Biomedical Engineering Reference
In-Depth Information
Table 7.1 An overview of the options for antimicrobial hard surfaces in hospitals
Candidate
Application
Mode of action
Pros
Cons
Metals
Copper
Manufactured in
[ 31 ]/
retrofitted
[ 70 , 124 ]/
liquid
disinfectant
[ 68 ]
Redox activity of copper resulting in
reactive oxygen species [ 57 ]
Rapidly microbicidal; [ 125 ]
large evidence-base; [ 57 ]
evidence of reduced
acquisition [ 31 ]
Sporicidal activity equivocal;
[ 60 ] cost, acceptability
and durability may be
questionable [ 53 ]
Silver
Manufactured in
[ 77 ]/liquid
disinfectant
[ 97 ]
Microbes accumulate silver until
toxicity threshold exceeded [ 52 ].
Broadly microbicidal [ 55 , 81 ]
? sporicidal; tolerance
development; relies on
leaching so surface loses
efficacy over time [ 55 , 81 ]
Chemicals
Organosilane
Periodic
application
[ 72 , 103 ]
Microscopic physical damage
to microbe through direct
contact [ 72 ]
Easy to apply [ 72 , 103 ]
Limited microbicidal activity;
questionable “real-world”
efficacy [ 72 , 103 ]
Light-activated (e.g. titanium
dioxide or photosensitisers)
Manufactured
in/periodic
application
[ 75 , 109 ]
Microbicidal reactive oxygen
species generated when
irradiated with light of a suitable
wavelength [ 75 , 109 ]
Broadly microbicidal; can be
activated by natural light
[ 75 , 109 ]
? sporicidal; requires light
source for photoactivation
(some require UV light); may
lose activity over time [ 75 ,
109 ]
Quaternary ammonium
compound based agents
with residual activity
Liquid
disinfectant
[ 105 ]
Disruption of cell membrane [ 105 ]
Easy to apply, well-adopted
[ 105 ]
Limited microbicidal activity
(formulation dependent);
limited evidence for residual
activity; environmental
toxicity [ 105 ]
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