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Copper Surfaces Reduce the Rate of Healthcare-Acquired Infections in the Intensive Care Unit

Published online by Cambridge University Press:  02 January 2015

Cassandra D. Salgado ,
Kent A. Sepkowitz ,
Joseph F. John ,
J. Robert Cantey ,
Hubert H. Attaway ,
Katherine D. Freeman ,
Peter A. Sharpe ,
Harold T. Michels  and
Michael G. Schmidt
Cassandra D. Salgado*
Affiliation:
Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
Kent A. Sepkowitz
Affiliation:
Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
Joseph F. John
Affiliation:
Department of Medicine, Ralph H. Johnson VA Medical Center, Charleston, South Carolina
J. Robert Cantey
Affiliation:
Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
Hubert H. Attaway
Affiliation:
Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, South Carolina
Katherine D. Freeman
Affiliation:
Extrapolate LLC, Delray Beach, Florida
Peter A. Sharpe
Affiliation:
Sharpe and Associates, West Orange, New Jersey
Harold T. Michels
Affiliation:
Copper Development Association, New York, New York
Michael G. Schmidt
Affiliation:
Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, South Carolina
*
135 Rutledge Avenue, Division of Infectious Diseases, Charleston, SC 29425 (salgado@musc.edu)
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Abstract

Objective.

Healthcare-acquired infections (HAIs) cause substantial patient morbidity and mortality. Items in the environment harbor microorganisms that may contribute to HAIs. Reduction in surface bioburden may be an effective strategy to reduce HAIs. The inherent biocidal properties of copper surfaces offer a theoretical advantage to conventional cleaning, as the effect is continuous rather than episodic. We sought to determine whether placement of copper alloy-surfaced objects in an intensive care unit (ICU) reduced the risk of HAI.

Design.

Intention-to-treat randomized control trial between July 12, 2010, and June 14, 2011.

Setting.

The ICUs of 3 hospitals.

Patients.

Patients presenting for admission to the ICU.

Methods.

Patients were randomly placed in available rooms with or without copper alloy surfaces, and the rates of incident HAI and/or colonization with methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE) in each type of room were compared.

Results.

The rate of HAI and/or MRSA or VRE colonization in ICU rooms with copper alloy surfaces was significantly lower than that in standard ICU rooms (0.071 vs 0.123; P = .020). For HAI only, the rate was reduced from 0.081 to 0.034 (P = .013).

Conclusions.

Patients cared for in ICU rooms with copper alloy surfaces had a significantly lower rate of incident HAI and/or colonization with MRSA or VRE than did patients treated in standard rooms. Additional studies are needed to determine the clinical effect of copper alloy surfaces in additional patient populations and settings.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 34 , Issue 5: Special Topic Issue: The Role of the Environment in Infection Prevention , May 2013 , pp. 479 - 486
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

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References

1.Klevens, RM, Edwards, JR, Richards, CL, et al.Estimating health care-associated infections and deaths in U.S. hospitals, 2002. Public Health Rep 2007;122:160–166.CrossRefGoogle ScholarPubMed
2.Scott, RD. The Direct Medical Costs of Healthcare-Associated Infections in U.S. Hospitals and the Benefits of Prevention. Atlanta: Centers for Disease Control and Prevention, 2009.Google Scholar
3.Martin, J. The Impact of Healthcare-Associated Infections in Pennsylvania. Harrisburg, PA: Pennsylvania Health Care Cost Containment Council, 2011. http://www.phc4.org. Accessed February 28, 2013.Google Scholar
4.Boyce, JM. Environmental contamination makes an important contribution to hospital infection. J Hosp Infect 2007;65:50–54.CrossRefGoogle ScholarPubMed
5.Blythe, D, Keenlyside, D, Dawson, SJ, Galloway, A. Environmental contamination due to methicillin-resistant Staphylococcus aureus (MRSA). J Hosp Infect 1998;38:67–69.CrossRefGoogle ScholarPubMed
6.Duckro, AN, Blom, DW, Lyle, EA, Weinstein, RA, Hayden, MK. Transfer of vancomycin-resistant enterococci via health care worker hands. Arch Intern Med 2005;165:302–307.CrossRefGoogle ScholarPubMed
7.Hayden, MK, Blom, DW, Lyle, EA, Moore, CG, Weinstein, RA. Risk of hand or glove contamination after contact with patients colonized with vancomycin-resistant Enterococcus or the colonized patients' environment. Infect Control Hosp Epidemiol 2008;29:149–154.CrossRefGoogle ScholarPubMed
8.Kramer, A, Schwebke, I, Kampf, G. How long do nosocomial pathogens persist on inanimate surfaces? a systematic review. BMC Infect Dis 2006;6:130.CrossRefGoogle Scholar
9.Huang, SS, Datta, R, Platt, R. Risk of acquiring antibiotic-resistant bacteria from prior room occupants. Arch Intern Med 2006;166:1945–1951.CrossRefGoogle ScholarPubMed
10.Shaughnessy, MK, Micielli, RL, DePestel, DD, et al.Evaluation of hospital room assignment and acquisition of Clostridium difficile infection. Infect Control Hosp Epidemiol 2011;32:201–206.CrossRefGoogle ScholarPubMed
11.Huskins, WC, Huckabee, CM, O'Grady, NP, et al.Intervention to reduce transmission of resistant bacteria in intensive care. N Engl J Med 2011;364:1407–1418.CrossRefGoogle ScholarPubMed
12.Rutala, WA, Weber, DJ; Healthcare Infection Control Practices Advisory Committee. Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008. Atlanta: Centers for Disease Control and Prevention, 2008. http://www.cdc.gov/hicpac/Disinfection_Sterilization/acknowledg.html. Accessed February 28, 2013.Google Scholar
13.Otter, JA, Yezli, S, French, GL. The role played by contaminated surfaces in the transmission of nosocomial pathogens. Infect Control Hosp Epidemiol 2011;32:687–699.CrossRefGoogle ScholarPubMed
14.Otter, JA, Puchowicz, M, Ryan, D, et al.Feasibility of routinely using hydrogen peroxide vapor to decontaminate rooms in a busy United States hospital. Infect Control Hosp Epidemiol 2009;30:574–577.CrossRefGoogle Scholar
15.Rutala, WA, Gergen, MF, Weber, DJ. Room decontamination with UV radiation. Infect Control Hosp Epidemiol 2010;31:1025–1029.CrossRefGoogle ScholarPubMed
16.US Environmental Protection Agency. EPA registers copper-containing alloy products, http://www.epa.gov/opp00001/factsheets/copper-alloy-products.htm. Published 2008. Accessed February 28, 2013.Google Scholar
17.Michels, HT. Anti-microbial characteristics of copper. Stand News 2006;34:28–31.Google Scholar
18.Noyce, JO, Michels, H, Keevil, CW. Potential use of copper surfaces to reduce survival of epidemic methicillin-resistant Staphylococcus aureus in the healthcare environment. J Hosp Infect 2006;63:289–297.CrossRefGoogle ScholarPubMed
19.Warnes, SL, Green, SM, Michels, HT, Keevil, CW. Biocidal efficacy of copper alloys against pathogenic enterococci involves degradation of genomic and plasmid DNAs. Appi Environ Microbiol 2010;76:5390–5401.CrossRefGoogle ScholarPubMed
20.Weaver, L, Michels, HT, Keevil, CW. Survival of Clostridium difficile on copper and steel: futuristic options for hospital hygiene. J Hosp Infect 2008;68:145–151.CrossRefGoogle ScholarPubMed
21.Weaver, L, Noyce, JO, Michels, HT, Keevil, CW. Potential action of copper surfaces on methicillin-resistant Staphylococcus aureus. J Appl Microbiol 2010;109:2200–2205.CrossRefGoogle Scholar
22.Grass, G, Rensing, C, Solioz, M. Metallic copper as an antimicrobial surface. Appl Environ Microbiol 2011;77:1541–1547.CrossRefGoogle ScholarPubMed
23.Mehtar, S, Wiid, I, Todorov, SD. The antimicrobial activity of copper and copper alloys against nosocomial pathogens and Mycobacterium tuberculosis isolated from healthcare facilities in the Western Cape: an in-vitro study. J Hosp Infect 2008;68:45–51.CrossRefGoogle ScholarPubMed
24.Marais, F, Mehtar, S, Chalkley, L. Antimicrobial efficacy of copper touch surfaces in reducing environmental bioburden in a South African community healthcare facility. J Hosp Infect 2010;74:80–82.CrossRefGoogle Scholar
25.Schmidt, MG, Attaway, HH, Sharpe, PA, et al.Sustained reduction of microbial burden on common hospital surfaces through the introduction of copper. J Clin Microbiol 2012;50(7):2217–2223.CrossRefGoogle ScholarPubMed
26.Mikolay, A, Huggett, S, Tikana, L, Grass, G, Braun, J, Nies, DH. Survival of bacteria on metallic copper surfaces in a hospital trial. Appl Microbiol Biotechnol 2010;87:1875–1879.CrossRefGoogle Scholar
27.Casey, AL, Adams, D, Karpanen, TJ, et al.Role of copper in reducing hospital environment contamination. J Hosp Infect 2010;74:72–77.CrossRefGoogle ScholarPubMed
28.Karpanen, TJ, Casey, AL, Lambert, PA, et al.The antimicrobial efficacy of copper alloy furnishings in the clinical environment: a crossover study. Infect Control Hosp Epidemiol 2012;33:3–9.CrossRefGoogle ScholarPubMed
29.Freitas, EF, Harris, RM, Blake, RK, Salgado, CD. Prevalence of USA300 community-acquired methicillin-resistant Staphylococcus aureus among patients with nasal colonization identified by active surveillance. Infect Control Hosp Epidemiol 2010;31:469–475.CrossRefGoogle ScholarPubMed
30.Jain, R, Kralovic, SM, Evans, ME, et al.Veterans Affairs initiative to prevent methicillin-resistant Staphylococcus aureus infections. N Engl J Med 2011;364:1419–1430.CrossRefGoogle ScholarPubMed
31.Olivier, CA, Blake, RK, Steed, LL, Saigado, CD. Risk of vancomycin-resistant Enterococcus (VRE) bloodstream infection among patients colonized with VRE. Infect Control Hosp Epidemiol 2008;29:404–409.CrossRefGoogle ScholarPubMed
32.Sharpe, PA, Schmidt, MG. Control and mitigation of healthcare-acquired infections: designing clinical trials to evaluate new materials and technologies. Herd 2011;5(1):94–115.CrossRefGoogle ScholarPubMed
33.Schmidt, MG, Anderson, T, Attaway, H, et al.Patient environment microbial burden reduction: a pilot study comparison of two terminal cleaning methods. Am J Infect Control 2012;40:559–561.CrossRefGoogle Scholar
34.Horan, TC, Andrus, M, Dudeck, MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2008;36:309–332.CrossRefGoogle ScholarPubMed
35.American Thoracic Society, Infectious Diseases Society of America. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med 2005;171:388–416.CrossRefGoogle Scholar
36.Weber, DJ, Rutala, WA. Self-disinfecting surfaces. Infect Control Hosp Epidemiol 2012;33:10–13.CrossRefGoogle ScholarPubMed