Abstract

The development of a biofilm constitutes a survival strategy by providing bacteria a protective environment safe from stresses such as microbicide action and can thus lead to important health-care problems. In this study, biofilm resistance of a Bacillus subtilis strain (called hereafter NDmedical) recently isolated from endoscope washer-disinfectors to peracetic acid was investigated and its ability to protect the pathogen Staphylococcus aureus in mixed biofilms was evaluated. Biocide action within Bacillus subtilis biofilms was visualised in real time using a non-invasive 4D confocal imaging method. The resistance of single species and mixed biofilms to peracetic acid was quantified using standard plate counting methods and their architecture was explored using confocal imaging and electronic microscopy. The results showed that the NDmedical strain demonstrates the ability to make very large amount of biofilm together with hyper-resistance to the concentration of PAA used in many formulations (3500 ppm). Evidences strongly suggest that the enhanced resistance of the NDmedical strain was related to the specific three-dimensional structure of the biofilm and the large amount of the extracellular matrix produced which can hinder the penetration of peracetic acid. When grown in mixed biofilm with Staphylococcus aureus, the NDmedical strain demonstrated the ability to protect the pathogen from PAA action, thus enabling its persistence in the environment. This work points out the ability of bacteria to adapt to an extremely hostile environment, and the necessity of considering multi-organism ecosystems instead of single species model to decipher the mechanisms of biofilm resistance to antimicrobials agents.

Highlights

  • In response to environmental conditions, bacteria have developed different strategies to adapt and survive

  • As biofilm formation is frequently associated with increased resistance to sanitizing treatments and antibiotic therapies [30,31,32], the enhanced biofilm-forming ability of strain NDmedical can represent a strategy to survive despite the regular exposure to biocide treatments

  • Our present results showed a very high resistance of the NDmedical biofilm to peracetic acid (PAA), an oxidizing agent commonly used in formulations used in endoscope disinfection; highlighting that biofilm formation could enable this strain to persist despite drastic disinfection treatments applied during endoscope decontamination

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Summary

Introduction

In response to environmental conditions, bacteria have developed different strategies to adapt and survive. The formation of multicellular communities known as biofilms is one such strategy, which is associated with increased bacterial resistance to environmental stress accompanying antimicrobial treatments [1,2]. It has been shown that non-lethal concentrations of antibiotics or disinfectants can stimulate biofilm formation [3,4] which constitutes a defensive response to the toxic effects of the biocides. The presence of a protective extracellular matrix via the expression of specific genes in the biofilm, the metabolic state of cells due to microenvironmental conditions have all been identified as playing a role in biofilm resistance to antimicrobial agents [5].

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