ECJ EUROPEAN Cleaning Journal

Recently-published research from a joint US-Chile clinical trial studying the contribution of antimicrobial copper touch surfaces to environmental hygiene in a paediatric intensive care unit describes the intervention as a ‘no-touch disinfection technology' that warrants serious consideration as part of a bundle of infection prevention measures.

Noting the built hospital environment serves as a significant and continuous reservoir of microbes that can cause infections, the researchers observe that whilst cleaning, hand hygiene and other measures are effective, they cannot completely eliminate contamination risk. Adding continuously active antimicrobial copper surfaces offers another hygiene measure.

The new study - conducted at Roberto del Rio Children's Hospital in Chile - aimed to build on the evidence that copper and copper alloy surfaces (collectively called ‘antimicrobial copper') decrease the burden of micro-organisms in healthcare environments, and assess whether this reduced the risk of healthcare-associated infections in paediatric intensive and intermediate care units, as has been reported in adult ICUs.

Admitted infants were assigned sequentially to a room, eight with standard surfaces and eight where key touch surfaces had been replaced with antimicrobial copper items: bed rails, bed rail levers, IV poles, tap handles and the nurses' workstation. Infection data were collected on a daily basis for the 12-month duration of the study, with HCAIs confirmed according to protocol definitions.

The copper surfaces were found to harbour, on average, 88 per cent fewer bacteria than those in the control rooms, and 94 per cent met the bacterial concentration limit for terminal cleaning (<500 cfu per 100 cm2), compared to 48 per cent of controls.

For the second part of the study, clinical outcomes from 515 patients were considered in the analysis: 261 patients from the intervention arm of the study, and 254 from the control arm. Crude analysis showed an HCAI rate of 10.6 versus 13.0 per 1,000 patient days for copper- and non-copper-exposed patients, respectively, for a crude relative risk reduction of 19 per cent.

The researchers concluded that exposure of paediatric patients to solid antimicrobial copper objects in the ICU resulted in decreased HCAI rates when compared with those in non-copper surroundings. They note the relative risk reduction was not statistically significant, and report that certain events such as overcrowding may have limited the antimicrobial contribution provided by the copper intervention.

The authors also remarked that designing a randomised control trial was challenging. Nonetheless, they believe copper interventions should be considered as part of a systems-based approach to controlling HCAIs.

www.antimicrobialcopper.org