An Overview of the Options for Antimicrobial Hard Surfaces in Hospitals - Use of Biocidal Surfaces for Reduction of Healthcare Acquired Infections - page 135

Chapter 7
An Overview of the Options
for Antimicrobial Hard Surfaces in Hospitals
Jonathan A. Otter
Contents
7.1 Role of the Environment in Transmission . . .............................................. 139
7.1.1 Evidence That Contaminated Surfaces Contribute to Transmission . . . . . . . . . . . . 139
7.1.2 The Relationship Between Contamination Burden and Transmission Risk . . . . 139
7.1.3 Potential Role for Antimicrobial Surfaces ....................................... 142
7.2 Current Options and the 'Ideal' Candidate for Antimicrobial Surfaces . . . .............. 143
7.2.1 Considering the 'Ideal' Antimicrobial Surface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146
7.3 Assessing Antimicrobial Surfaces . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147
7.3.1 In Vitro Activity . .................................................................. 147
7.3.2 In Situ Activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148
7.3.3 Clinical Impact . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154
7.3.4 Cost-Effectiveness ................................................................. 154
7.4 Appraising the Options .................................................................... 155
7.4.1 Metals .............................................................................. 155
7.4.2 Chemical ........................................................................... 158
7.4.3 Physical Alteration of Surface Properties ........................................ 160
7.4.4 Other Options ...................................................................... 160
7.5 Summary ................................................................................... 160
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160
Abstract Contaminated surfaces make an important contribution to the transmission
of several important pathogens, including methicillin-resistant Staphylococcus
aureus (MRSA), Clostridium difficile and a number of resistant Gram-negative