Role of the Microbial Burden in the Acquisition and Control of Healthcare Associated Infections: The Utility of Solid Copper Surfaces - Use of Biocidal Surfaces for Reduction of Healthcare Acquired Infections - page 71

multidrug-resistant Gram-negative rods were reduced, but failed to reach significance.
However, in spite of the failure to reach significance the effectiveness of this no-touch
infection control solution was able to significantly alter the proportion of rooms
environmentally contaminated with MDRs. Here the concentration of MDRs in the
HPV treated units were significantly reduced (relative risk, 0.65, p

0.03), but not on
non-HPV treated units leading the authors to conclude that the use of HPV can reduce
the risk of acquiring MDRs compared with standard cleaning protocols [ 59 ].
In spite of the success demonstrated here and in other studies [ 14 , 21 ] vapor-
phase disinfection of the built environment has limitations in that the ventilation to
the room must be controlled/and or limited for the duration of the disinfection
cycle. This time can vary depending upon the concentration of peroxide or
disinfecting gas used. These two technologies, HPV and UV, have been found to
be effective for the disinfection of inanimate objects and surfaces. However, neither
technology is intended as a substitute for cleaning or for the removal of soil from
the resident objects and surfaces within the built patient care environment (see also
Chap. 9 ). An appropriately trained environmental service team must accomplish
cleaning, with subsequent disinfection of the built environment.

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4.4 Antimicrobial Copper: A Continuously Active
No-Touch Disinfection Solution for Healthcare

Recently, we have begun to witness the incorporation of another 'no-touch'
technology. However, unlike UV and vapor phase oxygen radicals (H 2 O 2 ) that
distribute their antimicrobial activity through the atmosphere, this technology
requires the microbe come in contact or be in close proximity with the material in
order to facilitate its antimicrobial activity. In contrast to UV and HVP, once
placed, this no-touch system simply requires that the fugitive microbe come in
contact with the surface in order to effect disinfection. Thus, the inactivation or
killing of the microbe does not require any user intervention once deployed. One
such example of this type of no-touch technology is solid antimicrobial copper. The
resident microbial burden associated with the built environment is continuously
reduced through the strategic placement of solid copper surfaces onto critical high
touch surfaces within the patient care setting [ 75 ].
Copper has been used by humans for millennia, first as tools and then as a measure
to fight the spread of infectious agents. Metallic copper intrinsically displays a strong
antibacterial activity in aquatic systems [ 2 , 38 ] as well as on dry surfaces [ 32 , 54 , 96 ,
102 , 104 ]. In 2008 the United States Environmental Protection Agency (EPA)
registered five families of copper-containing alloys as antimicrobial, establishing
that products manufactured from one of these registered alloys can make public
health claims wherein the label indication states that the alloys kill greater than
99.9 % of bacteria within 2 h of exposure [ 87 ]. It is anticipated that the solid
antimicrobial copper surfaces will remain microbiocidal for the life of the product
( 10 years). A variety of controlled studies have looked at the antimicrobial activity

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