Biocidal Hard and Soft Surfaces Containing Copper Oxide Particles for the Reduction of Healthcare-Acquired Pathogens - Use of Biocidal Surfaces for Reduction of Healthcare Acquired Infections - page 88

Table 5.2 Key properties that biocidal textiles should have
Wide spectrum antimicrobial, antifungal and antiviral properties
Effective against the already existent antibiotic resistant micro-organisms involved in healthcare-
acquired infections
Not allow development of resistance to the active component in the textiles by micro-organisms;
Withstand multiple industrial washings without losing biocidal potency;
Not cause skin irritation or sensitization;
Be safe to humans

In the last 20 years, the development of biocidal textiles in general and specifically
for the use in the hospital environment has gained momentum, and different biocidal
compounds are being explored for this purpose [ 84 - 87 ]. Biocides can by chemically
or physically attached to the natural or synthetic fibres from which the textile
products are made or to the surface of the finished textile products. Surface applica-
tions usually have a lower persistence over time, as the active ingredient is lost due to
friction and washing. Other biocides are introduced earlier during the production
stage by impregnating them in the polymeric fibres used in the textile industry. Some
of the biocidal active ingredients being studied are Cliniweave

, organofunctional
silane, citric acid, copper, silver, zinc, triclosan, quaternary ammonium compounds,
chitosan and zeolite. Some of the above active ingredients have been found not to be
appropriate for use in hospital related applications (e.g. [ 88 , 89 ]).
Only a few clinical trials have been performed to determine the efficacy of
biocidal textiles in clinical settings. Most of the studies examined the capacity of
the biocidal textiles to reduce microbial contamination [ 4 , 90 - 94 ]. These studies,
which included personnel uniforms, patient linens, scrubs, blankets, privacy cur-
tains, cloths and mops, found statistically significant lower bioburden levels than
those found in the matched non-biocidal controls. One study, performed with only
10 workers that used silver containing jackets and pants, did not find any significant
difference in the extent of microbial contamination between the silver containing
textiles and control textiles [ 95 ]. It may be that a larger sample size was required to
prove the silver containing fabric's efficacy. Also, a randomized controlled study
that compared the bacterial contamination of uniforms of healthcare workers when
using a regular textile and two textile containing antimicrobial finishes, did not find
any decrease in the bioburden levels in the antimicrobial textiles [ 96 ]. Unfortu-
nately, the identity and nature of the antimicrobial components in the scrubs tested
is not clear.

®

Interestingly, in a recent study in which copper-coated films

(21 39.7 cm) were attached to bed sheets used by a heavily MRSA-colonized

patient found 20-130 MRSA colony forming units (cfu) in these films as opposed to
6,600-11,000 cfu on the surface of the non-film-coated control sheet areas [ 97 ].
The capacity of antimicrobial cleaning cloths to reduce bioburden and HAI was
demonstrated. For example, a recent study examined the capacity of copper treated
cleaning cloths in neutralizing the bacterial virus MS2. This virus serves as a
non-pathogenic surrogate virus to clinically relevant viruses such as hepatitis A,
enteroviruses, poliovirus or novovirus, due to its structure and environmental stabil-
ity. Ninety percent of the absorbed virus in the cloths were killed, reducing