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From Laboratory Research to a Clinical Trial: Copper Alloy Surfaces Kill Bacteria and Reduce Hospital-Acquired Infections.

Michels HT, Keevil CW, Salgado CD, Schmidt MG - HERD (2015)

Bottom Line: This is a translational science article that discusses copper alloys as antimicrobial environmental surfaces.Greater than a 99.9% reduction in live bacteria was realized in laboratory tests.Thus, based on the presented information, the placement of copper alloy components, in the built environment, may have the potential to reduce not only hospital-acquired infections but also patient treatment costs.

View Article: PubMed Central - PubMed

Affiliation: Copper Development Association, New York, NY, USA harold.michels@copperalliance.us.

No MeSH data available.


Related in: MedlinePlus

Microbial burden measured on six objects, in the noncopper rooms (dark gray bars) and copper rooms (light gray bars; Schmidt, Attaway, Sharpe, et al., 2012).
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fig4-1937586715592650: Microbial burden measured on six objects, in the noncopper rooms (dark gray bars) and copper rooms (light gray bars; Schmidt, Attaway, Sharpe, et al., 2012).

Mentions: Patients admitted to the ICU were randomly placed in available rooms, without regard to which rooms contained copper surfaces. Bed control personnel were not informed as to which rooms contained copper, but treatment teams were. Information on patient demographics and clinical characteristics was recorded by personnel who were also masked as to which rooms contained copper. The facilities continued to follow existing cleaning protocols, including those prescribed for terminal cleaning. No additional cleaning measures were adopted during the trial. Each hospital also monitored hand hygiene. In addition, no outbreaks of HAIs or epidemiologically significant organisms occurred. Samples were taken weekly from the six objects associated with the copper intervention (eight rooms) and control rooms (eight) from the three hospitals. The microbial burden on the surface of the components made from copper alloys in copper rooms, as well as components made from conventional materials, including plastics, coated carbon steel, aluminum, and stainless steel, in the standard rooms, were sampled and analyzed. It should be noted that one noncopper object, the bed footboard, was sampled in both the copper and the noncopper rooms, unbeknownst to the participating clinicians, environmental services, or the healthcare teams, to control for bias. As can also be seen in Figure 4, the bed rail is the most contaminated item in the standard room, followed by the call button, chair arms, IV pole, tray table, and data input device. A microbial burden below 250 CFU/cm2 is generally accepted as benign (Dancer, 2004; Lewis, Griffith, Gallo, & Weinbren, 2008; Malik, Cooper, & Griffith, 2003; Mulvey et al., 2011; Schmidt, Attaway, Sharpe, et al., 2012; White, Dancer, Robertson, & McDonald, 2008). However, the average microbial burden in the copper rooms, at 465 CFU/cm2, is somewhat above that level, while the average amount measured in the standard rooms, at 2,674 CFU/cm2, is significantly higher. Minor differences in microbial burden can be seen between the components in the copper rooms, as shown in Figure 4. For example, the copper call button has the highest level of contamination, followed by the copper chair arms, copper data input device, copper bed rail, copper tray table, and copper IV pole. The bed rail is a major area of interaction between the patient, healthcare workers, and visitors. Thus, the difference in the microbial burden on copper and noncopper bed rails is very important and most dramatic. This difference in microbial burden decreases in the following order: the bed rail, the call button, the chair arms, IV pole, and tray table. The data input device shows an unexplained anomaly, in that the microbial burden on the copper is slightly higher than that seen on the noncopper counterpart. The contamination levels on both the copper and the noncopper data input devices are quite low, plus the difference in contamination levels is the smallest when compared to the other five objects. The use of the data input device is restricted to healthcare professionals, which is not the case for the other five objects. Healthcare professionals as a group are more cognizant of consequences of patients acquiring infections, which we believe may account not only for the low contamination levels seen on both the noncopper and copper data input devices, but also for the above mentioned anomaly, rather than any difference in frequency of cleaning. The average reduction in microbial burden, when comparing the copper to the noncopper components over 21 months, was 83% (Schmidt, Attaway, Sharpe, et al., 2012). This result is similar to that of another recent study conducted in a pediatric ICU in Chile, where a 88% reduction in microbial burden was observed (Michael G. Schmidt, private communication, January 23, 2015).


From Laboratory Research to a Clinical Trial: Copper Alloy Surfaces Kill Bacteria and Reduce Hospital-Acquired Infections.

Michels HT, Keevil CW, Salgado CD, Schmidt MG - HERD (2015)

Microbial burden measured on six objects, in the noncopper rooms (dark gray bars) and copper rooms (light gray bars; Schmidt, Attaway, Sharpe, et al., 2012).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2 - License 3
Show All Figures
getmorefigures.php?uid=PMC4561453&req=5

fig4-1937586715592650: Microbial burden measured on six objects, in the noncopper rooms (dark gray bars) and copper rooms (light gray bars; Schmidt, Attaway, Sharpe, et al., 2012).
Mentions: Patients admitted to the ICU were randomly placed in available rooms, without regard to which rooms contained copper surfaces. Bed control personnel were not informed as to which rooms contained copper, but treatment teams were. Information on patient demographics and clinical characteristics was recorded by personnel who were also masked as to which rooms contained copper. The facilities continued to follow existing cleaning protocols, including those prescribed for terminal cleaning. No additional cleaning measures were adopted during the trial. Each hospital also monitored hand hygiene. In addition, no outbreaks of HAIs or epidemiologically significant organisms occurred. Samples were taken weekly from the six objects associated with the copper intervention (eight rooms) and control rooms (eight) from the three hospitals. The microbial burden on the surface of the components made from copper alloys in copper rooms, as well as components made from conventional materials, including plastics, coated carbon steel, aluminum, and stainless steel, in the standard rooms, were sampled and analyzed. It should be noted that one noncopper object, the bed footboard, was sampled in both the copper and the noncopper rooms, unbeknownst to the participating clinicians, environmental services, or the healthcare teams, to control for bias. As can also be seen in Figure 4, the bed rail is the most contaminated item in the standard room, followed by the call button, chair arms, IV pole, tray table, and data input device. A microbial burden below 250 CFU/cm2 is generally accepted as benign (Dancer, 2004; Lewis, Griffith, Gallo, & Weinbren, 2008; Malik, Cooper, & Griffith, 2003; Mulvey et al., 2011; Schmidt, Attaway, Sharpe, et al., 2012; White, Dancer, Robertson, & McDonald, 2008). However, the average microbial burden in the copper rooms, at 465 CFU/cm2, is somewhat above that level, while the average amount measured in the standard rooms, at 2,674 CFU/cm2, is significantly higher. Minor differences in microbial burden can be seen between the components in the copper rooms, as shown in Figure 4. For example, the copper call button has the highest level of contamination, followed by the copper chair arms, copper data input device, copper bed rail, copper tray table, and copper IV pole. The bed rail is a major area of interaction between the patient, healthcare workers, and visitors. Thus, the difference in the microbial burden on copper and noncopper bed rails is very important and most dramatic. This difference in microbial burden decreases in the following order: the bed rail, the call button, the chair arms, IV pole, and tray table. The data input device shows an unexplained anomaly, in that the microbial burden on the copper is slightly higher than that seen on the noncopper counterpart. The contamination levels on both the copper and the noncopper data input devices are quite low, plus the difference in contamination levels is the smallest when compared to the other five objects. The use of the data input device is restricted to healthcare professionals, which is not the case for the other five objects. Healthcare professionals as a group are more cognizant of consequences of patients acquiring infections, which we believe may account not only for the low contamination levels seen on both the noncopper and copper data input devices, but also for the above mentioned anomaly, rather than any difference in frequency of cleaning. The average reduction in microbial burden, when comparing the copper to the noncopper components over 21 months, was 83% (Schmidt, Attaway, Sharpe, et al., 2012). This result is similar to that of another recent study conducted in a pediatric ICU in Chile, where a 88% reduction in microbial burden was observed (Michael G. Schmidt, private communication, January 23, 2015).

Bottom Line: This is a translational science article that discusses copper alloys as antimicrobial environmental surfaces.Greater than a 99.9% reduction in live bacteria was realized in laboratory tests.Thus, based on the presented information, the placement of copper alloy components, in the built environment, may have the potential to reduce not only hospital-acquired infections but also patient treatment costs.

View Article: PubMed Central - PubMed

Affiliation: Copper Development Association, New York, NY, USA harold.michels@copperalliance.us.

No MeSH data available.


Related in: MedlinePlus