Biofilms in Infection Prevention and Control

Biofilms in Infection Prevention and Control, 1st Edition

A Healthcare Handbook

Biofilms in Infection Prevention and Control, 1st Edition,Steven Percival,David Williams,Tracey Cooper,Jacqueline Randle,ISBN9780123970435

Percival   &   Williams   &   Cooper   &   Randle   

Academic Press




235 X 191

The only book to explain the science of biofilms—the most common source of Health Care Associated Infections-- and to provide practical guidance for infection prevention and control.

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Key Features

  • Provides specific procedures for controlling and preventing infection
  • Includes case studies of HCAI, and identifies appropriate treatments
  • Presents national government standards for infection prevention and control
  • Includes extensive references and links to websites for further information


Biofilms in Infection and Disease Control: A Healthcare Handbook outlines the scientific evidence and rationale for the prevention of infection, the role biofilms play in infection control, and the issues concerning their resistance to antimicrobials. This book provides practical guidance for healthcare and infection control professionals, as well as students, for preventing and controlling infection.

Biofilms are the most common mode of bacterial growth in nature. Highly resistant to antibiotics and antimicrobials, biofilms are the source of more than 65 percent of health care associated infections (HCAI), which, according to the WHO, affect 1.4 million people annually. Biofilms are involved in 80 percent of all microbial infections in the body, including those associated with medical devices such as catheters, endotracheal tubes, joint prostheses, and heart valves. Biofilms are also the principle causes of infections of the middle-ear, dental caries, gingivitis, prostatitis and cystic fibrosis. Importantly, biofilms also significantly delay wound healing and reduce antimicrobial efficiency in at-risk or infected skin wounds.


Infections control professionals, healthcare professionals, and postgraduate students in medicine, biology, health, and microbiology.

Steven Percival

Professor Steven L. Percival holds a PhD in medical microbiology and biofilms, a BSc in Applied Biological Sciences, Postgraduate Certificate in Education, diploma in Business Administration, an MSc in Public Health and an MSc in Medical and Molecular Microbiology. He is also a fellow of the Institute of Biomedical Science and Institute of Biology. Early in his career, Steven held R&D positions for over 3 years at The British Textile Technology Group Plc, followed then by 6 years as a senior university lecturer in medical microbiology and later the positions of Chief Scientific Officer and Director of R and D at Aseptica, Inc., and senior clinical fellowships at the Centers for Disease Control, Atlanta, and Leeds Teaching Hospitals Trust, Leeds, United Kingdom. More recently, Steven held senior R&D manager positions at Bristol Myers Squibb, ConvaTec, Advanced Medical Solutions PLC and also held an honorary Professorship of Microbiology at West Virginia University. In 2011, Steven joined ScapaHealthcare PLC as Vice President of Global Healthcare R&D and was awarded an honorary Professorship at The University of Liverpool, UK. He has written over 260 scientific publications and conference abstracts on water microbiology, biofilms, antimicrobials, and infection control and has authored or edited six textbooks on biofilms and microbiology and provided over 100 presentations on biofilms and public health worldwide.

Affiliations and Expertise

Leeds Teaching Hospitals, UK

David Williams

BSc (Hons), PhD

Dr. Williams currently leads the Oral Microbiology Group based at the School of Dentistry, at Cardiff University, Cardiff, UK. Since Dr. Williams’ first degree (Cardiff University), he has worked in the pharmaceutical industry, food microbiology and as an academic researcher. Having completed a PhD at the School of Dentistry in Cardiff on the immunopathogenesis of oral candidosis, Dr. Williams’ research has continued within Cardiff University and primarily focuses within the field of Clinical Microbiology with an emphasis on studies involving microbial biofilms. Dr. Williams’ research encompasses investigating biofilm susceptibility to antimicrobial agents, expression of virulence factors such as hydrolytic enzyme production, adhesion, and microbial modulation of innate immune responses. Of particular interest has been research into the development of biomaterials (e.g. silicone rubber, acrylic, titanium) to inhibit biofilm formation on medical devices. Dr. Williams is a previous recipient of the Senior Colgate Award (British Society for Oral and Dental Research) and the International Hatton Award (The International Association for Dental Research).

Affiliations and Expertise

Professor of Oral Microbiology, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Heath Park, Cardiff, Wales, UK

Tracey Cooper

Tracey Cooper works as Assistant Director of Nursing - Infection Prevention for Betsi Cadwaladr University Health Board in Wales. Prior to this she worked as a Director of Infection Prevention and Control in London for four years, having first ‘got the bug’ for infection prevention and control in 1996. She has also previously worked in infection prevention in Devon, on the Isle of Wight, and in Southampton, covering both acute and community issues. Her background includes work in intensive and coronary care, as well as acute hospital ward experience. Tracey has experience as both an author and peer reviewer and was the Infection Prevention Society (IPS) Editor from 2004-2008. She subsequently served as IPS Vice-President, and then President until 2012. She continues to participate in national and professional society initiatives and projects, and is particularly interested in professional development, change management and patient safety initiatives. Outside work she enjoys running, loves the outdoors and participates in several Mountain Marathons each year.

Affiliations and Expertise

South London Healthcare NHS Trust, UK

Jacqueline Randle

Until recently Jacqueline Randle was working as an Associate Professor at the University of Nottingham where she was involved with a range of funded research projects in the area of infection prevention and control. She worked as the Research Lead for Nottingham University Hospitals NHS Trust and also worked as a national Research Mentor. She was also Visiting Professor in Infection Control at Belo Horizonte University, Brazil and has published widely in the area of infection prevention and healthcare practice. Currently she is working as a freelance Medical Investigator.

Affiliations and Expertise

Queens Medical Centre, University of Nottingham, UK

Biofilms in Infection Prevention and Control, 1st Edition



List of Contributors

List of Figures

List of Tables

List of Exhibits

Part 1: Fundamentals of Infection Control

Chapter One. Introduction to Infection and Infection Prevention


The Impact of Infection

ICUS and Healthcare-Associated Infections

The Law and Healthcare-Associated Infection

Working with Patients and Their Families and/or Caregivers

Training, Education and Roles



Chapter Two. Infection Prevention: Principles of Safe Practice in Healthcare


Standard Precautions

Maintaining Asepsis Using an Aseptic Technique

Safe Collection of Specimens

Transmission-Based Precautions



Chapter Three. Hand Hygiene


Issues Associated with Healthcare Workers’ Compliance

Factors Affecting Hand Hygiene Compliance

Recommendations for Effective Hand Hygiene



Chapter Four. Decontamination


Useful Definitions

Choosing the Appropriate Process

Decontamination of Medical Devices

Decontamination of the Environment

Decontamination of Blood Spillage



Chapter Five. Challenges to Healthcare Providers


Clostridium Difficile

Meticillin-Resistant Staphylococcus Aureus




Chapter Six. Changing Practice


The Code of Practice

Commissioning Infection Prevention and Control Services

The Francis Report

Empowerment and Power




Chapter Seven. Invasive Devices


Short- and Long-Term Urinary Catheters

Faecal Management Systems

Intravenous Access Devices




Chapter Eight. Wounds and Infection


Wounds and the Healing Process

Wounds and Micro-organisms

Recognising and Preventing Wound Infection

Surgical Site Infections

Categories of Surgical Wounds and Infection Risk



Part 2: Biofilms and Infection Control

Chapter Nine. Biofilms: From Concept to Reality


Prevalence of Biofilms

Models to Study Biofilms

Formation of Biofilms

Detachment and Dissemination of Biofilms

Biofilm Structure

The Biofilm Community



Chapter Ten. Healthcare-Associated Infections and Biofilms


Biofilm Formation: A Strategy for Survival

Host Responses to Biofilms

Biofilm Detection

The Micro-Organisms

Biofilm Prevention



Chapter Eleven. Biofilms’ Role in Intravascular Catheter Infections


Complications of Intravascular Catheters

Routes of Intravascular Catheter Infection

Diagnosis of Infection

Evidence and Impact of Biofilm Formation

Prevention and Treatment of Infections



Chapter Twelve. Ventilator-Associated Pneumonia, Endotracheal Tubes and Biofilms


Diagnosis and Complications

Biofilms and Endotracheal Tubes

VAP and Biofilm Control



Chapter Thirteen. Antimicrobial Chemotherapy: Significance to Healthcare


Development of Antimicrobial Therapy

Principles of Antibiotic Therapy

Classes of Antibiotics

Microbiological Examination

Indication and Selection of Antibiotics

Drug Interactions and Adverse Effects

Antibiotic Resistance





Chapter Fourteen. An Introduction to the Biology of Biofilm Recalcitrance


Evidence for Clinical Recalcitrance

Contributions of the Biofilm Matrix to Recalcitrance

Bacterial Persistence as a Biofilm-Specific Phenotype

The clinical significance of bacterial persistence



Chapter Fifteen. Microbial Resistance and Superbugs


Definitions of Antimicrobial Resistance

Mechanisms of Antimicrobial Resistance

Genetics of Resistance


Prevention and Control of MDR Organisms



Chapter Sixteen. Preventing Infection Associated with Urethral Catheter Biofilms



Biofilm on the Urinary Catheter


CA-UTI Prevention Guidelines and Recommendations

Future Directions


Chapter Seventeen. Presence and Control of Legionella pneumophila and Pseudomonas aeruginosa Biofilms in Hospital Water Systems


Pseudomonas Aeruginosa

Legionella Pneumophila

Legislation and Guidance for Control of Micro-Organisms

Point-of-Use Water Filtration




Chapter Eighteen. Wound Infection and Biofilms


Biology of Wound Healing

Microbial Communities

The Potential Significance of Biofilms in Wounds

Biofilm Formation




Quotes and reviews

"Many of the initial chapters...serve as review for practitioners who are experienced in infection prevention...the later chapters on biofilms and the role of biofilms in infection prevention will be of interest to these readers. Rating: 3 Stars"-- Doody's.com, September 12 2014

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