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 76

Fig. 4.4 EPA registered antimicrobial cooper alloys used in the fabrication or surfacing of high
touch items. Items were fabricated from a variety of EPA registered antimicrobial copper alloys as
listed. The criterion used to select an alloy was reflective of the ability of the antimicrobial alloy to
be readily fabricated into that particular component and withstand the rigors of healthcare
fabricated into that particular component (Fig. 4.4 ). Properties of strength and
durability were operationally defined such that the resulting component would be
able to withstand the rigors placed on the finished goods within the built environ-
ment of an active clinical setting and for the ability of the materials to withstand
standard hospital cleaners, including sodium hypochlorite. Additionally, the surface
finish was to provide consistent wear and aesthetics over the lifespan of the product.
All of the copper alloys used for component fabrication were made from solid
alloys registered with the EPA [ 87 ]. Subsequent to the published report, manufac-
turers have introduced numerous products fabricated from EPA registered solid
copper that meet or exceed the criteria used by the referenced authors [ 70 , 74 , 75 ].
From a design standpoint, it is important to note that these results were 'additive'
to other infection-control implementations already in place. Single patient rooms,
hand-washing sinks, hand sanitizing alcohol dispensers, contact precautions
required of MRSA and VRE carriers/infected patient(s), and an active hand hygiene
staff education program were already in place in the units of the hospitals studied.
Should these conclusions expand to other areas of the hospital, then employing
inherently antimicrobial surfaces could represent a significant enhancement to
mitigating infectious bacteria within hospitals. For example, by instituting a 'best
practices' approach that implemented cleaning and hand hygiene designs and pro-
tocols, the California's Healthcare-Associated Infection Prevention Initiative
showed a reduction of HAI by 3.2 %. With many of these best practices already
in place, the initial findings from the clinical trials are showing an additional
double-digit reduction in infections.
Although the relative infection rate in the medical ICUs where the clinical
effectiveness of antimicrobial copper surfaces were evaluated is generally higher
than hospitals at large, patients in ICUs are typically not mobile, and their interac-
tion with the built environment is very limited. Consequently, items where antimi-
crobial copper alloys might have been easily incorporated, e.g. grab bars, sinks,
faucets, paper dispensers, shelves and towel racks were not present. The further
evaluation of antimicrobial copper surfaces is warranted beyond the medical ICU to
include, but not be limited to, the effect of inherently antimicrobial materials in