The Imperative for Change Ending Biofilms in Canadian Healthcare

In the demanding environment of Canadian healthcare, the pursuit of patient safety and effective infection control is a continuous journey. Despite diligent efforts and stringent protocols, healthcare-associated infections (HAIs) continue to be a formidable challenge. Annually, over 220,000 Canadian patients develop HAIs, costing our system $1 billion and contributing to up to 12,000 preventable deaths. A significant contributor to this persistent threat remains largely out of sight and often misunderstood the pervasive presence of biofilms. These complex, organized communities of multi-species bacteria thrive in hospital drains and on environmental surfaces, acting as silent reservoirs for pathogens. This article delves into the critical threat posed by biofilms, exposes the limitations of traditional disinfection methods, and introduces a transformative, physics-based solution for Canadian ICPs.

The Invisible Threat The Unyielding Nature of Biofilms

Biofilms are far more than simple clusters of bacteria. They are intricate microbial “cities” where bacteria embed themselves within a self-produced protective matrix composed of extracellular polymeric substances (EPS) and extracellular DNA (eDNA). This matrix acts as a formidable shield, rendering these communities 10 to 1,000 times more resistant to disinfectants and antibiotics than their free-floating counterparts. This inherent resistance is a major factor in their persistence and their profound association with infections. It is estimated that 65-80% of all bacterial and chronic infections are linked to biofilms, including a significant portion of HAIs.

FAQs on Biofilm Resistance

1. What makes biofilms so difficult to eradicate with traditional cleaning methods? Biofilms are communities of microbes encased in a protective matrix. This matrix makes them 10 to 1,000 times more resistant to disinfectants and antibiotics than free-floating bacteria. Traditional chemicals often cannot penetrate this matrix effectively, leading to rapid regrowth of the biofilm.

Drains A Critical and Overlooked Reservoir for MDROs

Hospital sinks and drains, though often overlooked, are prime locations for biofilm formation. The continuous flow of nutrient-rich fluids from hand hygiene activities and the disposal of various medical substances create an ideal environment for these microbial communities to flourish. These drain systems are frequently contaminated with multidrug-resistant organisms (MDROs), acting as persistent reservoirs. Studies show that organisms can rapidly grow up the tailpipe to the strainer at a rate of an inch per day when nutrients are added to the system. There is also demonstrated transmission of bacteria between sinks via a common pipe, suggesting premise plumbing may be a continuous system with shared microbiology rather than isolated sinks.

The Public Health Agency of Canada (PHAC) reports concerning trends from the Canadian Nosocomial Infection Surveillance Program (CNISP). Between 2018 and 2022, vancomycin-resistant Enterococcus (VRE) bloodstream infections increased by 5.9% across the CNISP network, while carbapenemase-producing Enterobacterales (CPE) infections saw a significant 133% increase nationally. These MDROs are commonly found in biofilm reservoirs within hospital plumbing. Outbreaks associated with hospital drainage systems have been reported for over two decades and continue to pose significant challenges. Some outbreaks can even range in duration from 2 months to 6 years.

The Limitations of Traditional Disinfection

The challenge of biofilms is compounded by the ineffectiveness of conventional cleaning and disinfection protocols. Traditional strategies are often not working. Chlorine-based disinfectants, frequently used in drainage systems, kill free-floating microbes, but the biofilm’s protective structure severely limits chlorine’s killing effect. Unless biofilms are effectively removed, they will regrow rapidly and continue to pose a threat. Studies have shown that bacterial loads in treated biofilms can return to pre-treatment levels within 4-7 days. Research using a hydrogen peroxide and sodium hypochlorite-based foam on environmental sink samples from ICUs showed that while disinfectants reduced bacterial load, biofilms were able to regrow within 7 days and reverted to pre-treatment levels. Furthermore, intermittent use of foam disinfectants for sink drain colonization with gram-negative bacilli resulted in bacterial load returning to baseline within 1 week after treatments were discontinued. Daily application of such foam disinfectants may be required to achieve consistent reduction.

Your standard disinfectants are often flowing right past the problem. These protocols were largely designed for planktonic bacteria, not the complex, resistant microbial communities that dominate healthcare environments. Attempts to eradicate organisms in drains using conventional methods have failed in outbreak scenarios, sometimes leading to sink closures or replacement. This ongoing struggle highlights a critical gap in our current infection control strategies and underscores the need for a more targeted approach.

FAQs on Traditional Methods

2. Why Your Current Drain Protocols Are Failing Traditional cleaning protocols were designed for free-floating bacteria, not complex biofilm communities. The biofilm’s protective matrix can neutralize chemical agents like hypochlorite before they reach embedded pathogens, allowing rapid regrowth.
3. What is the optimal frequency of sink drain disinfection with a foam disinfectant to address biofilms? Studies suggest that even with foam disinfectants, bacterial load can return to baseline within 1 week after treatments are discontinued. Daily application may be required to achieve a rapid and consistent reduction in colonization. This highlights the challenge of sustained efficacy with traditional methods.

Introducing the SteamKing Classic Physics Over Chemistry for Biofilm Eradication

To overcome the inherent limitations of chemical disinfectants, a fundamental shift in approach is required. Enter steam cleaning technology—a game-changing, physics-based approach that bypasses biofilm resistance mechanisms entirely. The SteamKing Classic harnesses nano technology to deliver superheated steam vapour that physically disrupts the protective biofilm matrix and kills microorganisms. This method is effective even in areas unreachable by surface-applied liquid disinfectants.

The efficacy of steam vapour disinfection as a useful technology for disinfecting biofilms on environmental surfaces is supported by research. Saturated steam vapour has been described as posing no more risk to electronics and other devices than normal liquid disinfectants, though care should be used around thin plastic films to prevent distortion from heat.

Targeting the Core Problem The Plumber’s Helper Drain Tool

Biofilms in drains represent a particularly tough challenge. This is precisely why the SteamKing Classic seamlessly integrates with the 4.5 Plumber’s Helper Drain Cleaning and Disinfection Attachment. This specialized tool is engineered to deliver superheated steam directly into drain systems, targeting the infamous biofilm reservoirs where MDROs thrive. This enables ICPs to easily implement a standardized operating procedure (SOP) for effective drain disinfection, providing a straightforward method to manage these critical high-risk areas. One hospital has reported a sink remaining culture negative after steam cleaning with steam disinfection systems.

FAQs on Steam Technology

4. How does steam cleaning specifically target and remove biofilms? Steam cleaning uses thermal disruption from superheated steam to physically break down the biofilm matrix and kill embedded microorganisms. This physics-based approach bypasses the resistance mechanisms that chemicals struggle with.
5. How does the 4.5 Plumber’s Helper Drain Cleaning and Disinfection Attachment enhance biofilm control? The Plumber’s Helper is specifically designed to deliver superheated steam directly into sink and drain systems, targeting biofilm reservoirs that are often inaccessible to surface-applied liquid disinfectants. This enables a focused and effective approach to a high-risk area.

Unrivaled Efficacy Scientific Proof

The effectiveness of steam technology is not merely anecdotal; it is supported by scientific research.

• A 3-second steam treatment has been shown to rapidly kill each biofilm tested (>99.95% killing efficiency). This includes biofilms of Escherichia coli, Acinetobacter baumannii, Pseudomonas aeruginosa, and Staphylococcus aureus on various surfaces like polycarbonate, rubber, stainless steel, and ceramics.
• Compared with chemical disinfection, steam treatment for less than 1 second achieved a similar level of biofilm disinfection as incubation with 10-ppm sodium hypochlorite (bleach) for 10-20 minutes.
• A study using the SteamKing 1500 demonstrated a 5-6 log10 reduction of MRSA and VRE on heavily contaminated hospital surfaces (tabletop laminate, toilet seat plastic, stainless steel) after just 5 seconds of steam exposure.
• A diverse assortment of pathogenic microorganisms was rapidly killed by a portable, saturated steam vapour disinfection system; all of the pathogens tested were completely inactivated within 5 seconds. This includes MRSA, VRE, Salmonella enterica, E. coli, Shigella flexneri, Pseudomonas aeruginosa, Staphylococcus aureus, Listeria monocytogenes, Candida albicans, Aspergillus niger, and Clostridium difficile endospores.
• Steam systems equipped with Plus+ Technology kill enveloped viruses on surfaces, including COVID-19.

FAQs on Efficacy

6. Is the SteamKing Classic proven effective against common healthcare pathogens like MRSA and VRE? Yes, studies using the SteamKing 1500 demonstrated a 5-6 log10 reduction of MRSA and VRE on heavily contaminated hospital surfaces after just 5 seconds of steam exposure. It has also been shown to inactivate C. difficile endospores and enveloped viruses like COVID-19.

Beyond Disinfection The Comprehensive Advantages

The SteamKing Classic offers more than just superior biofilm eradication; it presents a holistic solution with numerous operational and environmental benefits.

• Chemical-Free & Sustainable The steam produced is made from plain tap water. This eliminates the need for hazardous chemical purchases, preventing toxic vapours, skin or respiratory irritation for staff and patients. It avoids issues like “double-dipping” cloths in contaminated solutions and leaves no chemical residue, allowing for immediate use of surfaces. This method is non-toxic to patients, staff, and the environment.
• Cost-Effective & Efficient While the initial article focused on efficacy, secondary findings suggest that steam cleaning supports sustainability across a broad range of applications and industries. Effective biofilm control through steam can lead to significant cost reductions. Some studies suggest 76-91% reductions in cleaning costs and 40% less cleaning time, translating to considerable labor and material savings. It also reduces water consumption by up to 90%. This directly impacts financial benefits for healthcare facilities by improving patient turnover.
• No Resistance Development Unlike chemical disinfectants, steam cleaning does not introduce new chemistry that could lead to microbial cross-resistance.
• Unmatched Versatility The SteamKing Classic with its various attachments can clean and disinfect a wide range of surfaces in one step, including areas traditionally difficult to treat.
  • Hospital Drains & Sinks with the Plumber’s Helper Drain Tool As discussed, this is a critical application.
  • High-Touch Surfaces Attachments designed for flat surfaces can be used on bedrails, door handles, IV poles, and light switches for quick yet thorough disinfection.
  • Textiles Lower pressure settings can be used for curtains, upholstery, and mattresses to avoid saturating fabrics while still achieving sanitization. Steam might be able to penetrate fibers and expose pathogens to disinfection in difficult-to-treat materials like carpet, where pathogens can persist.
  • Commode Chairs and Transport Chairs often these shared items spread bacteria between patients and physical environments.  Steam can eliminate the bacteria quickly allowing the items to be in use at all times.

FAQs on Benefits

7. What are the environmental and safety benefits of using steam cleaning? Steam cleaning is chemical-free, using only tap water. This eliminates risks of toxic chemical exposure for staff and patients, reduces hazardous waste, and contributes to environmental sustainability. It also prevents issues like chemical residue and microbial cross-resistance.
8. Can implementing steam technology be cost-effective for Canadian hospitals? Yes, steam cleaning can lead to 76-91% reductions in cleaning costs, 40% less cleaning time, and elimination of chemical purchases, alongside using 90% less water. With up to 30% of HAIs considered preventable, the potential savings from effective biofilm control could reach $300 million annually across the Canadian healthcare system.

Implementation & Regulatory Alignment for Canadian Healthcare

Adopting advanced technologies like the SteamKing Classic and its Plumber’s Helper Drain Tool requires a strategic and compliant integration into existing infection prevention and control frameworks. For Canadian ICPs, this means aligning with national standards and optimizing operational workflows.

• Regulatory Alignment The CSA Z317.12:2025 standard explicitly addresses sinks and drains (Clause 6) and includes a dedicated clause on Innovative cleaning and disinfecting technologies (Clause 8), indicating a clear recognition of new approaches. An informative annex (Annex D) on the “Role of wet surface biofilm and dry surface biofilm in cleaning and disinfecting healthcare environments” is also included, along with Annex E offering additional information on innovative technologies. PIDAC (Provincial Infectious Diseases Advisory Committee) in its 2012 Best Practices for Environmental Cleaning document recognized steam vapour cleaning systems as “New and Evolving Technologies,” noting their rapidity, cost-effectiveness, environmental safety, and lack of residue, suggesting they “may offer a viable alternative for the future”. There is a need for ICPs to evaluate and validate such technologies within their specific clinical contexts. Health Canada’s guidance for biocides states that for claims against biofilms, the biocide must meet the performance criteria for a general or hospital disinfectant and demonstrate efficacy against P. aeruginosa and S. aureus biofilms.
• Easy Standard Operating Procedure (SOP) for Drains The Plumber’s Helper Drain Tool simplifies establishing a consistent, effective SOP for drain disinfection. Proactive drain treatments are recommended to reduce biofilm and the organisms within it on a regular basis. These treatments should consider plumbing infrastructure and involve collaboration with facilities maintenance, plumbing experts, and product manufacturers. This systematic approach allows your team to proactively manage these critical high-risk areas, where bacterial loads can rapidly re-colonize after traditional disinfection.
• Strategic Rollout A phased approach is recommended for maximum impact.
  • Phase 1 High-Risk Areas Begin by deploying the system in critical zones such as ICUs, operating rooms, and isolation units where biofilm control delivers maximum return on investment (ROI). The initial investment can pay for itself through reduced infection costs, considering an individual Clostridioides difficile infection (CDI) case costs $11,056 in excess healthcare spending.
  • Phase 2 Monitoring & Validation Rigorous monitoring is key to demonstrating efficacy. This involves combining ATP bioluminescence for rapid, real-time feedback on cleaning thoroughness with scheduled microbial sampling. ATP bioluminescence is a widely used method for assessing cleanliness of hospital surfaces. Regular audits of cleaning practices, coupled with feedback sessions, can help reinforce proper techniques and identify areas needing improvement.
  • Phase 3 System-Wide Deployment Once successful pilot programs are established and validated, scale the implementation across all patient care areas. This evidence-based expansion supports sustainable, facility-wide biofilm control.

FAQs on Implementation & Compliance

9. Does steam cleaning align with Canadian infection control standards? Yes, steam cleaning technology aligns with CSA Z317.12:2025 environmental cleaning standards, which include provisions for sinks, drains, and innovative technologies. PIDAC (2012) also recognized steam vapour cleaning systems as “New and Evolving Technologies”. Health Canada requires biocides claiming biofilm efficacy to meet specific performance criteria against P. aeruginosa and S. aureus biofilms.
10. How can facilities monitor the effectiveness of steam cleaning for biofilm removal? Effectiveness can be monitored through a combination of methods. ATP bioluminescence testing provides rapid feedback on organic contamination. Microbial sampling offers direct measurement of bacterial loads. Regular audits of cleaning practices, coupled with feedback sessions, also contribute to continuous improvement.

The Imperative for Action

The convergence of rising antimicrobial resistance, biofilm persistence, and operational pressures creates an urgent need for transformative solutions in Canadian healthcare. The SteamKing Classic with its Plumber’s Helper Drain Tool provides a scientifically validated pathway from chemical-dependent to physics-based pathogen control. With 30% of HAIs considered preventable, the potential savings from effective biofilm control could reach $300 million annually across the Canadian healthcare system. The question is not whether you can afford to implement advanced steam technology—it is whether you can afford not to.

Looking for a complete solution to remove biofilms from your facility? Intersteam is proud to offer a new, complete package making the process of removing biofilms easy and cost effective.