Infection prevention and control
Copper – a weapon in the war on pathogens
The bacteria responsible for healthcare-associated infections can survive for anything from days to weeks on the fabricated surfaces, typically made from stainless steel and polymeric materials, that surround patients in our hospitals. Here Angela Vessey, director of the Copper Development Association (CDA) in the UK, describes some of the latest evidence from installations and studies worldwide of how using anti-microbial copper for common hospital items and surfaces can help to reduce environmental contamination, and thus lower healthcare-acquired infection rates.
G
iven the ability of many potentially harmful bacteria to survive for lengthy periods, the fabricated
surfaces in wards and other clinical and non-clinical ‘spaces’ within a typical hospital can serve as reservoirs of infectious bacteria that can be transferred to hands and around a facility, consequently serving as direct or indirect transmission pathways, and presenting a risk to patients. Cleaning and disinfection are key to
tackling this problem, but are frequently inadequate. More needs to be done, without burdening already over-stretched nursing and cleaning staff. The strategic placement of an effective and durable antimicrobial material offers another weapon in the war on pathogens. Laboratory experiments have found that, on copper, and many of its alloys, pathogens such as MRSA and E. coli die very rapidly. In the clinical environment, copper surfaces have been shown to continuously reduce bioburden by over 80% compared with control surfaces, over periods of many months. Fewer pathogens, logically, means a more hygienic, safer patient environment, but until recently, there was no evidence to link reduced environmental contamination with improved patient outcomes.
Study results published The results from a study designed to address the question: ‘Can the limited placement of copper on high-touch surfaces around the ICU patient not only reduce bioburden, but also reduce infections?’, have now been published. This article provides an update on the latest evidence for copper’s role in
groups around the world have been investigating, both in the laboratory and in the clinical environment, the potential of antimicrobial copper to aid in tackling the issue of healthcare-acquired infections (HCAIs) and rising antibiotic resistance. In total, more than 75 studies1
have been
reported. The UK is home to one of the world’s
leading experts on the antimicrobial efficacy of copper. At the University of Southampton, Professor Bill Keevil and his team have established copper’s efficacy against a broad spectrum of bacteria, viruses, and fungi. The efficacy tests used by Professor
Keevil are more appropriate than currently available test standards, such as JIS Z 2801 and ISO 22196, as they reflect in-use conditions, such as temperature and humidity, and are thus better predictors of in situ performance. The Southampton test aimed to
Professor Bill Keevil, and researcher, Sarah Warnes, in a University of Southampton laboratory.
reducing environmental contamination, and the reported impact on patients’ acquisition of infections. It goes on to describe how this research is translating into practical applications around the world, and addresses the question of the effectiveness of an antimicrobial copper installation.
Antimicrobial characteristics of copper and its alloys ‘Antimicrobial Copper’ is shorthand for a portfolio of solid materials – copper and copper alloys – that benefit from copper’s inherent antimicrobial activity. Research
simulate a wet contamination incident, such as a sneeze or a splash, and demonstrate a log 5 reduction in colony- forming units (cfus) recovered from different hard surfaces. It has been used to demonstrate copper’s superior efficacy, compared to silver ion containing coatings, which were shown to behave as the stainless steel control.2 A similar test to that developed at
Southampton was used for the US Environmental Protection Agency’s 2008 registration of copper and over 200 alloys as approved antimicrobial materials, able to be marketed with public health claims. Organisms tested were MRSA, Staphylococcus aureus, Enterobacter aerogenes, Pseudomonas aeruginosa, E. coli O157:H7, and Vancomycin-resistant Enterococcus faecalis.
Health Estate Journal September 2013
65
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