A B S T R A C TDrinking water biofilm formation on polyvinyl chloride (PVC), cross-linked polyethylene (PEX), high density polyethylene (HDPE) and polypropylene (PP) was followed in three different reactors operating under stagnant or continuous flow regimes. After one week, a quasi-steady state was achieved where biofilm total cell numbers per unit surface area were not affected by fluctuations in the concentration of suspended cells. Metabolically active cells in biofilms were around 17-35% of the total cells and 6-18% were able to form colony units in R 2 A medium. Microbiological analysis showed that the adhesion material and reactor design did not affect significantly the biofilm growth. However, operating under continuous flow (0.8-1.9 Pa) or stagnant water had a significant effect on biofilm formation: in stagnant waters, biofilm grew to a less extent. By applying mass balances and an asymptotic biofilm formation model to data from biofilms grown on PVC and HDPE surfaces under turbulent flow, specific growth rates of bacteria in the biofilm were found to be similar for both materials (around 0.15 day À1) and much lower than the specific growth rates of suspended bacteria (around 1.8 day À1 ).

The effects of water stagnation and flushing on the biological stability of drinking water were studied by promoting the formation of biofilms under continuous flow (turbulent or laminar) and subsequently subjecting them to unsteady hydraulic situations. Independently of the flow regime under which the biofilm was formed, stagnation promoted bacterial accumulation, either in attached or suspended form, which were carried away in higher numbers when flow was re-started, thereby compromising its biological quality. In all cases, Betaproteobacteria was the dominant phylogenetic group, although Gamma and Alpha subclasses were also present. These results suggest that special attention should be given to the biological quality of drinking water where consumption is subjected to strongly variable demands such as in seasonal hotels, week-end houses or dental clinics after week-ends as abnormal changes may have occurred in the microbiological parameters. Moreover, this study showed that the cultivable bacterial numbers are not related to those of total bacteria and, thus, should not be the basis for the routine tests of bacteriological control in these systems.

Nanohydroxyapatite possesses exceptional biocompatibility and bioactivity regarding bone cells and tis-sues, justifying its use as a coating material or as a bone substitute. Unfortunately, this feature may also encourage bacterial adhesion and biofilm formation. Surface functionalization with antimicrobials is a promising strategy to reduce the likelihood of bacterial infestation and colonization on medical devices. Chlorhexidine digluconate is a common and effective antimicrobial agent used for a wide range of medical applications. The purpose of this work was the development of a nanoHA biomaterial loaded with CHX to prevent surface bacterial accumulation and, simultaneously, with good cytocompatibility, for application in the medical field. CHX (5-1500 mg/L) was loaded onto nanoHA discs and the materials were evaluated for CHX adsorption and release profile, physic-chemical features, antibacterial activity against Escherichia coli, Staphylococcus aureus and Staphylococcus epidermidis, and cytocompatibility toward L929 fibroblasts. Results showed that the adsorption of CHX on nanoHA surface occurred by electrostatic inter-actions between the cationic group of CHX and the phosphate group of nanoHA. The release of CHX from CHX-loaded nanoHA showed a fast initial rate followed by a slower kinetics release, due to constraints caused by dilution and diffusion-limiting processes. NanoHA.50 to nanoHA.1500 showed strong anti-sessile activity, inhibiting bacterial adhesion and the biofilm formation. CHX-nanoHA caused a dose-and time-dependent inhibitory effect on the proliferation of fibroblasts for nanoHA.100 to nanoHA.1500. Cellular behavior on 2 nanoHA.5 and nanoHA.50 was similar to control. Therefore, CHX-loaded nanoHA surfaces appear as a promising alternative to prevention of devices-related infections.

Nanohydroxyapatite (nanoHA), due to its chemical properties, has appeared as an exceptionally promising bioceramic to be used as bone regeneration material. Staphylococcus epidermidis have emerged as major nosocomial pathogens associated with infections of implanted medical devices. In this work, the purpose was to study the influence of the nanoHA surface characteristics on S. epidermidis RP62A biofilm formation. Therefore, two different initial inoculum concentrations (Ci) were used in order to check if these would affect the biofilm formed on the nanoHA surfaces. Biofilm formation was followed by the enumeration of cultivable cells and by scanning electron microscopy. Surface topography, contact angle, total surface area and porosimetry of the biomaterials were studied and correlated with the biofilm data. The surface of nanoHA sintered at 830 o C (nanoHA830) showed to be more resistant to S. epidermidis attachment and accumulation than that of nanoHA sintered at 1000 o C (nanoHA1000). The biofilm formed on nanoHA830 presented differences in terms of structure, surface coverage and EPS production when compared to the one formed on nanoHA1000 surface. It was observed that topography and surface area of nanoHA surfaces had influence on the bacterial attachment and accumulation. Ci influenced bacteria attachment and accumulation on nanoHA surfaces over time. The choice of the initial inoculum concentration was relevant proving to have an effect on the extent of adherence thus being a critical point for human health if these materials are used in implantable devices. This study showed that the initial inoculum concentration and surface material properties determine the rate of microbial attachment to substrata and consequently are related to biofilm-associated infections in biomaterials.

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Implant-associated infections are caused by surface-adhering microorganisms persisting as biofilms, resistant to host defense and antimicrobial agents. Given the limited efficacy of traditional antibiotics, novel strategies may rely on the prevention of such infections through the design of new biomaterials. In this work, two antimicrobial agents applied to nanohydroxyapatite materials-namely, chlorhexidine digluconate (CHX) and zinc oxide (ZnO) nanoparticles-were compared concerning their ability to avoid single- or dual-species biofilms of Staphylococcus aureus and Escherichia coli. The resulting biofilms were quantified by the enumeration of colony-forming units and examined by confocal microscopy using both Live/Dead staining and bacterial-specific fluorescent in situ hybridization. The sessile population arrangement was also observed by scanning electron microscopy. Both biomaterials showed to be effective in impairing bacterial adhesion and proliferation for either single- or dual-species biofilms. Furthermore, a competitive interaction was observed for dual-species biofilms wherein E. coli exhibited higher proliferative capacity than S. aureus, an inverse behavior from the one observed in single-species biofilms. Therefore, either nanoHA-CHX or nanoHA-ZnO surfaces appear as promising alternatives to antibiotics for the prevention of devices-related infections avoiding the critical risk of antibiotic-resistant strains emergence. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 491-497, 2017.

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