## 9 Biofilm Prevention and Control  
Preventing and controlling biofilm-related HAIs requires a proactive and holistic strategy. The significant occurrence of biofilms in hospital environments and its correlation with MDROs in HAIs highlights the need for stringent infection control protocols [187]. Studies demonstrate that as much as 35% of HAIs may be averted by robust infection control initiatives and monitoring, highlighting the want for meticulously crafted techniques to reduce biofilm-associated hazards [372].  
Compliance with hand hygiene measures is essential for avoiding the transmission of biofilm-associated infections. Healthcare professionals' hands may serve as conduits for biofilm transmission, presenting a considerable danger to patients. Regrettably, healthcare professionals' compliance rates with hand hygiene protocols persist low, fluctuating between 20 and 40% [373]. This figure underscores the need for extensive training and ongoing education for healthcare professionals about infection control practices. Advocating for rigorous compliance with hand hygiene protocols is fundamental to reducing biofilm development and related HAIs.  
Effective disinfection and sterilization of medical instruments and ambient surfaces are essential for avoiding biofilm reservoirs and reducing the incidence of HAIs. DSBs provide a distinct problem due to their resistance to standard cleaning and disinfection methods and their ability to renew upon exposure to moisture and nutrients [374]. Efficient cleaning agents, including compounds with adamantane, have shown efficacy in reducing biofilm bulk and viable cell counts; nevertheless, their potential toxicity necessitates further assessment [375]. Consistent cleaning regimens specific to high-touch surfaces are essential since irregular cleaning prevents biofilm development [376; 377].  
Implementing antimicrobial stewardship programs is crucial for efficiently managing biofilm-associated HAIs. These initiatives aim to optimize antibiotic use to avert the development of resistance and decrease the occurrence of HAIs. Evidence-based antimicrobial stewardship programs promote appropriate antimicrobial use and assure conformity with local antibiotic susceptibility patterns [378; 379]. Consistently revising hospital infection control policies to include antimicrobial stewardship may improve biofilm management initiatives.  
Integrating modern surveillance and monitoring technologies is crucial for rapidly detecting and managing biofilm-associated HAIs. These systems assist healthcare institutions in detecting infection trends, identifying biofilm reservoirs, and executing targeted actions for their eradication. Recent innovations, including real-time automated nosocomial infection monitoring systems, have effectively decreased HAIs incidence by enabling early diagnosis and management [380,381] Surveillance facilitates outbreak management and enhances healthcare safety via ongoing monitoring and action.  
An integrated approach incorporating personnel training, monitoring, and environmental sanitation is crucial for effectively tackling biofilm-related HAIs. Consistent training, rigorous hygiene protocols, and cutting-edge cleaning technologies can significantly reduce biofilm occurrence, enhance patient outcomes, and lower healthcare costs. By confronting the complex challenges biofilms pose head-on, healthcare institutions will strengthen their infection control measures and provide a safer environment for patients and staff.