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Biofilm Definition of Surgical Instruments

Potentially deadly biofilm on surgical instruments results in 2 million infections, 90,000 deaths and $4.5 billion in excess health-care costs each year for the U.S. Centers for Disease Control and Prevention (or CDC) as well as health-care providers struggling to prevent and control the infectious bacteria. Microorganisms that are highly resistant to disinfectants and antibiotics attach to moist living tissue or implanted medical devices, forming a biological film coating.

  1. Types

    • Swiftly developing biofilm pathogens reside on contact lenses, central venous catheters, endotracheal tubes, mechanical heart valves and dialysis and urinary catheters in colonies that are difficult to eradicate. Staphylococcus epidermidis, S. aureus, Candida albicans, P. aeruginosa, K. pneumoniae and Enterococcus faecalis populate catheters while S. epidermidis, S. aureus, Streptococcus, diphtheroids, enterococci and Candida colonize on central venous catheters or even on dental work, as reported by the Journal of Microbiology and the American Dental Association.

    Development

    • Water and nutrient content of the host tissue or surface determines the type of bacteria, rate of attachment and characteristics of the biofilm.The attached filmy structure, only microns in size, incubates other forms of bacteria and may migrate depending on temperature and availability of plasma or protein, as explained by the CDC's "Biofilm and Device-Associated Infections."

    Treatment

    • Patients with weakened immune systems are particularly vulnerable to biofilm infections. Biofilm infections require immediate intravenous antibiotic, vancomycin. Catheters coated with a cephalosporin cause fewer infections than those treated with chlorhexidine and silver sulfadiazine. Topical antibiotics may prevent skin-borne pathogens from migrating and attaching to medical devices. Other effective treatment options are available from CDC's "Biofilms and Device-Associated Infections."

    Endocarditis

    • The CDC report "Biofilms and Device-Associated Infections" explains that endocarditis can result from a Streptococcus infection from dental work or any other invasive procedure. Tissue damaged by the implantation of mechanical heart valves increases circulating platelets, nutrients for biofilm. Staphylococcus epidermidis biofilm on mechanical heart valves and surrounding heart tissue is the leading cause of prosthetic-valve endocarditis.

    Disinfectants

    • Even pseudomonas become resistant to disinfectants. Germicides can not penetrate the tenacious biofilm. Ceragenins, which mimic the activity of the bacteria, have been developed to rid surgical instruments of biofilm. Brigham Young University displays the broad spectrum activity and directions for use of CSA-13 against Escherichia coli, Pseudomonas aeruginosa, Salmonella choleraesuis, and Staphylococcus aureus (or MRSA). In "New Disinfection and Sterilization Methods," the CDC details approximately 24 agents for health-care providers.

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