An Overview of the Options for Antimicrobial Hard Surfaces in Hospitals - Use of Biocidal Surfaces for Reduction of Healthcare Acquired Infections - page 158

7.4.3 Physical Alteration of Surface Properties
A number of options that are not directly antimicrobial but either reduce the
deposition of microbes on surfaces, or improve their cleanability, or both (Table 7.1 ).
These include “liquid glass” (silicon dioxide), Sharklet pattern [ 113 , 114 ], advanced
polymer coatings (such as polyethylene glycol (PEG), superhydrophobic/philic and
zwitterionic) [ 115 - 118 ] and diamond-like carbon (DLC) films [ 119 ]. These technol-
ogies are currently at an early stage of development in terms of producing AMS, and
no in situ studies have been performed. However, there is a potential that several of
these methods to make surfaces less liable to microbial deposition, or easier to clean,
could be combined with the addition of an antimicrobial agent [ 54 ]. This potential
should be the focus of development activities.
7.4.4 Other Options
There are some other options not listed in the table, that could be considered
candidates for antimicrobial surfaces, although they are currently at an early stage
of development, including: negative air ionization to repel bacteria from surfaces
[ 120 ], enzymes [ 121 ] or bacteriophages [ 122 ] immobilized on surfaces, or
polyphenol-based AMS derived from foods such as green tea, red wine and dark
chocolate [ 123 ]. These options are at an early stage of development, but offer
potential for the future.
7.5 Summary
There's a plethora of potential options and approaches to make a hospital surface
'antimicrobial'. Copper is leading the way as a candidate, although other options
are available. Making a surface less able to support contamination in the first place,
and/or easier to clean is another tempting option, particularly if this can be
combined with a level of antimicrobial activity. Finding and evaluating the optimal
antimicrobial surface requires a multidisciplinary approach, involving industrial
partners, materials scientists, healthcare scientists and epidemiologists to refine and
test the available options. More studies in the clinical setting, including those with a
clinical outcome and an evaluation of cost-effectiveness, are required.
References
1. Maki DG, Alvarado CJ, Hassemer CA, Zilz MA (1982) Relation of the inanimate hospital
environment to endemic nosocomial infection. N Engl J Med 307:1562-1566
2. Otter JA, Yezli S, French GL (2011) The role played by contaminated surfaces in the
transmission of nosocomial pathogens. Infect Control Hosp Epidemiol 32:687-699