leads to a decreasing textile quality and consumer comfort. To design prevention and removal mechanisms, we investigated the behavior of bacteria during the four stages of their life cycle in textiles: adhesion, growth, drying, and washing. The bacterial behavior in textiles during all four stages is found to be affected by the textile's ability to bind water and fat. The study indicates that sweat malodor and bacterial accumulation in textiles over time can be reduced by making the textiles more repellant to water and fat.

Bacteria Adhesion of Textiles Influenced by Wettability and Pore Characteristics of Fibrous Substrates

Bacteria adhesion on the surface is an initial step to create biofouling, which may lead to a severe infection of living organisms and humans. This study is concerned with investigating the textile properties including wettability, porosity, total pore volume, and pore size in association with bacteria adhesion. As model bacteria, Gram-negative, rod-shaped Escherichia coli and the Gram-positive, spherical-shaped Staphylococcus aureus were used to analyze the adhesion tendency. Electrospun webs made from polystyrene and poly(lactic acid) were used as substrates, with modification of wettability by the plasma process using either O2 or C4F8 gas. The pore and morphological characteristics of fibrous webs were analyzed by the capillary flow porometer and scanning electron microscopy. The substrate's wettability appeared to be the primary factor influencing the cell adhesion, where the hydrophilic surface resulted in considerably higher adhesion. The pore volume and the pore size, rather than the porosity itself, were other important factors affecting the bacteria adherence and retention. In addition, the compact spatial distribution of fibers limited the cell intrusion into the pores, reducing the total amount of adherence. Thus, superhydrophobic textiles with the reduced total pore volume and smaller pore size would circumvent the adhesion. The findings of this study provide informative discussion on the characteristics of fibrous webs affecting the bacteria adhesion, which can be used as a fundamental design guide of anti-biofouling textiles.