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Archive July 2016 XVII, No. 7

Beating Back Bacterial Biofilms

Tips to prevent the growth of the slimy coating that lets bacteria survive and thrive.

Donna Swenson, BS, CRCST, CHL, ACE


biofilm HIDDEN MENACE Could biofilm — a slimy microscopic coating that harbors bacteria — be hiding in your lumened instruments?

Biofilms are a reprocessor's nightmare. Resilient, relentless and often microscopic, these slimy, sticky coatings that bacteria excrete can form in minutes on moist surfaces and in lumened instruments. Once they form, good luck removing them. Biofilms can be up to 1,000 times more resistant to antimicrobial agents than the standard bacteria you're used to fighting. But there are steps you can take to prevent biofilm from forming.

  • Point-of-use cleaning. The longer biofilm sits on instruments, the stronger it becomes and the harder it is to remove. Begin the cleaning process as soon as possible after instruments have been used. After you wipe and rinse away all gross, heavy organic debris and flush cannulas with sterile water, keep instruments moist. You can spray them with an enzymatic solution or foam, cover them with a moist towel, or place them in a plastic bag or pouch. Don't let moist instruments sit for too long. The conditions for biofilm to form are perfect when bacteria remain in a wet environment for a long time. Then it becomes even more difficult to get your instrument microbe-free.
  • Transport to central sterile. After point-of-use cleaning is complete, promptly transport instruments to central processing in a covered container. New AORN guidelines state that OR staff should document when the procedure ended so techs know how much time has elapsed between the end of the procedure and the start of cleaning.
  • Cleaning. This step depends on the instrument and the manufacturer's instructions for use (IFU). Follow these instructions exactly to ensure thorough cleaning. Depending on the type of instrument, this might include manual cleaning, ultrasonic washing or using an automated washer. If allowed by the IFU, mechanical cleaning is preferred over manual scrubbing because it's more thorough and less variable, according to some endoscope reprocessing guidelines (
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