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Rutala WA, Boyce JM, Weber DJ. Disinfection, sterilization and antisepsis: An overview. Am J Infect Control 2023; 51:A3-A12. [PMID: 37890951 DOI: 10.1016/j.ajic.2023.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 01/05/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Each year in the United States there are approximately 100,000,000 outpatient/inpatient surgical procedures. Each of these procedures involves contact by a medical device or surgical instrument with a patient's sterile tissue and/or mucous membrane. A major risk of all such procedures is the introduction of infection. METHODS We searched published literature for articles on the use and effectiveness of disinfectants, sterilization methods and antiseptics. RESULTS The level of disinfection is dependent on the intended use of the object: critical (items that contact sterile tissue such as surgical instruments), semicritical (items that contact mucous membrane such as endoscopes), and noncritical (devices that contact only intact skin such as stethoscopes) items require sterilization, high-level disinfection and low-level disinfection, respectively. Cleaning must always precede high-level disinfection and sterilization. Antiseptics are essential to infection prevention as part of a hand hygiene program as well as other uses such as surgical hand antisepsis and pre-operative patient skin preparation. CONCLUSIONS When properly used, disinfection and sterilization can ensure the safe use of invasive and non-invasive medical devices. Cleaning should always precede high-level disinfection and sterilization. Strict adherence to current disinfection and sterilization guidelines is essential to prevent patient infections and exposures to infectious agents.
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Affiliation(s)
- William A Rutala
- Statewide Program for Infection Control and Epidemiology, UNC School of Medicine, Chapel Hill, NC; Division of Infectious Diseases, UNC School of Medicine, Chapel Hill, NC.
| | - John M Boyce
- J.M. Boyce Consulting, Boyce Consulting, LLC, Middletown, CT
| | - David J Weber
- Statewide Program for Infection Control and Epidemiology, UNC School of Medicine, Chapel Hill, NC; Division of Infectious Diseases, UNC School of Medicine, Chapel Hill, NC; Infection Prevention, University of North Carolina Medical Center, Chapel Hill, NC
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2
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Cobrado L, Ricardo E, Ramalho P, Fernandes AR, Rodrigues AG. Does repeated exposure to hydrogen peroxide induce Candida auris resistance? Antimicrob Resist Infect Control 2023; 12:92. [PMID: 37674229 PMCID: PMC10483791 DOI: 10.1186/s13756-023-01281-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 07/27/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND To minimize environmental colonization by microorganisms that may persist and thrive in healthcare settings, thus reducing healthcare-associated infections (HAIs), new insights over already known biocides are certainly of relevance. Although the efficacy of hydrogen peroxide (H2O2) against the emergent yeast Candida auris is moderately documented, concerns over the potential induction of resistance after repeated exposure do persist. The main objective of the present study was to evaluate the hypothetical induction of Candida auris resistance following 30 days of consecutive exposure to lethal and sublethal concentrations of H2O2. Furthermore, the authors aimed to elucidate about the rank of efficacy of H2O2 against C. auris comparing to other Candida species and whether different strains of C. auris may display different susceptibilities to H2O2. METHODS During the induction of resistance assays, both type strains and clinical isolates of Candida auris, Candida albicans and Candida parapsilosis were exposed repeatedly to defined concentrations of H2O2, for 30 days. RESULTS After that period, no significant differences were found when comparing the minimal inhibitory concentration values of H2O2 in case of the induced strains versus each respective positive control. Moreover, H2O2 displayed similar effectiveness against all the tested Candida species and no differences were demonstrated among the distinct strains of C. auris. CONCLUSIONS The adoption of H2O2 solutions in routine protocols in order to promote disinfection standards against Candida auris, improving patient safety and reducing healthcare costs, is certainly welcomed.
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Affiliation(s)
- Luis Cobrado
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Al. Prof. Hernâni Monteiro, Porto, 4200 - 319, Portugal.
- Center for Health Technology and Services Research / Rede de Investigação em Saúde, CINTESIS / RISE, University of Porto, Porto, Portugal.
- Burn Unit, Department of Plastic and Reconstructive Surgery, University Hospital Center of São João, Porto, Portugal.
| | - Elisabete Ricardo
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Al. Prof. Hernâni Monteiro, Porto, 4200 - 319, Portugal
- Center for Health Technology and Services Research / Rede de Investigação em Saúde, CINTESIS / RISE, University of Porto, Porto, Portugal
| | - Patricia Ramalho
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Al. Prof. Hernâni Monteiro, Porto, 4200 - 319, Portugal
- Center for Health Technology and Services Research / Rede de Investigação em Saúde, CINTESIS / RISE, University of Porto, Porto, Portugal
| | - Angela Rita Fernandes
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Al. Prof. Hernâni Monteiro, Porto, 4200 - 319, Portugal
| | - Acacio Goncalves Rodrigues
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Al. Prof. Hernâni Monteiro, Porto, 4200 - 319, Portugal
- Center for Health Technology and Services Research / Rede de Investigação em Saúde, CINTESIS / RISE, University of Porto, Porto, Portugal
- Burn Unit, Department of Plastic and Reconstructive Surgery, University Hospital Center of São João, Porto, Portugal
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Kelley AM, Voorn MG, Tembo GM, Horn CM, Li X, Teska PJ, Oliver HF. Contact time has limited impact on the efficacy of disinfectant towelettes when tested under conditions reflective of realistic use. Antimicrob Resist Infect Control 2023; 12:71. [PMID: 37455322 PMCID: PMC10350269 DOI: 10.1186/s13756-023-01266-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 06/13/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Disinfectant towelettes are increasingly being used as a means to prevent transmission of clinically important pathogens which could lead to healthcare-associated infections (HAIs). However, the efficacy of disinfectant towelette products when tested under realistic use conditions is understudied. A test model was designed to replicate realistic wiping conditions. The objective of this study was to determine the impact of varied contact time on disinfectant towelette efficacy under these conditions. METHODS Five product types were tested against Staphylococcus aureus (ATCC 6538) and Pseudomonas aeruginosa (ATCC 15,442) at five contact times (30 s, one min, two min, three min, and 10 min) on hard, non-porous laminate templates to determine the impact of contact time on disinfectant towelette efficacy when tested under realistic use. RESULTS Product type had a significant impact on the efficacy of disinfectant towelettes when tested under conditions reflective of realistic use. The effect of contact time was limited and no differences in efficacy were seen at a contact time of one min compared with the other contact times tested. Only one disinfectant towelette product achieved a mean 5-log reduction under the tested conditions. CONCLUSION Efficacy of disinfectant towelettes was primarily impacted by product type when applied in a model designed to replicate realistic use in which only a limited effect of contact time was observed. There is a need for further investigation into which factors have the greatest impact on disinfectant towelette efficacy when applied in clinical settings.
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Affiliation(s)
- Alyssa M. Kelley
- Department of Food Science, Purdue University, 745 Agriculture Mall Drive, West Lafayette, IN 47907 USA
| | - Maxwell G. Voorn
- Department of Food Science, Purdue University, 745 Agriculture Mall Drive, West Lafayette, IN 47907 USA
| | - Geraldine M. Tembo
- Department of Food Science, Purdue University, 745 Agriculture Mall Drive, West Lafayette, IN 47907 USA
| | - Connor M. Horn
- Department of Food Science, Purdue University, 745 Agriculture Mall Drive, West Lafayette, IN 47907 USA
| | | | | | - Haley F. Oliver
- Department of Food Science, Purdue University, 745 Agriculture Mall Drive, West Lafayette, IN 47907 USA
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Warren BG, Barrett A, Graves A, King C, Turner NA, Anderson DJ. An Enhanced Strategy for Daily Disinfection in Acute Care Hospital Rooms: A Randomized Clinical Trial. JAMA Netw Open 2022; 5:e2242131. [PMID: 36378308 PMCID: PMC9667331 DOI: 10.1001/jamanetworkopen.2022.42131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
IMPORTANCE Environmental contamination is a source of transmission between patients, health care practitioners, and other stakeholders in the acute care setting. OBJECTIVE To compare the efficacy of an enhanced daily disinfection strategy vs standard disinfection in acute care hospital rooms. DESIGN, SETTING, AND PARTICIPANTS This randomized clinical trial (RCT) was conducted in acute care hospital rooms at Duke University Hospital in Durham, North Carolina, from November 2021 to March 2022. Rooms were occupied by patients with contact precautions. Room surfaces (bed rails, overbed table, and in-room sink) were divided into 2 sides (right vs left), allowing each room to serve as its own control. Each side was randomized 1:1 to the intervention group or control group. INTERVENTIONS The intervention was a quaternary ammonium, salt-based, 24-hour continuously active germicidal wipe. It was applied in addition to routine disinfection for the intervention group. The control group received no intervention beyond routine disinfection. MAIN OUTCOMES AND MEASURES The primary outcome was the total contamination, measured in colony-forming units (CFUs) on the bed rails, overbed table, and sink on study day 1. The secondary outcomes were the proportion of sample areas with positive test results for clinically important pathogens, including methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and carbapenem-resistant Enterobacteriaceae; the similarity in baseline contamination between sample area sides on study day 0 before application of the intervention, and the proportion of sample areas with removed UV luminescent gel on study day 1. RESULTS A total of 50 study rooms occupied by 50 unique patients (median [IQR] age, 61 [45-69] years; 26 men [52%]) with contact precautions were enrolled. Of these patients, 41 (82%) were actively receiving antibiotics, 39 (78%) were bedridden, and 28 (56%) had active infections with study-defined clinically important pathogens. On study day 1, the median (IQR) total CFUs for the intervention group was lower than that for the control group (3561 [1292-7602] CFUs vs 5219 [1540-12 364] CFUs; P = .002). On study day 1, the intervention side was less frequently contaminated with patient-associated clinically important pathogens compared with the control side of the room (4 [14%] vs 11 [39%]; P = .04). CONCLUSIONS AND RELEVANCE Results of this RCT demonstrated that a quaternary ammonium, salt-based, 24-hour continuously active germicidal wipe decreased the environmental bioburden in acute care hospital rooms compared with routine disinfection. The findings warrant large-scale RCTs to determine whether enhanced daily disinfection strategies can decrease patient acquisition and adverse patient outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05560321.
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Affiliation(s)
- Bobby G. Warren
- Division of Infectious Diseases, Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina
- Disinfection, Resistance and Transmission Epidemiology (DiRTE) Lab, Duke University School of Medicine, Durham, North Carolina
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina
| | - Aaron Barrett
- Division of Infectious Diseases, Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina
- Disinfection, Resistance and Transmission Epidemiology (DiRTE) Lab, Duke University School of Medicine, Durham, North Carolina
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina
| | - Amanda Graves
- Division of Infectious Diseases, Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina
- Disinfection, Resistance and Transmission Epidemiology (DiRTE) Lab, Duke University School of Medicine, Durham, North Carolina
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina
| | - Carly King
- Division of Infectious Diseases, Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina
| | - Nicholas A. Turner
- Division of Infectious Diseases, Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina
- Disinfection, Resistance and Transmission Epidemiology (DiRTE) Lab, Duke University School of Medicine, Durham, North Carolina
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina
| | - Deverick J. Anderson
- Division of Infectious Diseases, Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina
- Disinfection, Resistance and Transmission Epidemiology (DiRTE) Lab, Duke University School of Medicine, Durham, North Carolina
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina
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Maloney B, McKerlie T, Nasir M, Murphy C, Moi M, Mudalige P, Naser NE, Duane B. The Environmental Footprint Of Single versus Reusable Cloths For Clinical Surface Decontamination: A Life Cycle Approach. J Hosp Infect 2022; 130:7-19. [PMID: 36115619 DOI: 10.1016/j.jhin.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/03/2022] [Accepted: 09/05/2022] [Indexed: 10/14/2022]
Abstract
Global sustainability is a major health concern facing our planet today. The healthcare sector is a significant contributor to environmentally damaging activity. Reusable cloths should be considered as an environmentally friendly alternative to the predominantly used single-use surface wipes in cleaning and disinfection of environmental surfaces in healthcare settings. To understand its feasibility, a rapid review of current policies on surface decontamination in healthcare settings was conducted. A life cycle impact assessment (LCIA) was then carried out to compare the impact of reusable cotton and microfibre cloths versus conventional single-use cloths, with three compatible disinfectants. Seven countries were included in the rapid review of policies. For the LCIA, inputs, outputs, and processes across the life cycle were included, using EcoInvent database v3.7.1 and open LCIA software. Sixteen European-recommended environmental impact categories and eight human health categories were considered. Infection prevention policies examined do not require single-use wipes for cleaning and disinfection. The disinfectant with the highest environmental impact was isopropyl-alcohol. The most environmentally-sustainable option for clinical surface decontamination was the microfibre cloth when used with a quaternary ammonium compound. The least environmentally sustainable option was cotton with isopropyl-alcohol. Impacts were primarily attributed with the use of the disinfectant agent and travel processes.
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Affiliation(s)
- Brian Maloney
- School of Dental Science, Trinity College Dublin, Dublin, Ireland.
| | - Taylor McKerlie
- School of Dental Science, Trinity College Dublin, Dublin, Ireland
| | - Malaika Nasir
- School of Dental Science, Trinity College Dublin, Dublin, Ireland
| | - Caroline Murphy
- School of Dental Science, Trinity College Dublin, Dublin, Ireland
| | - Michelle Moi
- School of Dental Science, Trinity College Dublin, Dublin, Ireland
| | - Pavanee Mudalige
- School of Dental Science, Trinity College Dublin, Dublin, Ireland
| | | | - Brett Duane
- Trinity College Dublin, Department of Child and Public Dental Health, Dublin, Ireland
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Duane B, Ashley P, Ramasubbu D, Fennell-Wells A, Maloney B, McKerlie T, Crotty J, Johnstone M, Wilmott S. A review of HTM 01-05 through an environmentally sustainable lens. Br Dent J 2022; 233:343-350. [PMID: 36028700 PMCID: PMC9412769 DOI: 10.1038/s41415-022-4903-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 04/12/2022] [Indexed: 11/09/2022]
Abstract
Patients deserve to be treated in a safe and clean environment with consistent standards of care every time they receive treatment. It is essential that the risk of person-to-person transmission of infections be minimised, yet it is also essential that planetary harm (and therefore public harm) is minimised with respect to resource consumption, air pollution, environmental degradation etc.In 2013, the Department of Health introduced the Health Technical Memorandum (HTM) 01-05 providing dental practices with advice on patient safety when decontaminating reusable instruments in primary care. This paper provides a commentary on HTM 01-05 and similar decontamination guidance. We believe all decontamination documents needs to reflect the so-called 'triple bottom line' - the finance, social cost and impact on the planet.The authors provide an environmental commentary on a number of items mentioned in decontamination documents, including autoclaves (including the use of helix tests), disposable paper towels, undertaking hand hygiene, using a log book, plastic bag use, the use of personal protective equipment, remote decontamination units, single use instruments, single use wipes, disinfection chemicals (for example, sodium hypochlorite) thermal disinfection and wrapping of instruments.It is hoped, in the spirit of the ever-increasing numbers of papers published to highlight how healthcare (and dentistry) could become more sustainable, that these critiques will be taken in the spirit of providing a beginning of further discussion from an environmental perspective.
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Huang J, Park GW, Jones RM, Fraser AM, Vinjé J, Jiang X. Efficacy of EPA-registered disinfectants against two human norovirus surrogates and Clostridioides difficile endospores. J Appl Microbiol 2022; 132:4289-4299. [PMID: 35279925 PMCID: PMC9119914 DOI: 10.1111/jam.15524] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/04/2022] [Accepted: 03/10/2022] [Indexed: 11/27/2022]
Abstract
AIMS To determine the efficacy of a panel of nine EPA-registered disinfectants against two human norovirus (HuNoV) surrogates (feline calicivirus [FCV] and Tulane virus [TuV]) and Clostridioides difficile endospores. METHODS AND RESULTS Nine EPA-registered products, five of which contained H2 O2 as active ingredient, were tested against infectious FCV, TuV and C. difficile endospores using two ASTM methods, a suspension and carrier test. Efficacy claims against FCV were confirmed for 8 of 9 products. The most efficacious product containing H2 O2 as ingredient achieved a >5.1 log reduction of FCV and >3.1 log reduction of TuV after 5 min, and >6.0 log reduction of C. difficile endospores after 10 min. Of the five products containing H2 O2 , no strong correlation (R2 = 0.25, p = 0.03) was observed between disinfection efficacy and H2 O2 concentration. Addition of 0.025% ferrous sulphate to 1% H2 O2 solution improved efficacy against FCV, TuV and C. difficile. CONCLUSION Disinfectants containing H2 O2 are the most efficacious disinfection products against FCV, TuV and C. difficile endospores. Product formulation, rather than the concentration of H2 O2 in a product, impacts the efficacy of a disinfection product. SIGNIFICANCE AND IMPACT OF STUDY H2 O2 -based disinfectants are efficacious against surrogate viruses for HuNoV and C. difficile endospores.
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Affiliation(s)
- Jinge Huang
- Department of Food, Nutrition, and Packaging Sciences, Clemson University, Clemson, South Carolina, USA
| | - Geun Woo Park
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Rachael M. Jones
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Angela M. Fraser
- Department of Food, Nutrition, and Packaging Sciences, Clemson University, Clemson, South Carolina, USA
| | - Jan Vinjé
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Xiuping Jiang
- Department of Food, Nutrition, and Packaging Sciences, Clemson University, Clemson, South Carolina, USA
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Cobrado L, Ramalho P, Ricardo E, Fernandes ÂR, Azevedo MM, Rodrigues AG. Efficacy assessment of different time-cycles of nebulized hydrogen peroxide against bacterial and yeast biofilm. J Hosp Infect 2022; 127:7-14. [PMID: 35594987 DOI: 10.1016/j.jhin.2022.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND The prevention of healthcare-associated infections requires a continuous effort. In order to achieve better practical results, the control of environmental microbial biofilms with effective disinfection strategies should be addressed. AIM This study aims to test the efficacy of different time-cycles of nebulized H2O2 against bacterial and yeast dry biofilm. METHODS The efficacy of a standard cycle (SC) and of a fast cycle (FC) of nebulized H2O2 was compared. Microbial biofilms were previously grown on different material coupons. The biofilm metabolic activity was determined by XTT assay and the biofilm total biomass by crystal violet assay. FINDINGS Regarding the efficacy of nebulized H2O2 against biofilms, the mean reduction of metabolic activity of the SC was 55.2% (±19.4%), comparing to a reduction of 50.4% (±17.7%) of the FC. The mean reduction of total biomass of the SC was 45.5% (±22.7%), versus 46.7% (±21.7%) of the FC. No statistical significant differences were found when comparing the tested cycles and distinct materials. CONCLUSION H2O2 nebulization was found to exhibit a good efficacy against healthcare-associated microbial dry biofilms. Moreover, similar efficacies were found between the tested cycles.
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Affiliation(s)
- Luís Cobrado
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Portugal; CINTESIS, Center for Health Technology and Services Research, Portugal; Burn Unit and Department of Plastic and Reconstructive Surgery, University Hospital Center of São João, Porto, Portugal.
| | - Patrícia Ramalho
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Portugal; CINTESIS, Center for Health Technology and Services Research, Portugal
| | - Elisabete Ricardo
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Portugal; CINTESIS, Center for Health Technology and Services Research, Portugal
| | - Ângela Rita Fernandes
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Portugal
| | - Maria-Manuel Azevedo
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Portugal; CINTESIS, Center for Health Technology and Services Research, Portugal
| | - Acácio Gonçalves Rodrigues
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Portugal; CINTESIS, Center for Health Technology and Services Research, Portugal; Burn Unit and Department of Plastic and Reconstructive Surgery, University Hospital Center of São João, Porto, Portugal
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Centeleghe I, Norville P, Hughes L, Maillard JY. Dual species dry surface biofilms; Bacillus species impact on Staphylococcus aureus survival and surface disinfection. J Appl Microbiol 2022; 133:1130-1140. [PMID: 35543339 PMCID: PMC9543557 DOI: 10.1111/jam.15619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/11/2022] [Accepted: 05/06/2022] [Indexed: 12/05/2022]
Abstract
Aims Dry surface biofilms (DSB) survive on environmental surfaces throughout hospitals, able to resist cleaning and disinfection interventions. This study aimed to produce a dual species DSB and explore the ability of commercially available wipe products to eliminate pathogens within a dual species DSB and prevent their transfer. Methods and Results Staphylococcus aureus was grown with two different species of Bacillus on stainless steel discs, over 12 days using sequential hydration and dehydration phases. A modified version of ASTM 2967–15 was used to test six wipe products including one water control with the Fitaflex Wiperator. Staphylococcus aureus growth was inhibited when combined with Bacillus subtilis. Recovery of S. aureus on agar from a dual DSB was not always consistent. Our results did not provide evidence that Bacillus licheniformis protected S. aureus from wipe action. There was no significant difference of S. aureus elimination by antimicrobial wipes between single and dual species DSB. B. licheniformis was easily transferred by the wipe itself and to new surfaces both in a single and dual species DSB, whilst several wipe products inhibited the transfer of S. aureus from wipe. However, S. aureus direct transfer to new surfaces was not inhibited post‐wiping. Conclusions Although we observed that the dual DSB did not confer protection of S. aureus, we demonstrated that environmental species can persist on surfaces after disinfection treatment. Industries should test DSB against future products and hospitals should consider carefully the products they choose. Significance and Impact of the Study To our knowledge, this is the first study reporting on the production of a dual species DSB. Multispecies DSB have been identified throughout the world on hospital surfaces, but many studies focus on single species biofilms. This study has shown that DSB behave differently to hydrated biofilms.
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Affiliation(s)
- Isabella Centeleghe
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, Wales
| | - Phillip Norville
- GAMA Healthcare Ltd., Hemel Hempstead, Hertfordshire, United Kingdom
| | - Louise Hughes
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, Wales
| | - Jean-Yves Maillard
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, Wales
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