Preface - Use of Biocidal Surfaces for Reduction of Healthcare Acquired Infections - page 2

Current Rigorously Implemented Measures to Reduce HAI Rates
￿ Hand washing before and after every contact with a patient or

object

￿ Isolation of infected patients

HAI
Rates

￿ Use disposable and personal protective equipment

￿ Use of HEPA filters and better ventilation management

￿ Improved disinfection regimens

￿ Improved hospital cleaning

￿ Increased personnel per patient

￿ Increase in infection control personnel

￿ Aggressive antibiotic control programs

Overlooked and neglected -
bio-control of the inanimate
environment

Years

Fig. 1.1 HAI are not eliminated by the current implemented measures

there is a clear correlation between the environmental bioburden present in a clinical
setting and the risk of patient of acquiring an infection [ 4 - 14 ]. Thus using self-
disinfecting surfaces can be a very important adjunct in the fight against HAI [ 15 , 16 ].
Copper is an essential trace element needed for the normal function of all aerobic
life forms. Its ability to cycle between two oxidation states, Cu 1+ and Cu 2+ , is key
to a wide array of metalloenzymes that catalyze electron transfer reactions.
Conversely, copper can be highly toxic due in part to its ability to generate reactive
oxygen species. Thus microorganisms have developed a complex series of mech-
anisms to regulate copper intracellular accumulation and distribution [ 17 , 18 ]. How-
ever, above a certain threshold of exposure to copper, which varies between
microorganisms, the microorganisms are killed, sometimes within minutes
(e.g. [ 19 - 21 ]), via different multisite parallel mechanisms [ 22 ].
The ancient Greeks in the time of Hippocrates (400 BC) were the first to discover
the sanitizing power of copper. They prescribed copper for pulmonary diseases and
for purifying drinking water. Since then copper has been used as a biocide for
treating sores and skin diseases and for purifying water by many civilizations, such
as the Celts, Phoenicians, Egyptians, Hindus, and Aztecs [ 23 ]. By the eighteenth
century copper had come into wide clinical use in the Western world for the
treatment of mental disorders and afflictions of the lungs. Furthermore, in the
eighteenth century it was discovered that no fungi grew on seed grains soaked in
copper sulphate. Beginning in the early 1950s [e.g. [ 24 - 26 ]], the biocidal properties
of copper and copper compounds were demonstrated in controlled laboratory
studies. Notably, copper surfaces or copper compounds have been shown to be
efficacious against hard-to-kill spores [ 27 - 33 ].
Today copper biocides have become indispensable and many thousands of tons
are used annually all over the world for (i) prevention of roof moss formation [ 34 ];