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Enterococcus spp. ability to form a dry surface biofilm: a route to persistence on environmental surfaces

Harsent, R., Cattoir, V., Pascoe, M. ORCID: https://orcid.org/0000-0002-7794-8970, Pertusati, F. ORCID: https://orcid.org/0000-0003-4532-9101, Westwell, A. C. ORCID: https://orcid.org/0000-0002-5166-9236 and Maillard, J-Y. ORCID: https://orcid.org/0000-0002-8617-9288 2025. Enterococcus spp. ability to form a dry surface biofilm: a route to persistence on environmental surfaces. Journal of Hospital Infection 10.1016/j.jhin.2025.09.008

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Abstract

Healthcare-associated infections (HAIs) present a significant global burden, with resistant pathogens such as vancomycin-resistant enterococci (VRE) being of particular concern. Dry surface biofilms (DSB) have recently emerged as critical reservoirs for multidrug-resistant organisms in healthcare environments, yet little is known about enterococcal DSB formation and persistence. This study aimed to evaluate the ability of various Enterococcus species and clinical isolates to form DSB on healthcare-relevant materials, assess their long-term survival, and explore factors influencing DSB culturability. Multiple Enterococcus strains, including epidemic and vancomycin-resistant isolates, were cultured using a standardised DSB formation model on a range of surfaces and materials commonly found in healthcare settings. Culturability was assessed through serial dilutions and colony enumeration. Structural characterisation was performed via scanning electron microscopy (SEM), confocal microscopy and flow cytometry. All Enterococcus strains formed DSB on stainless steel and other clinical materials. DSB maintained high culturability (5-6 log ) for up to 84 weeks at 20°C and 55% relative humidity. VRE strains exhibited lower culturability compared to non-VRE. No correlation was found between DSB formation and surface roughness or hydrophobicity. SEM, confocal imaging and flow cytometry confirmed heterogeneity in DSB structure and viability across surfaces. Enterococcus spp. can form persistent, viable DSB on diverse healthcare surfaces, contributing to the environmental persistence of pathogens. The combination of mechanical removal with an effective disinfectant remains at present the best approach for DSB control on hard surfaces. As such, enhanced cleaning and disinfection might be, for the time being, the best approach to control DSB on hard surface. [Abstract copyright: Copyright © 2025. Published by Elsevier Ltd.]

Item Type: Article
Date Type: Published Online
Status: In Press
Schools: Schools > Chemistry
Schools > Pharmacy
Publisher: Elsevier
ISSN: 0195-6701
Date of Acceptance: 27 September 2025
Last Modified: 17 Nov 2025 15:45
URI: https://orca.cardiff.ac.uk/id/eprint/182463

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