ABSTRACT
BACKGROUND: Standardized efficacy surface tests for disinfectants are performed on pristine surfaces. There is a growing interest in understanding the impact of surface ageing on disinfectant activity, owing for example to the increased usage of ultraviolet (UV) radiation and oxidative chemistries for surface decontamination. This acknowledges that general surface 'wear and tear' following UV radiation and oxidative biocide exposure may impact biocidal product efficacy. METHODS: PVC surfaces were aged through thermal and UV-A radiation (340 nm wavelength) following the use of standard ageing surface protocols to simulate natural surface degradation. Surface roughness, contact angle and scanning electron microscopy were performed to evaluate physical changes in PVC surfaces before and after artificial ageing. The efficacy of five pre-impregnated disinfectant wipes were evaluated using the ASTM E2967-15 on stainless-steel (control) and PVC surfaces (aged and non-aged). RESULTS: The type of formulation and the organism tested remained the most significant factors impacting disinfectant efficacy, compared with surface type. Both thermal ageing and UV-A exposure of PVC surfaces clearly showed signs of surface degradation, notably an increase in surface roughness. Physical changes were observed in the roughness of PVC after artificial ageing. A difference in disinfectant efficacy dependent on aged PVC surfaces was observed for some, but not all formulations. CONCLUSION: We showed that surface type and surface ageing can affect biocidal product efficacy, although in a non-predictable manner. More research is needed in this field to ascertain whether surface types and aged surfaces should be used in standardized efficacy testing.
Subject(s)
Disinfectants , Disinfection , Polyvinyl Chloride , Surface Properties , Ultraviolet Rays , Disinfectants/pharmacology , Polyvinyl Chloride/pharmacology , Disinfection/methods , Microscopy, Electron, Scanning , Time Factors , HumansABSTRACT
BACKGROUND: The microbicidal efficacy of hand sanitizer formulations is usually measured through standardized quantitative suspension tests and fingerpad tests; these cannot evaluate long-lasting formulations or are impractical due to biological risks, high cost, or time required for testing. With increased numbers of long-lasting microbicidal activity claims of commercially available hand sanitizers, alternative testing strategies are required. AIM: To explore the use of a standardized ex-vivo pig skin model to reproducibly measure long-lasting efficacy of an alcohol-free hand sanitizer formulation. METHODS: The microbicidal efficacy of an alcohol-free hand sanitizer was tested against Staphylococcus aureus, Escherichia coli and Klebsiella pneumoniae, and the enveloped virus SARS-CoV-2 with quantitative suspension tests (EN13727 and EN14476) with a contact time of 5 min. The product was then tested over a 6 h period using an ex-vivo pig skin model with a modified version of PAS 2424 to simulate the impact of skin abrasion. FINDINGS: Quantitative suspension tests yielded a >5 log10 reduction for all organisms tested within a 5 min contact time. Pig skin tests showed reduced but consistent efficacy at all time points and indicated no significant impact of abrasion on efficacy. CONCLUSION: The use of the ex-vivo pig skin model provides a potentially viable and convenient model system to test long-lasting hand sanitizer formulations, providing a path for sustainable hand sanitizer formulation claims of activity on skin.
Subject(s)
Anti-Infective Agents , Hand Sanitizers , Animals , Swine , Hand Sanitizers/pharmacology , Ethanol , Escherichia coli , Skin , Hand DisinfectionABSTRACT
Environmental dry surface biofilms are a new type of biofilm found on dry surfaces, that are not visible to the human eye. Dry surface biofilms harbour multidrug-resistant organisms, are resistant to cleaning and disinfection and cannot be detected by wet or dry swabbing, so may play an important role in the persistence of pathogens in the healthcare environment.
Subject(s)
Biofilms , Disinfection , HumansABSTRACT
BACKGROUND: Disinfectant wipes containing quaternary ammonium compounds (QACs) are widely used within health care. Viscose remains a popular material for these products, although limited information is available concerning its impact on performance against biofilms when compared with alternatives. AIM: To identify disinfectant wipe materials and surface properties which optimize product performance against biofilms. METHODS: Biofilm eradication performance of two commercial viscose-QAC wipes was determined against Staphylococcus aureus and Acinetobacter baumannii dry surface biofilms (DSBs) using an ASTM E2967-based procedure. Additionally, five materials were impregnated with a commercial liquid formulation containing didecyldimethylammonium chloride (DDAC). Following 24 h of storage, eradication performance and DDAC content of extracted liquid were determined and compared with material properties, including zeta potential, hydrophobicity and surface area. FINDINGS: Under stringent test conditions, eradication of DSBs by commercial products was no greater than equivalent materials impregnated with water. Extract from one viscose-based product contained 89% less DDAC than the impregnation solution, indicating extensive adsorption. Of the other tested materials, viscose performed worst; nearly 70% of DDAC had depleted from material extracts within 24 h. In contrast, DDAC depletion from polypropylene extracts was only 25%, and DSB eradication was >100 times greater than viscose. Biofilm eradication performance against both species correlated with the DDAC content of extracts, which, in turn, correlated with zeta potential and hydrophobicity. CONCLUSION: Biofilm eradication performance of QAC-based wipes was significantly greater when selecting thermoplastic substrates over viscose. However, these materials are non-sustainably sourced and non-biodegradable. This study highlights a need to develop new wipe products that are more effective against biofilms.
Subject(s)
Disinfectants , Quaternary Ammonium Compounds , Adsorption , Biofilms , Disinfectants/chemistry , Disinfectants/pharmacology , Humans , Quaternary Ammonium Compounds/pharmacology , Staphylococcus aureusABSTRACT
BACKGROUND: Decontamination of non-critical objects shared by patients is key in reducing hospital-acquired infections (HAIs), but it is a complex process that needs precise guidance from UK National Health Service (NHS) acute care organizations (ACOs). AIM: To review the indications given by NHS ACOs' policies regarding the decontamination of shared non-critical devices. METHODS: Detailed lists of decontamination protocols for shared non-critical objects were retrieved from cleaning, disinfection and decontamination policies of 35 NHS ACOs. Three parameters were considered for each object: decontamination method, decontamination frequency, and person responsible for decontamination. FINDINGS: In total, 1279 decontamination protocols regarding 283 different shared non-critical objects were retrieved. Of these, 689 (54%) did not indicate the person responsible for decontamination, and only 425 (33%) were complete, giving indications for all three parameters analysed. Only 2.5% (32/1279) of decontamination protocols were complete and identical in two policies. In policies where cleaning represented the major decontamination method, chemical disinfection was rarely mentioned and vice versa. General agreement among policies was found for four main decontamination methods (detergent and water, detergent wipes, disinfectant wipes, and use of disposable items), two decontamination frequencies (between events and daily) and two responsible person designations (nurses and domestic staff). CONCLUSIONS: Decontamination protocol policies for shared non-critical objects had some similarities but did not concur on how each individual object should be decontaminated. The lack of clear indications regarding the person responsible for the decontamination process put at risk the ability of policies to serve as guidance.
Subject(s)
Decontamination , State Medicine , Disinfection , Humans , Policy , United KingdomABSTRACT
INTRODUCTION: Healthcare environmental surfaces may be contaminated with micro-organisms that cause healthcare-associated infections (HCAIs). Special attention is paid to near-patient surfaces but sites outside the patient zone receive less attention. This paper presents data on keyboard contamination and the risk of pathogen transmission from keyboards. METHODS: Keyboards from nursing stations in three hospitals and a dental practice were analysed for bacterial contamination. Surfaces were pre-treated to remove planktonic bacteria so that any remaining bacteria were presumed to be associated with biofilm. Bacterial transfer from keyboard keys was studied following wiping with sterile water or sodium hypochlorite. The presence of multi-drug-resistant organisms (MDROs) was sought using selective culture. RESULTS: Moist swabbing did not detect bacteria from any keyboard samples. Use of enrichment broth, however, demonstrated MDROs from most samples. Gram-negative bacteria were recovered from almost half (45%) of the samples, with meticillin-resistant Staphylococcus aureus, vancomycin-resistant enterococcus and MDR Acinetobacter spp. recovered from 72%, 31% and 17% of samples, respectively. Isolates were transferred from 69% of samples after wiping with sterile water, and from 54% of samples after wiping with 1000 ppm sodium hypochlorite. DISCUSSION: While moist swabbing failed to detect bacteria from keyboards, pathogens were recovered using enrichment culture. Use of water- or NaOCl-soaked wipes transferred bacteria from most samples tested. This study implies that hospital keyboards situated outside the patient zone commonly harbour dry surface biofilms (DSBs) that offer a potential reservoir for transferable pathogens. While the role of keyboards in transmission is uncertain, there is a need to pursue effective solutions for eliminating DSBs from keyboards.
Subject(s)
Cross Infection , Methicillin-Resistant Staphylococcus aureus , Computers , Cross Infection/prevention & control , Delivery of Health Care , Enterococcus , HumansABSTRACT
Cationic biocides are widely utilized for surface disinfection. Photosensitizers such as toluidine blue O (TBO) produce reactive oxygen species following light excitation and are being investigated as novel biocides for similar applications. Aspergillus brasiliensis conidia contain melanin which protects against environmental stressors. The negative charge and antioxidant properties of melanin may confer resistance to photosensitizers and other biocides. In this study, the yeasticidal and fungicidal activity benzalkonium chloride (BZC), sodium dichloroisocyanurate (NaDCC) and TBO with red light were examined using quantitative suspension tests. All three biocides were highly effective against Candida albicans and > 5·0 log10 reductions in viability were attainable within 5 minutes. Wild-type A. brasiliensis conidia were highly tolerant to treatment and 0·4 log10 reductions in viability were observed within the same time frame when treated with TBO or BZC. NaDCC was markedly more effective. Inhibition of melanin biosynthesis by culturing with 100 µg ml-1 kojic acid resulted in a hypopigmented phenotype with significantly increased sensitivity to all three biocides. These observations indicate that melanin is a significant contributor towards A. brasiliensis tolerance of biocides and photosensitizers and demonstrate that cationic biocides are poorly suited to applications where the control of A. brasiliensis is required.
Subject(s)
Aspergillus/drug effects , Benzalkonium Compounds/pharmacology , Candida albicans/drug effects , Disinfectants/pharmacology , Melanins/metabolism , Tolonium Chloride/pharmacology , Triazines/pharmacology , Antifungal Agents/pharmacology , Aspergillus/metabolism , Candida albicans/metabolism , Disinfection/methods , Light , Photosensitizing Agents/pharmacology , Spores, Fungal/drug effectsABSTRACT
There is no standardized protocol to predict the concentration levels of microbicides that are left on surfaces as a result of the use of these products, and there is no standardized method to predict the potential risk that such levels pose to emerging antibacterial resistance. The ability to distinguish between selection and adaption processes for antimicrobial resistance in bacteria and the impact of different concentrations of microbicide exposure have not been fully investigated to date. This study considers the effect of exposure to a low concentration of chlorhexidine digluconate (CHX) on selected phenotypes of Escherichia coli and relates the findings to the risk of emerging antimicrobial resistance. A concentration of 0.006 mg/ml CHX is a realistic "during use" exposure concentration measured on surfaces. At this concentration, it was possible for CHX-susceptible bacteria to survive, adapt through metabolic alterations, exhibit a transient decrease in antimicrobial susceptibility, and express stable clinical cross-resistance to front-line antibiotics. Efflux activity was present naturally in tested isolates, and it increased in the presence of 0.00005 mg/ml CHX but ceased with 0.002 mg/ml CHX. Phenotypic microarray assays highlighted a difference in metabolic regulation at 0.00005 mg/ml and 0.002 mg/ml CHX; more changes occurred after growth with the latter concentration. Metabolic phenotype changes were observed for substrates involved with the metabolism of some amino acids, cofactors, and secondary metabolites. It was possible for one isolate to continue transferring ampicillin resistance in the presence of 0.00005 mg/ml CHX, whilst 0.002 mg/ml CHX prevented conjugative transfer. In conclusion, E. coli phenotype responses to CHX exposure are concentration dependent, with realistic residual CHX concentrations resulting in stable clinical cross-resistance to antibiotics.
Subject(s)
Anti-Infective Agents , Chlorhexidine , Anti-Bacterial Agents/pharmacology , Chlorhexidine/pharmacology , Escherichia coli/genetics , Microbial Sensitivity Tests , Plasmids/geneticsABSTRACT
BACKGROUND: Pathogens in drain biofilms pose a significant risk for hospital-acquired infection. However, the evidence of product effectiveness in controlling drain biofilm and pathogen dissemination are scarce. A novel in-vitro biofilm model was developed to address the need for a robust, reproduceable and simple testing methodology for disinfection efficacy against a complex drain biofilm. METHODS: Identical complex drain biofilms were established simultaneously over 8 days, mimicking a sink trap. Reproducibility of their composition was confirmed by next-generation sequencing. The efficacy of sodium hypochlorite 1000 ppm (NaOCl), sodium dichloroisocyanurate 1000 ppm (NaDCC), non-ionic surfactant (NIS) and peracetic acid 4000 ppm (PAA) was explored, simulating normal sink usage conditions. Bacterial viability and recovery following a series of 15-min treatments were measured in three distinct parts of the drain. RESULTS: The drain biofilm consisted of 119 mixed species of Gram-positive and -negative bacteria. NaOCl produced a >4 log10 reduction in viability in the drain front section alone, while PAA achieved a >4 log10 reduction in viability in all of the drain sections following three 15-min doses and prevented biofilm regrowth for >4 days. NIS and NaDCC failed to control the biofilm in any drain sections. CONCLUSIONS: Drains are one source of microbial pathogens in healthcare settings. Microbial biofilms are notoriously difficult to eradicate with conventional chemical biocidal products. The development of this reproducible in-vitro drain biofilm model enabled understanding of the impact of biocidal products on biofilm spatial composition and viability in different parts of the drain.
Subject(s)
Biofilms/drug effects , Disinfectants , Disinfection , Water Supply , Biofilms/growth & development , Cross Infection/prevention & control , Hospitals , Peracetic Acid/pharmacology , Reproducibility of Results , Sodium Hypochlorite/pharmacology , Surface-Active Agents/pharmacology , Triazines/pharmacologyABSTRACT
BACKGROUND: The introduction of antimicrobial surfaces into healthcare environments is believed to impact positively on the rate of healthcare-associated infections by significantly decreasing pathogen presence on surfaces. AIM: To report on a novel efficacy test that uses a dry bacterial inoculum to measure the microbicidal efficacy of antimicrobial surfaces. METHODS: An aerosolized dry inoculum of Staphylococcus aureus or Acinetobacter baumannii was deposited on copper alloy surfaces or a hospital-grade stainless-steel surface. Surviving bacteria were enumerated following incubation of the inoculated surfaces at an environmentally relevant temperature and relative humidity. Damage caused to bacteria by the aerosolization process and by the different surfaces was investigated. FINDINGS: Dry inoculum testing showed a <2-log10 reduction in S. aureus or A. baumannii on the copper alloy surfaces tested after 24 h at 20°C and 40% relative humidity. Potential mechanisms of action included membrane damage, DNA damage and arrested cellular respiration. The aerosolization process caused some damage to bacterial cells. Once this effect was taken into account, the antimicrobial activity of copper surfaces was evident. CONCLUSIONS: Our test provided a realistic deposition of a bacterial inoculum to a surface and, as such, a realistic protocol to assess the efficacy of dry antimicrobial environmental surfaces in vitro.
Subject(s)
Aerosols/pharmacology , Alloys , Bacteria/drug effects , Coated Materials, Biocompatible/standards , Copper/pharmacology , Microbial Viability , Acinetobacter baumannii/drug effects , Anti-Bacterial Agents/pharmacology , Anti-Infective Agents/pharmacology , Cross Infection/microbiology , Cross Infection/prevention & control , Freeze Drying , Humidity , Staphylococcus aureus/drug effects , Surface Properties , TemperatureABSTRACT
BACKGROUND: In the wake of the SARS-CoV-2 pandemic and unprecedented global demand, clinicians are struggling to source adequate access to personal protective equipment. Respirators can be in short supply, though are necessary to protect workers from SARS-CoV-2 exposure. Rapid decontamination and reuse of respirators may provide relief for the strained procurement situation. METHOD: In this study, we investigated the suitability of 70°C dry heat and microwave-generated steam (MGS) for reprocessing of FFP2/N95-type respirators, and Type-II surgical face masks. Staphylococcus aureus was used as a surrogate as it is less susceptible than enveloped viruses to chemical and physical processes. RESULTS: We observed >4 log10 reductions in the viability of dry S. aureus treated by dry heat for 90 min at 70°C and >6 log10 reductions by MGS for 90 s. After 3 reprocessing cycles, neither process was found to negatively impact the bacterial or NaCl filtration efficiency of the respirators that were tested. However, MGS was incompatible with Type-II surgical masks tested, as we confirmed that bacterial filtration capacity was completely lost following reprocessing. MGS was observed to be incompatible with some respirator types due to arcing observed around some types of metal nose clips and by loss of adhesion of clips to the mask. CONCLUSION: Considering the advantages and disadvantages of each approach, we propose a reprocessing personal protective equipment/face mask workflow for use in medical areas.
Subject(s)
Coronavirus Infections/prevention & control , Decontamination/methods , Equipment Reuse/standards , Hot Temperature , Masks/virology , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Respiratory Protective Devices/virology , Steam , Betacoronavirus , COVID-19 , Guidelines as Topic , Humans , Microwaves , SARS-CoV-2ABSTRACT
AIMS: The aims of this study were to explore the development of bacterial resistance and cross-resistance in four common human pathogens following realistic exposure to antibiotics found in over-the-counter (OTC) sore throat medicines: gramicidin, neomycin, bacitracin and tyrothricin. METHODS AND RESULTS: Bacterial exposure to in-use (concentration in the product before use) and diluted concentration (i.e. during use) of antibiotic where conducted in broth for 24 h or until growth was visible. The changes in bacterial susceptibility profile before and after exposure was determined using standardized ISO microdilution broth. Antibiotic testing was performed according to EUCAST guidelines. We demonstrated that test bacteria were able to survive exposure to the in-use concentrations of some antibiotics used in OTC medicines. Exposure to during use concentrations of bacitracin resulted in stable increase in minimal inhibitory concentration (MIC) (>8-fold) in Staphylococcus aureus and Acinetobacter baumannii. Exposure to tyrothricin resulted in a stable increase in MIC (2·4-fold) in Klebsiella pneumoniae, and exposure to neomycin resulted in a stable increase MIC (5000-fold higher than the baseline) in Streptococcus pyogenes. Clinical cross-resistance to other antibiotics (ciprofloxacin, fusidic acid, gentamicin, cefpodoxime, amoxicillin/clavulanic acid and cefotaxime) was also demonstrated following exposure to bacitracin or tyrothricin. Bacitracin exposure lead to a stable bacterial resistance after 10 passages. CONCLUSIONS: Our results indicate that OTC antibiotic medicines have the potential to drive resistance and cross-resistance in vitro. SIGNIFICANCE AND IMPACT OF THE STUDY: Tackling antibiotic resistance is a high worldwide priority. It is widely accepted that the overuse and misuse of antibiotics increase the risk of the development and spread of antibiotic resistance within communities. A number of OTC sore throat products, widely available across the world for topical use in respiratory indications, contain locally delivered antibiotics. Our findings showed that these antibiotics in OTC medicines present a risk for emerging cross-resistance in a number of bacterial respiratory pathogens.
Subject(s)
Anti-Infective Agents, Local/adverse effects , Drug Resistance, Bacterial/drug effects , Nonprescription Drugs/adverse effects , Pharyngitis/drug therapy , Anti-Infective Agents, Local/pharmacology , Bacteria/drug effects , Humans , Microbial Sensitivity Tests , Nonprescription Drugs/pharmacology , Pharyngitis/microbiologyABSTRACT
This study aimed to understand the efficacy and mechanisms of action of an aerosolized glycol-ethanol formulations against bacteria. We validated a small-scale in-house test chamber to determine the microbicidal efficacy of four aerosolized formulations combining dipropylene glycol and ethanol against Staphylococcus aureus and Escherichia coli embedded in alginate. The aerosolized glycol/ethanol formulation decreased bacterial viability by 3 log10 and was more efficacious than an ethanol only control formulation. Electron microscopic examination indicated extensive structural damage in both bacteria, and membrane damage was confirmed with potassium release in S. aureus and DNA release in E. coli. The development of a small test chamber facilitated the measurement of the microbicidal efficacy and experiments to understand the mechanism of action of an aerosolized microbicidal formulation. SIGNIFICANCE AND IMPACT OF THE STUDY: There is an increased interest in developing effective microbicidal-aerosolized formulations. The development of a small in-house test chamber allowed the measurement of the microbicidal efficacy of an aerosolized glycol/ethanol formulation at a low cost. We showed that a glycol/ethanol aerosolized formulation caused extensive structural damage in Gram-negative and -positive bacteria resulting in a 3 log10 reduction in viability.
Subject(s)
Anti-Infective Agents/pharmacology , Escherichia coli/drug effects , Glycols/pharmacology , Microbial Sensitivity Tests/instrumentation , Microbial Viability/drug effects , Staphylococcus aureus/drug effects , Aerosols , Ethanol/pharmacologyABSTRACT
The use of microfibre cloths with either water, detergent or disinfectant is currently recommended for hospital cleaning. This study explored the efficacy of a microfibre cloth with either water or detergent/disinfectant or sporicidal products using the ASTM2967-15 standard against Staphylococcus aureus, Acinetobacter baumannii and Clostridium difficile spores. The use of detergent/disinfectant or sporicidal products had a significantly (analysis of variance (ANOVA), P<0.001) better activity than water alone in reducing bacteria and spores' viability, and in reducing the transfer microorganisms between surfaces. The use of water alone with a microfibre cloth is less effective and should not replace the use of biocidal products.
Subject(s)
Detergents/pharmacology , Disinfectants/pharmacology , Disinfection/methods , Environmental Microbiology , Housekeeping, Hospital/methods , Textiles , Acinetobacter baumannii/drug effects , Acinetobacter baumannii/isolation & purification , Bacterial Load , Clostridioides difficile/drug effects , Clostridioides difficile/isolation & purification , Microbial Viability/drug effects , Spores, Bacterial/drug effects , Staphylococcus aureus/drug effects , Staphylococcus aureus/isolation & purificationABSTRACT
Dry surface biofilms (DSB) harbouring pathogens are widespread in healthcare settings, are difficult to detect and are resistant to cleaning and disinfection interventions. Here, we describe a practical test protocol to palliate the lack of standard efficacy test methods for DSB. Staphylococcus aureus DSB were produced over a 12-day period, grown with or without the presence of organic matter, and their composition and viability were evaluated. Disinfectant treatment was conducted with a modified ASTM2967-15 test and reduction in viability, transferability and biofilm regrowth post-treatment were measured. Dry surface biofilms produced over a 12-day period had a similar carbohydrates, proteins and DNA content, regardless of the presence or absence of organic matter. The combination of sodium hypochlorite (1000 ppm) and a microfiber cloth was only effective against DSB in the absence of organic load. With the increasing concerns of the uncontrolled presence of DSB in healthcare settings, the development of effective intervention model in the presence of organic load is appropriate for the testing of biocidal products, while the use of three parameters, log10 reduction, transferability and regrowth, provides an accurate and practical measurement of product efficacy. SIGNIFICANCE AND IMPACT OF THE STUDY: The widespread presence of biofilms on dry surfaces in healthcare settings has been recently documented. These dry surface biofilms (DSB) present an unprecedented challenge to cleaning and disinfection processes. Here, we describe a practical efficacy protocol based on an in vitro Staphylococcus aureus DSB model. The protocol measures reduction in viability, transferability and biofilm regrowth post-treatment to provide altogether a practical assessment of product efficacy against dry surface biofilms.
Subject(s)
Biofilms/growth & development , Disinfectants/pharmacology , Disinfection/methods , Sodium Hypochlorite/pharmacology , Staphylococcus aureus/growth & development , Organic ChemicalsABSTRACT
BACKGROUND: The use of effective cleaning/disinfectant products is important to control pathogens on healthcare surfaces. With the increasing number of wipe products available, there is a concern that combination of a formulation with the wrong material will decrease the efficacy of the product. This study aimed to use a range of efficacy test protocols to determine the efficacy of four formulations before and after binding to three commonly used wiping materials. METHODS: Two quaternary ammonium (QAC)-based products, one hydrogen-peroxide-based product and one neutral cleaner were combined with microfibre, cotton or non-woven materials and tested for efficacy against Pseudomonas aeruginosa and Staphylococcus aureus with two surface tests (ASTM E2197-17 and EN13697-15) and two 'product' tests (ASTM E2967-15 and EN16615-15). FINDINGS: Overall, the impact of using different materials on formulation efficacy was limited, except for an alkyl(C12-16)dimethylbenzylammonium chloride-based product used at 0.5% v/v. The hydrogen peroxide product was the most efficacious regardless of the material used. The results from wipe test ASTM E2967-15 were consistent with those from the surface tests, but not with EN16615-15 which was far less stringent. CONCLUSIONS: The use of different wiping cloth materials may not impact severely on the efficacy of potent disinfectants, despite the absorption of different volumes of formulation by the materials. QAC-based formulations may be at higher risk when a low concentration is used. There were large differences in efficacy depending on the standard test performed, highlighting the need for more stringency in choosing the test to make a product claim on label.
Subject(s)
Disinfectants/pharmacology , Disinfection/methods , Pseudomonas aeruginosa/drug effects , Staphylococcus aureus/drug effects , TextilesABSTRACT
BACKGROUND: Wet biofilms associated with medical devices have been widely studied and their link with healthcare-associated infections (HCAIs) is well recognized. Little attention has been paid to the presence of dry biofilms on environmental surfaces in healthcare settings. AIM: To investigate the occurrence, prevalence, and diversity of dry biofilms on hospital surfaces. METHODS: Sixty-one terminally cleaned items were received from three different UK hospitals. The presence of dry biofilm was investigated using culture-based methods and scanning electron microscopy (SEM). Bacterial diversity within biofilms was investigated using ribosomal RNA intergenic spacer analysis (RISA)-polymerase chain reaction and next-generation sequencing. FINDINGS: Multi-species dry biofilms were recovered from 95% of 61 samples. Abundance and complexity of dry biofilms were confirmed by SEM. All biofilms harboured Gram-positive bacteria including pathogens associated with HCAI; 58% of samples grew meticillin-resistant Staphylococcus aureus. Dry biofilms had similar physical composition regardless of the type of items sampled or the ward from which the samples originated. There were differences observed in the dominance of particular species: dry biofilms from two hospitals contained mostly staphylococcal DNA, whereas more Bacillus spp. DNA was found on surfaces from the third hospital. CONCLUSION: The presence of dry biofilms harbouring bacterial pathogens is virtually universal on commonly used items in healthcare settings. The role of dry biofilms in spreading HCAIs may be underestimated. The risk may be further exacerbated by inefficient cleaning and disinfection practices for hospital surfaces.
Subject(s)
Bacteria/classification , Bacteria/isolation & purification , Biofilms , Dehydration , Environmental Microbiology , Hospitals , Bacteriological Techniques , DNA, Bacterial/chemistry , DNA, Bacterial/genetics , DNA, Ribosomal Spacer/chemistry , DNA, Ribosomal Spacer/genetics , Humans , Microscopy, Electron, Scanning , Polymerase Chain Reaction , Prevalence , Sequence Analysis, DNA , United KingdomABSTRACT
The indiscriminate use of biocides for general disinfection has contributed to the increased incidence of antimicrobial tolerant microorganisms. This study aims to assess the potential of seven phytochemicals (tyrosol, caffeic acid, ferulic acid, cinnamaldehyde, coumaric acid, cinnamic acid and eugenol) in the control of planktonic and sessile cells of Staphylococcus aureus and Escherichia coli. Cinnamaldehyde and eugenol showed antimicrobial properties, minimum inhibitory concentrations of 3-5 and 5-12 mM and minimum bactericidal concentrations of 10-12 and 10-14 mM against S. aureus and E. coli, respectively. Cinnamic acid was able to completely control adhered bacteria with effects comparable to peracetic acid and sodium hypochlorite and it was more effective than hydrogen peroxide (all at 10 mM). This phytochemical caused significant changes in bacterial membrane hydrophilicity. The observed effectiveness of phytochemicals makes them interesting alternatives and/or complementary products to commonly used biocidal products. Cinnamic acid is of particular interest for the control of sessile cells.