Preface - Use of Biocidal Surfaces for Reduction of Healthcare Acquired Infections - page 3

(ii) wood preservation [ 35 ]; (iii) control of green slime in farm ponds, rice fields,
irrigation and drainage canals, rivers, lakes and swimming pools [ 36 ];
(iv) prevention of downy mildew on grapes [ 37 ]; and (v) antifouling paints [ 38 - 40 ].
Non-soluble copper compounds, such as degradable phosphate glass fibres
impregnated with CuO [ 41 , 42 ], glass coated with thin films of CuO [ 43 ], or
metallic and copper alloys [ 20 , 32 , 44 - 50 ] also exert potent biocidal properties,
including against hard-to-kill spores [ 27 - 33 ]. Importantly, in March 2008 the
U.S. Environmental Protection Agency (EPA) has approved the registration of
copper alloys as materials with antimicrobial properties, thus allowing the Copper
Development Association (CDA) to make public health claims [ 51 ]. More recently,
Cupron Inc. received similar approvals by the EPA to make public health claims
with its copper oxide infused countertops. These public health claims acknowledge
that alloys containing above 60 % copper and surfaces impregnated with 16 %
copper oxide particles are capable of killing more than 99.9 % of harmful, poten-
tially deadly bacteria, such as Methicillin-resistant S. aureus (MRSA) within 2 h,
and continue to kill more than 99 % of bacteria even after repeated contamination.
Copper is the only metal that has received this type of EPA registrations.
This topic discusses the role of the environment as a potential source for out-
breaks of HAI and focuses on the utility of solid copper surfaces and copper oxide
impregnated materials in reducing bioburden and fighting HAI. It also reviews
other biocidal surface alternatives and the economics of using biocidal surfaces in a
hospital environment. Finally, it discusses the pros and cons of existent disinfection
modalities other than biocidal surfaces.
More specifically, in Chap. 2 of this topic, Axel Kramer and Ojan Assadian,
discuss the ability of pathogenic bacteria, fungi and viruses to persist and survive
for long-term periods on inanimate surfaces. They discuss the factors influencing
the survival of these pathogens in the environment and the mechanisms by which
pathogens are transmitted from these inanimate surfaces to susceptible patients.
In Chap. 3 , Jon Otter, Saber Yezli and Gary L. French provide proof that surface
contamination by nosocomial pathogens shed by patients contributes to nosocomial
cross-transmission and HAI. They review evidence that improved environmental
hygiene can help bring HAI rates down and consider various options to address
contaminated surfaces in healthcare facilities.
In Chap. 4 , Michael G. Schmidt, Andrea L. Banks, and Cassandra D. Salgado,
further discuss the effect of environmental contamination and HAI and review the
studies showing the use of biocidal metallic copper surfaces resulting in dramatic
reduction of bioburden and importantly of HAI rates.
In Chap. 5 , I discuss how regular hospital linens, uniforms and other hospital
textiles are a neglected source of nosocomial pathogens and how self-disinfecting
biocidal textiles can significantly contribute to the reduction of HAI. Specifically I
review the studies showing that incorporation of copper oxide in hospital textiles
can reduce bioburden and HAI rates. I also briefly review the novel successful
endowment of biocidal properties to non-porous solid surfaces by impregnating
them with copper oxide particles.