Highlights
- •Bacterial adhesion forming a multilayer on surgical forceps can occurs in 1 hour.
- •Automated cleaning remove microbial load better than manual cleaning.
- •Microbial loads recovered from jaw and ratchet were higher compared to shank.
- •Structural damage on forceps may act as sites for microbial adhesion and shelter.
Background
Biofilm removal is a challenge during surgical instrument processing. We analyzed
the time required for Staphylococcus epidermidis to form biofilms on surgical instruments, and how cleaning methods removed them.
Methods
Different areas (ratchet, shank, and jaw) of straight crile forceps were contaminated
by soaking in Tryptic Soy Broth containing 106 colony forming units (CFU)/mL of S epidermidis for 1, 2, 4, 6, 8, and 12 hours. S epidermidis adhesion and removal, after manual or automated ultrasonic cleaning, was evaluated
by microbiological culture and scanning electron microscopy.
Results
Microbial load increased with time (101-102 CFU/cm2 after 1 hour; 104 CFU/cm2 after 12 hours). Exopolysaccharide was detected after 2 hours and gradually increased
thereafter. Bacterial load was reduced by 1-2 log10 after manual cleaning and 1-3 log10 after automated cleaning, but biofilms were not completely eliminated. In general,
bacterial load was lower in shank fragments. This difference was significant at 6
hours.
Conclusions
Rapid adhesion of S epidermidis and exopolysaccharide formation was observed on surgical instruments. Automated cleaning
was more effective than manual cleaning, but neither method removed biofilms completely.
The precleaning conditions and the forceps design are critical factors in processing
quality.
Key Words
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Article Info
Publication History
Published online: October 17, 2019
Footnotes
Funding/support: This study was supported by the Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG) by universal edict 2015, process APQ 02025-15.
Conflicts of interest: None to report.
Identification
Copyright
© 2019 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
