Biofilms are complex microbial communities which are ubiquitous in nature. Biofilms are found in our homes, in our workplaces and in the hospitals we use.
These microbial communities are encased in an exopolysaccharide or slime which provides protection from environmental stresses, disinfectant and antibiotics.
Biofilms are responsible for challenges in the different settings they are found. Biofilms on the hulls of ships can slow ships down and increase fuel costs. In the food industry biofilms are responsible for spoilage of crops, product recalls and food poisoning. All of this comes at cost with biofilms being predicted to resulting in estimated economic cost of $5 trillion USD annually1.
Attention as focused recently on the role of biofilms in spread of healthcare associated infections (HAIs).
Wet biofilms can harbour multidrug resistant microorganisms (MRDOs) which can be dispersed from biofilms and spread into the patient environment. Research has shown when operating a sink to perform hand hygiene water droplets can be spread up to 2 meters into the surrounding environment2. The same study audited the different types of equipment found within this ‘splash zone’ and found significant numbers of equipment for the car of patents to be in this splash zone.
A recent systematic review examined the impact of sink removal in the intensive care setting and other water-free interventions3. It concluded that in outbreak settings removal of sinks supports cessation of outbreaks. There has been increased interest in removal of sinks and a more to water free or water light care but what about in hospital wards and departments where sinks cannot be removed?
Disinfection of sinks is one option available to hospitals to try and eradicate biofilms. A variety of different disinfectants are available including peracetic acid, hydrogen peroxide and bleach. However, limitations of some of these disinfectants have been reported including poor log reductions and regrowth of biofilm4.
Hypochlorous acid or HOCl is a novel candidate for disinfection of healthcare facilities due to its sustainability (generated from salt and water) and safety benefits in comparison to bleach. HOCl has shown good efficacy against biofilms caused by Pseudomonas aeruginosa5 in wounds and Escherichia coli and Listeria monocytogenes biofilms in the food industry6.
So, is there a role for HOCl in the decontamination on sinks within healthcare?
The oxidative power of HOCl provides a broad efficacy profile against viruses, bacteria and spores7. The ability of HOCl containing products to incorporate sodium hydroxide into products and formulations is also advantageous, as sodium hydroxide can assist the removal of the exopolysaccharide found in biofilms8.
More data is emerging on HOCl and its applications in healthcare. Given its broad efficacy profile coupled with the sustainability and safety benefits HOCl has potential in supporting the eradication of biofilms in hospital sinks and drains to support a clean and safety environment to keep patents and healthcare professionals safe.
There is now an opportunity that is not only ground-breaking but where we can see what is causing our healthcare system a problem. At HOCL Health, we will unveil a solution that Detects & Eradicates Biofilms in sinks at the IPS Conference. Visit Stand 33 on the 23rd-25th of September to see this new innovation, come and speak to the HOCLologists about it.
References
- Highmore CJ, Melaugh G, Morris RJ, et al. Translational challenges and opportunities in biofilm science: a BRIEF for the future. NPJ Biofilms Microbiomes. 2022;8(1):68. Published 2022 Aug 29.
- Garvey MI, Williams N, Gardiner A, et al. The sink splash zone. J Hosp Infect. 2023;135:154-156.
- Low JM, Chan M, Low JL, Chua MCW, Lee JH. The impact of sink removal and other water-free interventions in intensive care units on water-borne healthcare-associated infections: a systematic review. J Hosp Infect. 2024;150:61-71.
- Ledwoch K, Robertson A, Lauran J, Norville P, Maillard JY. It's a trap! The development of a versatile drain biofilm model and its susceptibility to disinfection. J Hosp Infect. 2020;106(4):757-764.
- Fleming D, Bozyel I, Ozdemir D, et al. HOCl-producing electrochemical bandage for treating Pseudomonas aeruginosa-infected murine wounds. Antimicrob Agents Chemother. 2024;68(2):e0121623.
- Block MS, Rowan BG. Hypochlorous Acid: A Review. J Oral Maxillofac Surg. 2020;78(9):1461-1466. doi:10.1016/j.joms.2020.06.029
- Block MS, Rowan BG. Hypochlorous Acid: A Review. J Oral Maxillofac Surg. 2020;78(9):1461-1466
- Antoniou K, Frank JF. Removal of Pseudomonas putida biofilm and associated extracellular polymeric substances from stainless steel by alkali cleaning. J Food Prot. 2005;68(2):277-281