from the editor
from the editor
Biofilms and C . diff are Among the Myriad Challenges to Environmental Hygiene Efforts
No cleaning and disinfection program is complete without consideration of the role that biofilms on surfaces play in the transmission of healthcare-acquired infections ( HAIs ). As we know , biofilms serve as a reservoir for pathogens including multidrug-resistant organisms and their elimination requires different approaches , depending on whether facilities are facing hydrated biofilms in sink drains and parts of some medical devices and equipment , or dry biofilms ( DSB ) on environmental surfaces , or both .
I recommend a recent review by Maillard and Centeleghe ( 2023 ) which provides a very capable overview of the dangers of biofilms . As they advise , “ The control of hydrated ( drain ) biofilms should be informed by a reduction or elimination of microbial bioburden together with measuring biofilm regrowth time . The control of DSB should be measured by a combination of a reduction or elimination in microbial bioburden on surfaces together with a decrease in bacterial transfer post-intervention . Failure to control biofilms increases the risk for HAI , but biofilms are not solely responsible for disinfection failure or shortcoming .”
What is key to remember is the potential impact of biofilms on disinfectant efficacy . As Maillard and Centeleghe ( 2023 ) remind us , “ Bacteria embedded in biofilms are less susceptible than their planktonic counterparts and might account for the failure of surface disinfection , with bacteria remaining on surfaces after biocide exposure .”
Numerous studies have investigated the susceptibility of biofilms to disinfection , underscoring that the lack of disinfectant efficacy was associated with biofilm thickness and maturity or the presence of persisters . As Maillard and Centeleghe ( 2023 ) say , “… the use of disinfectants is often sub-optimal against biofilms , resulting in high numbers of viable and culturable bacteria … With drain biofilms , apart from the documented lack of disinfectant efficacy , the challenge is biofilm regrowth . While some disinfectants such as chlorine-based ones can also decrease biofilm mass , rapid regrowth is inevitable , and the species composition of the biofilm may remain the same . The efficacy of surface cleaning / disinfection against DSB has been recommended to be based on both reduction in viability from surfaces and decreased or lack of microbial transfer post-exposure , which in principle originated from studies on pre-wetted antimicrobial wipes and is integral part of the ASTM2967-15 antimicrobial wipe standard efficacy test . Bacterial transfer , including via the medium of gloves , is particularly relevant with DSB where the surface has been exposed to cleaning or disinfection .”
In this issue we talk to Phil Carling , a co-author of a study on C . diff cleaning and disinfection strategies , as well as Brett Mitchell , a co-author of a study on multimodal interventions for environmental cleaning and disinfection . It ’ s our hope that these two articles will provide you with insights and perspectives on the importance of a programmatic approach to environmental hygiene , which undoubtedly includes biofilm eradication . Until next month , bust those bugs !
Kelly M . Pyrek Editor & Publisher kelly @ healthcarehygienemagazine . com
Reference : Maillard J-Y and Centeleghe I . How biofilm changes our understanding of cleaning and disinfection . Antimicrobial Resistance & Infection Control . Vol . 12 , article number 95 . Sept . 7 , 2023 . healthcarehygienemagazine
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6 october 2023 • www . healthcarehygienemagazine . com