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 89

significantly potential cross contamination during cleaning [ 98 ]. More dramatically,
by introducing peracetic acid sporicidal wipes, the Clostridium difficile infections
rates in an acute London trust were reduced by 72 % during the monitored 18 months
as compared to the previous period [ 99 ].
In contrary to lab conditions, during in vivo use, continual re-inoculation with
pathogens occurs. Since the killing of the microorganisms is not instant, the
expectation is not to obtain a sterile fabric, but a fabric that prevents microbial
proliferation and reduces the bioburden levels significantly. The concept that such
textiles can reduce HAI, to the best of my knowledge, has been demonstrated in
only one clinical trial (to be discussed below) and obviously more trials are needed
to clearly establish the capacity of biocidal textiles to help in the fight against HAI.
Furthermore, as HAI are spreading into the community (e.g. [ 100 ]), the use of
biocidal textiles and biocidal hard surfaces may not only significantly contribute to
the reduction of HAI, but may also confer protection in other environments where
at-risk individuals run the risk of contracting infections such as in long term care
facilities.
5.3 Biocidal Textiles Containing Copper Oxide
Copper is one of the several materials that are being explored as a potent wide
spectrum biocide to be used in hard and soft surfaces in clinical settings for the
reduction of HAI. The biocidal mechanisms of copper are discussed in Chap. 6 of
this topic. Different copper compounds that were applied to different textile fibres
or polymers via different techniques, demonstrated potent in vitro biocidal efficacy
including against antibiotic resistant bacteria [ 4 , 101 - 116 ]. Most of these studies
were conducted in the academia and the only technology that has generated textile
products widely used commercially is the technology based on the impregnation of
copper oxide particles into products [ 4 , 108 - 110 , 117 - 123 ].
Copper oxide has been chosen as the active copper form to be introduced into
textiles due to two main reasons: it is a non-soluble form of copper and it is highly
reactive with potent wide spectrum biocidal properties [ 124 ]. As can be seen in
Fig. 5.2 , the copper oxide particles are an integral part of the polymeric fibers, as
they are homogenously distributed throughout the polymeric matrix. This is very
important for biocidal textiles as even when some of the external polymeric fiber
material disintegrates due to friction, repeated use and laundry resulting in loss of
the surface copper oxide particles, there are always “new” copper oxide particles
that “reach” the surface of the fiber, endowing the fiber with biocidal properties
for the life of the fiber.
The biocidal efficacy is not affected by repeated use, home or industrial wash-
ings [ 109 ] (Fig. 5.3 ). This is in contrast to coating technologies in which the active
material is only bound to the external layer of the fiber. Once this externally bound
active material is removed from the surface of the fiber due to friction or laundry,
the fiber losses its bioactive characteristics.