UVC fluencies for preventative treatment of Pseudomonas aeruginosa contaminated polymer tubes

A Comprehensive Analysis of the UVC LEDs' Applications and Decontamination Capability

The application of light-emitting diodes (LEDs) has been gaining popularity over the last decades. LEDs have advantages compared to traditional light sources in terms of lifecycle, robustness, compactness, flexibility, and the absence of non-hazardous material. Combining these advantages with the possibility of emitting Ultraviolet C (UVC) makes LEDs serious candidates for light sources in decontamination systems. Nevertheless, it is unclear if they present better decontamination effectiveness than traditional mercury vapor lamps. Hence, this research uses a systematic literature review (SLR) to enlighten three aspects: (1) UVC LEDs' application according to the field, (2) UVC LEDs' application in terms of different biological indicators, and (3) the decontamination effectiveness of UVC LEDs in comparison to conventional lamps. UVC LEDs have spread across multiple areas, ranging from health applications to wastewater or food decontamination. The UVC LEDs' decontamination effectiveness is as good as mercury vapor lamps. In some cases, LEDs even provide better results than conventional mercury vapor lamps. However, the increase in the targets' complexity (e.g., multilayers or thicker individual layers) may reduce the UVC decontamination efficacy. Therefore, UVC LEDs still require considerable optimization. These findings are stimulating for developing industrial or final users' applications.

Quantification and modeling of the response of surface biofilm growth to continuous low intensity UVC irradiation

Though germicidal UV radiation is widely applied for disinfection of water and food, it may also be used to prevent bacterial growth and colonization on surfaces within engineered systems. Emerging UV source technologies, such as ultraviolet-C (UVC) LEDs, present new opportunities for deterring biofilms within certain devices, including medical equipment, food equipment, and potentially in plumbing fixtures for prevention of opportunistic respiratory pathogen infections. Rational design for incorporation of UVC sources into devices with complex internal geometries is currently hampered by the lack of an engineering framework for predicting reductions in biofilm growth rates in response to continuous low-intensity irradiation. Herein we have developed an experimental apparatus and method for growing biofilms under concurrent UV irradiation and quantifying the resulting suppression of surface growth. Under accelerated growth conditions over 48 h, E. coli surface biovolume was reduced by 95% compared to control biofilms (grown in the dark) by a UV intensity of 50.5 µW/cm² (254 nm). The required intensity for biofilm prevention was higher than expected, given the UV dose response of the bacteria employed and the cumulative doses delivered to the test surfaces. The results indicate that biofilms can establish even under irradiation conditions that would result in complete inactivation of planktonic cells, likely due to the shielding effects of colloidal material and microbial exudates. A pseudo-mechanistic model was also developed which correlated UV intensity to the resultant reduction in specific surface biovolume.

Can incorporation of UVC LEDs into showerheads prevent opportunistic respiratory pathogens? - Microbial behavior and device design considerations

Respiratory infections from opportunistic bacterial pathogens (OBPs) have heightened research interests in drinking water distribution systems, premise plumbing, and point-of-use technologies. In particular, biofilm growth in showerheads increases OBP content, and inhalation of shower aerosols is a major exposure route for Legionellae and Mycobacteria infections. Incorporation of UVC LEDs into showerheads has thus been proposed as a point-of-use option for healthcare facilities. Herein we have examined incongruities between the nature of OBP contamination in shower water and the hypothetical application of conventional UV disinfection engineering concepts. Effective UV dosing within showerheads must overcome significant shielding effects imparted by the biological matrices in which common OBPs reside, including biofilm particles and protozoan hosts. Furthermore, prevention of biofilm growth in showerhead interiors requires a different UV irradiation approach and is lacking in established design parameters. Development of showerhead devices is also likely to face a trade-off between bathing functionality and simpler form factors that are more conducive to internal UV irradiation.

Efficacy of ultraviolet C light at sublethal dose in combination with antistaphylococcal antibiotics to disinfect catheter biofilms of methicillin-susceptible and methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis in vitro

Background

Biofilm formation inside inserted medical devices leads to their failure and acts as a source of refractory infections. The ultraviolet C (UVC) light is a potential therapy that can be used against the biofilm of bacterial pathogens.

Objective

We evaluated the efficacy of sublethal dose of UVC light with anti-staphylococcal antibiotics against biofilms made from 30 isolates of methicillin-susceptible Staphylococcus aureus and methicillin-resistant S. aureus and S. epidermidis on vascular catheters.

Materials and methods

A novel biofilm device was used to assess the combined approach. The biofilms on the catheters were irradiated with the UVC light at 254 nm and irradiance of 6.4 mW followed by treatment with vancomycin or quinupristin/dalfopristin at twice their minimum bactericidal concentrations or with linezolid at 64 µg/mL for 24 hours. The catheters were cut into segments and sonicated, and the number of the sessile cells was determined colorimetrically using XTT viable cells assay. The effect of UVC radiation followed by treatment with an antistaphylococcal antibiotic on the viability of the bacteria in the biofilm was visualized using LIVE/DEAD BacLight bacterial viability stain and confocal laser scanning microscopy.

Results

Exposure of the bacterial biofilms to the UVC light or each of the antibiotics alone was ineffective in killing the bacteria. Treatment of the biofilms with the antibiotics following their exposure to UVC light significantly (P<0.001) reduced the number of viable cells within the biofilms but did not completely eradicate them.

Conclusion

To our knowledge, this combinatorial approach has not been investigated before. The combined approach can be used as a therapeutic modality for managing biofilm-associated infections by preventing the establishment of biofilms and/or disrupting the formed biofilms on the inserted medical devices with the goal of increasing their usefulness and preventing infectious complications. Further investigations are needed to assess the effectiveness of the combined approach in the clinical settings.

Inactivation of Bacteria on Explanted Dialysis Catheter Lumens with Fiber Optically Delivered Ultraviolet Light

PURPOSE

To evaluate the germicidal effect of fiber optically delivered ultraviolet (UV) light on colonized explanted dialysis catheters.

MATERIALS AND METHODS

Explanted dialysis catheters were screened for intraluminal colonization by culturing 1 mL of a saline flush. Catheters growing >10 colony-forming units were treated with doses of fiber optically delivered UV light (range, 40-1,300 mJ/cm2). For each UV-treated catheter, an unexposed segment was first cut and set aside as a control sample. A sterile optical fiber was inserted into the catheter hub and advanced to the catheter tip. The fiber was slowly withdrawn at a constant rate while exposing the inner lumen to UV light. A second UV-exposed segment was then removed. The UV-exposed and control segments were split and sonicated to remove the adherent bacteria. The bacteria were counted and identified.

RESULTS

There were 14 colonized catheters treated with UV light. The catheters were primarily colonized with coagulase-negative staphylococci (60%) and Staphylococcus aureus (33%). There was a significant reduction in viable bacteria between the UV-treated versus untreated segments of each infected catheter (P = .04). In the seven treated catheters with >100,000 colony-forming units per cm2 of luminal surface area, there was a >99.5% reduction of viable bacteria in all UV-exposed samples, with no residual viable bacteria in four of seven (57%) of the samples.

CONCLUSIONS

This study demonstrates the technical feasibility and benchtop efficacy of using fiber optics to deliver UV light into the lumen of a colonized dialysis catheter and inactivating bacteria on the intraluminal surface.

Heritage materials and biofouling mitigation through UV-C irradiation in show caves: state-of-the-art practices and future challenges

Biofouling, i.e., colonization of a given substrate by living organisms, has frequently been reported for heritage materials and particularly on stone surfaces such as building facades, historical monuments, and artworks. This also concerns subterranean environments such as show caves, in which the installation of artificial light for tourism has led to the proliferation of phototrophic microorganisms. In Europe nowadays, the use of chemicals in these very sensitive environments is scrutinized and regulated by the European Union. New and environmentally friendly processes must be developed as alternative methods for cave conservation. For several years, the UV irradiation currently used in medical facilities and for the treatment of drinking water has been studied as a new innovative method for the conservation of heritage materials. This paper first presents a review of the biofouling phenomena on stone materials such as building facades and historical monuments. The biological disturbances induced by tourist activity in show caves are then examined, with special attention given to the methods and means to combat them. Thirdly, a general overview is given of the effects of UV-C on living organisms, and especially on photosynthetic microorganisms, through different contexts and studies. Finally, the authors' own experiments and findings are presented concerning the study and use of UV-C irradiation to combat algal proliferation in show caves. Both laboratory and in situ results are summarized and synthesized from their previously published works. The application of UV in caves is discussed and further experiments are proposed to enhance research in this domain.

Effect of chlorination on the development of marine biofilms dominated by diatoms

This study addressed the antifouling efficiency of commercially available chlorine at different concentrations (0.5%, 1%, and 2%) and exposure times (0.5 min, 1 min, 5 min, and 15 min). The rapid and non-destructive FIRe (fluorescence induction and relaxation) technique was used to evaluate the effects of the biocide on diatom dominated biofilms. The efficiency of chlorine in removing diatoms from the developed biofilms increased with an increase in concentration and exposure time. The fluorescence measurements revealed low F(v)/F(m) and high σ(PSII) values for chlorine-treated Navicula and Amphora biofilms indicating that chlorination was efficient in damaging the photosystem-II reaction centers. Chlorination also caused mortality of diatom cells by damaging the cell body. In natural biofilms, the biocidal effect of chlorine was species specific; species of Amphiphrora, Navicula, Cylindrotheca, and Coscinodiscus showed an increase in the density of the population, but species of Pleurosigma, Amphora, and Thalassionema did not increase in density after chlorine treatment. It was also demonstrated that diatoms can colonize, grow and photosynthesize on chlorine-treated surfaces. Under pulse chlorination (treatment every 6 h), irrespective of chlorine concentration, the development of biofouling decreased with an increase in exposure time. Differences between exposure times of 1 to 15 min were not significant. Additionally, transmission levels of the control (non-chlorine-treated) fouled coupons reduced significantly (∼20%) compared to the chlorine-treated fouled coupons (<2%). These results suggest that chlorine can be used as a biocide to control the development of diatom biofilms.

Ultraviolet-C light for treatment of Candida albicans burn infection in mice

Burn patients are at high risk of invasive fungal infections, which are a leading cause of morbidity, mortality, and related expense exacerbated by the emergence of drug resistant fungal strains. In this study, we investigated the use of UVC light (254 nm) for the treatment of yeast Candida albicans infection in mouse third degree burns. In vitro studies demonstrated that UVC could selectively kill the pathogenic C. albicans compared with a normal mouse keratinocyte cell line in a light exposure dependent manner. A mouse model of chronic C. albicans infection in non-lethal third degree burns was developed. The C. albicans strain was stably transformed with a version of the Gaussia princeps luciferase gene that allowed real-time bioluminescence imaging of the progression of C. albicans infection. UVC treatment with a single exposure carried out on day 0 (30 min postinfection) gave an average 2.16-log(10)-unit (99.2%) loss of fungal luminescence when 2.92 J cm(-2) UVC had been delivered, while UVC 24 h postinfection gave 1.94-log(10)-unit (95.8%) reduction of fungal luminescence after 6.48 J cm(-2). Statistical analysis demonstrated that UVC treatment carried out on both day 0 and day 1 significantly reduced the fungal bioburden of infected burns. UVC was found to be superior to a topical antifungal drug, nystatin cream. UVC was tested on normal mouse skin and no gross damage was observed 24 h after 6.48 J cm(-2). DNA lesions (cyclobutane pyrimidine dimers) were observed by immunofluorescence in normal mouse skin immediately after a 6.48 J cm(-2) UVC exposure, but the lesions were extensively repaired at 24 h after UVC exposure.