Biofilm Removal With Ozone

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    Ozone: Science & Engineering, 31: 39

    Copyright # 2009 International Ozone Association

    ISSN: 0191-9512 print / 1547-6545 online

    DOI: 10.1080/01919510802586566

    Studies on the Disinfection and Removal of Biofilms byOzone Water Using an Artificial Microbial Biofilm System

    Mariko Tachikawa,1 Kenzo Yamanaka,1 and Katsuhiko Nakamuro2

    1College of Pharmacy, Nihon University, 7-7-1 Narashinodai, Funabashi, Japan2Faculty of Pharmaceutical Sciences, Setsunan University, 45-1 Nagaotougemachi, Hirakata, Japan

    Inactivation rates of the biofilms ofP. fluorescence andP. aeruginosa established on a small slide glass in ozonewater (0.93.2 mg/L, 120 min) were determined in a

    batch or flow-through system. The effects of ozone wateron the biofilm matrices were defined clearly in situ byconfocal laser scanning microscopy. These results indicatethat ozone is an effective biocide against biofilms and it canremove exopolysaccharides in the biofilm matrices. How-ever, the effective concentration of ozone for disinfection ofbiofilms varied with the biofilms formed, mainly due toreactions of ozone with constituents of the biofilms.

    Keywords Ozone, Disinfection Efficacy, Biofilms, P. fluorescens,P. aeruginosa, Removal, Extracellular Polysaccharides

    INTRODUCTION

    The disinfection and removal of biofilms has become

    an important subject in maintaining water quality man-

    agement in the fields of swimming pools, food processing

    lines, industrial water systems, etc. Microorganisms, by

    attaching to surfaces to form biofilms which are protected

    by matrices of excreted exopolysaccharides (EPS), are

    usually highly resistant to antimicrobial agents. The

    importance of tests using a biofilm system has been

    pointed out in order to evaluate disinfection efficacy of

    biocides (LeChevallier et al., 1988a and Wright et al.,

    1991). We have attempted to establish a simple method

    of producing microbial biofilm from ubiquitous bacteria,Pseudomonas fluorescens, Pseudomonas aeruginosa and

    Klebsiella pnuemoniae in water environments and in

    biofilms, and compared the efficacy of several halogen

    biocides using the biofilms established. By using confocal

    laser scanning microscopy (CLSM), differences in cell

    density and structure among the biofilms established were

    visualized clearly, and the changes of biofilm structurescaused by halogen biocides were described (Tachikawa

    et al., 2005).

    Although ozone water is widely used as a potent

    oxidant in water treatments (White, 1999), the efficacy

    of ozone water for biofilm disinfection remains to be

    established. Thomas et al. (2004) studied the resistance

    of the amoebae, Legionella pneumophila, and biofilms of

    b-proteobacteria to disinfection treatments with ozone,

    chlorine dioxide, chlorine, etc. in pilot-scale domestic

    water systems. Planktonic and biofilm populations in

    the systems were reduced markedly, but they were still

    detectable after ozone treatment at 0.5 mg/L, which

    decreased to the undetectable limit (

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    of biofilm structures by ozone exposure were observed in

    situ by CLSM after staining with a fluorescent dye,

    LIVE/DEADBacLightTM. The effects of ozone water

    on the matrix EPS ofP. fluorescens biofilms were visua-

    lized in situ by confocal laser scanning microscopy

    (CLSM) after staining with a fluorescent conjugate of

    concanavaline A, a lectin binding to oligosaccharide

    selectively. Through these experiments, the implications

    of EPS and cell density in the disinfection treatments with

    ozone against biofilms would be clarified.

    EXPERIMENTAL

    Bacterial Strains and Preparation of Biofilm

    Pseudomonas fluorescens (JCM no. 2779) and

    Pseudomonas aeruginosa (JCM no. 2776) were obtained

    from the Japan Collection of Microorganisms (JCM),

    Wako, Japan. They were Gram-negative, rod-shaped ubi-

    quitous microorganisms, found in our daily environments

    such as biofilms, water, soil, humans, sewage, hospitals,

    etc. P. aeruginosa is an opportunistic human pathogen

    (Kapatral et al., 2000). Their stock cultures were kept at80C with 25% (wt/vol) glycerol. Luria-Bertanis (LB)

    medium was used for pre-cultivation of these bacteria,

    overnight at 28C. The biofilms of P. fluorescens were

    grown on clean and sterile microscope slides (14 26 mm)

    placed in a glass culture dish (i.d. 145 mm) with 150 ml of

    EPS growth medium, containing 1% of glucose and phos-

    phate and small amounts of minerals (LeChevallier et al.,

    1988b), which was inoculated with each overnight culture.

    For the formation of biofilms ofP. aeruginosa, 50 mL of

    LB medium was added to 100 mL of EPS growth medium.

    The dishes were incubated at 28 C with continuous slow

    stirring with magnetic stirrers. The number of viable cells

    in the biofilms formed on the slide was determined by

    colony counting on tryptone glucose yeast agar (APHA,

    AWWA, WEF, 1992a) following ultrasonic dispersion and

    serial dilution.

    Water

    Milli Q water was used for preparation and dilution

    of reagent solutions for the determination of available

    chlorine and ozone. For the preparation of ozone water,

    tap water distributed by Funabashi municipal water sup-

    ply was dechlorinated by passing through an activated

    carbon column and then led to an ozone water generator

    (AOD-TH, Ai Electronic Ind. Co. Ltd, Japan). The tap

    water containing 0.6 0.7 mg/L of free residual chlorine

    was used as a comparative control for ozone water. The

    temperature of the test water ranged between 14 and

    18 C and its pH was 6.56.7. Concentrations of residual

    chlorine and ozone in test water were determined by the

    DPD (N,N-diethyl-p-phenylenediamine, APHA, AWWA,

    WEF, 1992b) and indigo colorimetric (APHA, AWWA,

    WEF, 1992c) methods, respectively.

    Inactivation Experiments

    Biofilms formed on the slide glass were passed through

    sterile water twice to remove planktonic cells and growth

    medium. For the batch treatment, the biofilm formed on

    a slide glass was placed in a sterile flask containing 40 mL

    of test water for 5 to 10 min at room temperature. A

    suspended cell fraction was prepared by placing a glass

    slide of biofilms established in a sterile flask containing

    5 mL of sterile water and sonicating for 90 sec. 40 mL of

    ozone water was added into the dispersed cell suspension,

    and the cells were treated for 5 min. For the continuous

    flow-through treatment, a glass apparatus shown in Figure 1

    was used. By using this apparatus, the ozone concentra-

    tion was kept constant, and mechanical removal of

    biofilms by water stream could be minimized. The volume

    of the apparatus was ca. 500 mL and test water was

    circulated at a rate of 25 mL/sec. Biofilms on the slide

    glass were placed onto the wire-net stool placed in the

    apparatus. After the treatment, the slide was placed imme-

    diately into a flask containing a sterile solution of thiosul-

    fate for neutralization of residual ozone and chlorine.

    Colony forming units (CFU) of the biofilms in the flasksolution were determined after ultrasonic dispersion and

    serial dilution as described above.

    CLSM Observations

    For fluorescent staining of cells in the biofilms, LIVE/

    DEADBacLightTM, a mixture of SYTO 9 and propi-

    dium iodide, Molecular Probes Inc. OR, was used. For

    fluorescent staining of EPS in a biofilm matrix, Alexa

    Fluor 633 conjugate of concanavalin A (ConA-Fluor),

    Molecular Probes Inc. OR, was used. Biofilms on the

    Water flow :

    FIGURE 1. Schematic diagram of the flow-through exposure

    apparatus.

    4 M. Tachikawa, K. Yamanaka, and K. Nakamuro JanuaryFebruary 2009

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    glass slide were soaked and incubated in the dye solution

    for 15 min in the dark at room temperature (Tachikawa

    et al., 2005). A 0.1 mL of water was dropped on a cover

    glass (25 50 mm), and then the slide of stained biofilms

    was placed upside down. Photomicrographs were taken at

    a magnification of x100 with an oil immersion lens under

    a CLSM (LSM 510, Carl Zeiss). Computer image micro-

    graphs of the vertical section of biofilms were obtained by

    using the Z-stack function of the LSM 510.

    RESULTS AND DISCUSSION

    Formation of Biofilms

    The number of viable cells in the biofilms ofP. fluor-

    escens and P. aeruginosa formed on the glass slide was

    determined after incubation for 1 to 9 days (Figure 2).

    After incubation for 6 days, the mean cell density of the

    biofilms ofP. fluorescensreached 2.5 0.5 108 cfu / slide.

    That of the P. aeruginosa biofilms reached a plateau of

    1.9 0.2 x 107 cfu / slide after 2 days of incubation. The

    variation of the numbers of cfu between the biofilms formed

    on the slide was small enough for evaluation of the disin-fection efficacy of biocides.

    Effects of Biofilm Formation on Cellular Resistance

    to Ozone Water

    For investigation of changes of disinfection resistibility

    of cells against ozone by forming biofilms, the biofilms

    and suspended cells ofP. fluorescens and P. aeruginosa

    were treated with ozone water at 1.7 and 1.6 mg/L for,

    respectively, 5 min in the batch-type system. In both

    bacteria, the biofilm cells were more resistant to ozone

    water than the suspended cells (Table 1). Although the

    survival fractions of suspended P. fluorescens and

    P. aeruginosa were similar, i.e., 0.006 % and 0.008 %,

    respectively, those in their biofilms differed greatly, i.e.,

    22.7 % and 0.13 %, respectively. By forming biofilms,

    P. fluorescens and P. aeruginosa increased their resistibility

    against ozone more than 3000 and 10 times, respectively. It

    is known that, by forming biofilms, sessile cells may have

    altered their sensitivity toward antimicrobial agents not

    only by physical changes of their environment but also

    by changes of their gene expression (Costerton and

    Lewandowski, 1997). Therefore, the difference in sensitivity

    between biofilm-retained cells and suspended cells in thepresent experiment may represent physical hindrance to

    ozone penetration by biofilm formation. In a previous

    study (Tachikawa et al., 2005), we determined survival

    fractions of biofilm and suspended cells of P. fluorescence

    andP. aeruginosaafter treatments with hypochlorite (HOCl)

    and ammonia monochloramine (NH2Cl) at 1.21.7 mg/L

    for 5min. By forming biofilms, P. fluorescence increased its

    resistibility to HOCl and NH2Cl 8 and 2 times, respectively,

    and P. aeruginosa increased its resistibility to HOCl and

    NH2Cl, 40 and 7 times, respectively. Compared to these

    results, P. fluorescens greatly increased its disinfection

    resistibility against ozone by forming biofilms.

    Biofilms ofP. fluorescens were treated with ozone at

    different concentrations for different time intervals in the

    batch-type system. The survival fractions of biofilm cells

    treated by ozone at 0.6 and 1.7 mg/L for 5 min were 42 %

    and 18 %, respectively, and those treated for 10 min were

    31 % and 14 %, respectively (Table 2). Thus increasing

    the exposure time did not cause further decrease in the

    survival fraction at both ozone concentrations. Residual

    ozone in the test water of the batch system was deter-

    mined under similar conditions (Table 3). It indicated

    that more than 50% of initial ozone concentrations

    were remained in 10 min at both concentrations, and

    that the ozone consumption by biofilm was very slight.

    103

    104

    105

    106

    107

    108

    109

    1010

    0 1 2 3 4 5 6 7 8 9 10

    Time (days)

    Cfu/Glassslide P. aeruginosa

    P. fluorescens

    FIGURE 2. Growth of biofilms on incubation at 28 C. Each point, P. aeruginosa(~) andP. fluorescens(), with a bar represents a mean S.D.of cfu on the glass slide (n = 36).

    Disinfection and Removal of Biofilms by Ozone JanuaryFebruary 2009 5

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    The decrease of ozone concentration may be mainly due

    to the decomposition of ozone molecules in water

    (Staehelin and Hoigne, 1982; Buhler et al., 1984;

    Staehelin et al., 1984). Therefore the slowdown of inacti-

    vation rate with increasing exposure time could not be

    explained only by the decrease in ozone concentration.

    Viera et al. (1999) suggested occurrence of diffusional

    resistance to ozone penetration into biofilms by reactions

    of ozone with constituents of the biofilms.

    For evaluation of inactivation rates of biofilms

    in ozone water, biofilms ofP. fluorescens and P. aerugi-

    nosa were treated with ozone water and chlorinated tap

    water in a flow-through system for 1 to 20 min

    (Figure 3a and 3b). As shown in Figure 3a, the survival

    fractions of the biofilms ofP. fluorescensafter the treat-

    ment with ozone water at 0.9 and 1.4 mg/L for 5 min

    exposure were ca. 1%, and the inactivation rates became

    slow with increasing exposure time. With a higher con-

    centration of ozone at 3.2 mg/L, the survival fractions of

    the biofilms reached 0.01% in 5 min and further

    decreased to 0.00002% in 20 min. The survival fraction

    of the biofilm of P. aeruginosa after the treatment with

    ozone water at 1.0 and 3.0 mg/L for 5 min were ca. 0.2

    and 0.003 %, respectively, and then their inactivation rates

    declined gradually as shown in Figure 3b. At the lower

    concentrations of ozone, the inactivation rates were retarded

    in both bacteria and the retardation was lessened at the

    higher concentrations. The changes of inactivation rates

    during the treatment may support the occurrence of diffu-

    sional resistance to ozone within the biofilm as suggested by

    Viera et al. (1999). The inactivation rates in chlorinated tap

    water also became slow with increasing exposure time in

    both biofilms. This indicates that chlorine as well as ozoneencounters diffusional resistance within the biofilms. The

    different inactivation rates and their changes during the

    treatment between P. fluorescens and P. aeruginosa may

    indicate that the diffusional impediment may vary with

    ozone concentrations and constituents of the biofilms,

    such as biomass, growth medium, EPS excreted etc.

    Effective concentrations of ozone for disinfection of

    TABLE 2. Effects of Concentration and Time on the Disinfection

    Efficacy of Ozone Water on the Biofilms of P. fluorescens in Batch

    Treatments. Mean S.D. (n = 3)

    O3mg/L

    Exposure

    time min.

    Biofilm cells

    cfu / plate ( 106)

    Survival

    fractiona) %

    0 (control) 380 43 100

    0.6 5 161 82 42 21

    0.6 10 118 24 31 6

    1.7 5 69 4 18 1

    1.7 10 54 8 14 2

    a)(cfu treated / cfu control) 100.

    TABLE 1. Disinfection Efficacy of Ozone Water on Biofilm-Retained and Suspended Cells of P. fluorescens and P. aeruginosa in the Batch

    Treatment for 5 min. Mean S.D.(n = 3)

    Biofilm cells cfu / plate ( 106) Suspended cellsa) cfu / suspension ( 106)

    Microorganisms O3(mg/L) Treated (%)b) O3(mg/L) Treated (%)

    b)

    P. fluorescens control 159 26

    1.7 36.1 24.7 22.7 15.5 1.5 0.009 0.012 0.006 0.008

    P. aeruginosa control 23.8 9.7

    1.6 0.03 0.01 0.13 0.04 1.4 0.002 0.001 0.008 0.004

    a)Suspended cells were obtained by ultrasonic dispersion of the biofilms established on glass plates. Therefore, the control biofilm-retained and

    suspended cells should contain almost the same number of cfu.b)(cfu treated / cfu control) 100.

    TABLE 3. Changes of Ozone Concentrations with Increasing Exposure Time in the Batch Treatments of

    Biofilms of P. fluorescens. Mean S.D. (n 3) or Ranges (n = 2)

    Residual O3

    (mg/L) in test water at exposure time (min)

    0 1 5 10

    Low O3water 0.48 0.51a) 0.43 0.04 0.35 0.01 0.26 0.01

    (0.29 0.30)b)

    High O3water 1.57 0.03a) 1.09 1.51 1.27 1.30 0.96 1.04

    (0.99 1.07)b)

    a)Concentration of ozone water determined just before a glass plate ofP. fluorescensbiofilm was placed in the flask.b)Concentration of ozone water in the flask without biofilms.

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    biofilms may vary with the biofilm matrix formed.

    Therefore, the concept of CT (concentration time),

    which is used for the evaluation of disinfection efficacy of

    biocides for planktonic cells, could not be applied to the

    evaluation of disinfection efficacy of ozone for biofilms.

    Observation of Biofilm Matrixes by CLSM andEffects of Ozone Water

    Since the results obtained above strongly suggest the

    participation of biofilm matrices in the biocidal efficacy

    of ozone, changes of biofilm matrix by the treatment with

    ozone were observed in situ by the computer image

    analysis by CLSM after staining with the fluorescent

    dye, LIVE/DEADBacLightTM. The differences in cell

    density and cell distribution in the biofilm matrices of

    P. fluorescens and P. aeruginosa were clearly defined

    (Figure 4). By using LIVE/DEADBacLightTM, bacteria

    having intact cell membranes were stained in fluorescent

    green, whereas those having damaged membranes were

    stained in fluorescent red. In the biofilms ofP. fluorescens,the cells formed dense aggregates (Figure 4a), whereas in

    P. aeruginosa, the cells were scattered in the biofilm matrix

    (Figure 4c). The biofilms ofP. fluorescensandP. aeruginosa

    after the treatment with ozone at 1.11.2 mg/L for 1 min are

    shown in Figure 4b and 4d, respectively. In the biofilms

    ofP. fluorescens, ozone caused cell exfoliation mainly

    (Figure 4b). In the biofilms of P. aeruginosa, ozone

    lessened the thickness of the biofilm and increased the

    0.00001

    0.0001

    0.001

    0.01

    0.1

    1

    10

    100

    0 5 10 15 20 25

    Time (min)

    Survival

    fraction(%)

    0.00001

    0.0001

    0.001

    0.01

    0.1

    1

    10

    100

    0 5 10 15 20 25

    Time (min)

    Survivalfraction(%)

    Ozone 3.0mg/L

    Ozone 1.3mg/L

    Ozone 1.0mg/L

    Chlorine* 0.7mg/L

    Ozone 3.2mg/L

    Ozone 1.4mg/L

    Ozone 0.9mg/L

    Chlorine* 0.6mg/L

    (a) P. fluorescens

    (b) P. aeruginosa

    FIGURE 3. Efficacy of ozone water (ozone, , ~ and &)and chlorinated tap water (free chlorine*,*) on the biofilms ofP. fluorescens (a) and P. aeruginosa (b) treated in the flow-

    through system at indicated ozone concentrations. Each point

    with a bar represents the mean cfu value and S.D. of 3 slides.

    (a) P. fluorescensbiofilm (control).

    (b) P. fluorescensbiofilm treated with ozone water (1.2 mg/L) for 1min.

    (c) P. aeruginosa biofilm (control).

    (d) P. aeruginosa biofilm treated with ozone water (1.1 mg/L) for 1 min.

    Cover glass

    Cover glass

    Slide glass

    Slide glass

    Cover glass

    Slide glass

    Cover glass

    Slide glass

    FIGURE 4. Changes of the biofilms ofP. fluorescens(aand b)

    andP. aeruginosa(c and d) by treatment with ozone water. CLSM

    images of the vertical section of biofilms were obtained after

    staining with LIVE/DEADBacLightTM . (a) and (c), Controls; (b)

    and (d), biofilms treated with ozone water in the flow-through

    system. The bars represent 20 mm.

    Disinfection and Removal of Biofilms by Ozone JanuaryFebruary 2009 7

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    proportion of injured cells, which were stained red, in the

    biofilm matrix, indicating ozone penetration into the bio-

    film matrix (Figure 4d). It was reported that P. fluorescens

    excretes glucuronic acid- and gulcuronic acid-rich EPS

    (Kives et al., 2006), while P. aeruginosa excretes alginic

    acid (a polymer of mannuron acid)-rich EPS in the bio-

    films (Davis et al., 1993). Korber et al. (1995) indicated

    that the biofilm structure might be dependent on the con-

    stituents of EPS. The difference of the biofilm structures,

    consisting of biomass and EPS, may influence the localreactions of ozone within the biofilms.

    Since we found that EPS excreted in the P. fluorescens

    biofilm was stained with the lectine-conjugated fluores-

    cent (ConA-Fluor), we attempted to visualize the matrix

    of EPS by CLSM for observation of removal of EPS

    matrix by ozone. Computer images of a vertical section

    of the P. fluorescens biofilm, stained with SYTO 9

    (component A of LIVE/DEADBacLightTM) and ConA-

    Fluor in turn, are shown in Figure 5. The bacteria cells were

    observed as green areas (Figure 5a), the EPS matrix as red

    areas (Figure 5b) and these two images were merged as seen

    in Figure 5c. These images indicate that EPS is abundant

    in the bottom of the biofilm matrix and it helps keep the

    bacterial cells aggregated. After the treatment with

    ozone at 1.0 and 2.0 mg/L for 10 min, EPS matrices in

    the biofilm were stained with ConA-Fluor and observed

    by CLSM (Figure 6). Compared with the intact EPS

    matrix (Figure 5, (b)), the EPS matrix decreased appar-

    ently by the treatment with ozone and the extent of

    removal was dependent on the ozone concentration. At

    the higher ozone concentration of 2 mg/L, the EPS

    matrix was removed more effectively than at 1.0 mg/L

    (Figure 6a and 6b). It was reported that one of the reac-

    tions of ozone with polysaccharides is a direct glycosidic

    bond cleavage reaction by the insertion of ozone into the

    anomeric C-H bond. Fragmentation of the hydrotrioxide

    yields aldonic acid-lactones. The conversion to the lactone

    leads to a shortening of the chain length (Pan et al., 1981).

    The other is oxidation of hydroxyl groups at C2, C3, or C6

    positions in polysaccharides to produce carbonyl groups

    by ozone itself (Katai and Schuerch 1966). When the pH of

    ozone water is >7, ozone also can react nonselectively or

    indirectly through HO radicals formed by the hydroxyl

    ion-catalyzed decomposition of ozone (Wojtowicz, 1998).

    Taking together the above results of EPS removal shown in

    Figure 6 with the inactivation rates in Figure 3a, the slow

    inactivation rates in ozone water at 0.9 and 1.4 mg/L for

    10 min may be explained by the lesser decrease of EPS in

    the treatment with ozone at 1.0 mg/ L, and the more

    effective removal of EPS at 2.0 mg/L could contribute to

    the greater inactivation rate at the higher ozone concentra-

    tion of 3.2 mg/L. The amounts of EPS excreted into the

    biofilms in the present experiment are too small to be

    analyzed by chemical assay. Hence, for further studies on

    the removal of EPS in the biofilms, this way of EPS obser-

    vation by CLSM will be helpful.

    CONCLUSIONS

    The cells in the biofilms ofP. fluorescens and P. aeru-

    ginasawere more resistant to ozone than their suspended

    cells. However, the survival cells in both biofilms were

    decreased to less than 1 % by exposure to ozone at ca. 1

    mg/L for 5 min in the flow-through system. Each biofilm

    established showed different inactivation rates in ozone

    water at different ozone concentrations after various

    exposure times. The decrease of inactivation rates with

    increasing exposure time may suggest occurrence of diffu-

    sional impediment a reactions of ozone with constituents

    of the biofilms. These results indicate that, though

    ozone is an effective biocide against biofilms, effective

    (a)

    (b)

    (c)

    FIGURE 5. CLSM images of P. fluorescens biofilm matrix

    stained with SYTO 9 and concanavalin A, Alexa Fluor 633 con-

    jugate. Biofilm matrix stained was scanned by multi track with

    argon laser at 488 nm and helium/neon laser at 633 nm. ( a), a

    computer image obtained by scanning at 488 nm, bacterial cells

    stained with SYTO; (b), a computer image by scanning at 633 nm,

    EPS stained with ConA-Fluor; (c), merged images of (a) and (b).

    The bars represent 20 mm.

    (a)

    (b)

    Ozone water at 1.0 mg/L

    for 10 min.

    Ozone water at 2.0 mg/L

    for 10 min.

    FIGURE 6. Decrease of EPS in theP. fluorescensbiofilm matrix

    by treatment with ozone water. EPS attached on the glass slide

    was stained with concanavalin A, Alexa Fluor

    633 conjugateafter the treatment. The bars represent 10 mm in (a), and 5 mm

    in (b).

    8 M. Tachikawa, K. Yamanaka, and K. Nakamuro JanuaryFebruary 2009

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    concentrations for biofilm disinfection may vary with

    the biofilms formed and cannot be estimated from CT

    values obtained by counting planktonic cells. The

    observations of biofilms in situ by CLSM showed the

    differences in cell density and structure of the biofilms

    between P. fluorescens and P. aeruginosa, and suggested

    that these differences might have influenced the efficacy of

    ozone water. An apparent decrease of EPS in the matrix

    of the P. fluorescens biofilm by ozone was visualized by

    CLSM observation with a lectine-fluorescent conjugatedye. The observation indicated a relationship between

    removal of EPS and inactivation rates and suggested the

    importance of EPS removal for effective disinfection of

    biofilms.

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