Medical Device Disinfectant
Medical device related infections pose a significant financial burden to healthcare services and threaten patient safety. However, they are often preventable. According to the CDC, the most commonly reported medical device related Healthcare Associated Infections (HAIs) involve central line-associated bloodstream infections (CLABSIs), ventilator-associated pneumonia (VAP), and catheter-associated urinary tract infections (CAUTIs). The microorganisms associated with these infections include biofilm-forming species of Gram-positive bacteria, Gram-negative bacteria and yeast. Despite the range of microbes implicated in medical device related infections, S. epidermidis and S. aureus are widely acknowledged as the main contributors. In addition, multi-drug resistant Gram-negative bacteria are becoming more widespread in both long-term and acute care facilities.
The trait that makes these microbes successful at causing infections is their ability to form biofilms. Biofilms are communities of microorganisms that can attach to both biotic and abiotic surfaces. A major feature of biofilms is the production of extracellular polymeric substances (EPS), which protects the community of microorganisms from external threats from the human immune system and antimicrobials. Biofilm formation comprises several stages: reversible and irreversible attachment, colonization, maturation and dispersion. When a biofilm develops on living tissues or medical devices, it is possible for cells to detach, disseminated, and cause a systemic infection, especially if the host immune response is compromised.
Molecular iodine is a major disinfectant used for the prevention of HAIs. Studies investigating the development of I2 resistance demonstrate that acute and long-term use of molecular iodine does not cause any bacterial resistance. A study investigated the development of bacterial resistance during long-term daily use of disinfectants on catheter exit wounds of continuous ambulatory peritoneal dialysis (CAPD) patients. In contrast to the well known phenomenon of enhanced resistance under selection pressure of antibiotics, they found long-term use of PVP-1 did not enhance resistance in coagulase-negative Staphylococci (CNS) of CAPD patients. A curing experiment further demonstrated that the loss of antibiotic resistance determinants did not influence sensitivity to PVP-I. This proved that there was no evidence of plasmid encoded resistance against molecular iodine adjacent to the antibiotic resistance determinants included in the curing tests.