Hygienic Relevance and Risk Assessment of Antimicrobial-Impregnated Textiles

Abstract

The antimicrobial impregnation of textiles is intended to provide protection of textiles against microbial corrosion, prevention of malodor or prophylaxis and therapy of infections, respectively. For every biocidal product a careful risk assessment for humans and the environment has to be performed. The advantage of antimicrobially active textiles has to be documented for every agent as well as for every application, and a balance has to be found between a textile's quality rating and the potential risks, e.g. sensitization, disturbance of the ecology of the skin, toxic side effects by means of systemic absorption, cytotoxicity, genotoxicity, carcinogenicity, teratogenicity and ecotoxicity. This article evaluates the applicability of silver compounds as well as the classic antimicrobials triclosan, quaternary ammonium compounds, copper and further new options like chitosan and zeolite. It has to be emphasized that there are no objections against the use of antimicrobially active textiles if their use is equal or superior to other preventive or therapeutic measures. This applies to the amelioration of the course of dermatological diseases with disturbed skin flora, in particular atopic dermatitis, the prevention and therapy of acute and chronic wound infections by wound dressings, the use of impregnated surgical suture material as well as special indications in the prevention of infection in medical facilities. The use of antimicrobial textiles for the prevention of dermatomycosis by antifungal impregnation is of questionable use; the antimicrobial impregnation of textiles for deodorization purposes has to be avoided. Presently, from a hygienic point of view, the following questions have to be clearly determined: declaration of any antimicrobial impregnation; development of international standards for in vitro testing and preclinical evaluation of efficacy and tolerance; evaluation of the advantage of the antimicrobial properties for the intended use including the risk-benefit assessment.

Healthcare Laundry and Textiles in the United States: Review and Commentary on Contemporary Infection Prevention Issues

“…Risk-benefit analyses for patientsafety purposes should be performed as part of treated textile research to evaluate potential skin reactions to continual contact with antimicrobial chemical residues. 83,103 Once a textile treatment is deemed safe for skin contact, the antimicrobial performance of the textile should be evaluated in a clinical setting. 104 Lazary et al 105 recently studied the impact on HAI incidence when copper oxide-impregnated (biocidal) HCTs and patient garments were used in a long-term brain injury ward.…”

Bacterial Burden of Worn Therapeutic Silver Textiles for Neurodermitis Patients and Evaluation of Efficacy of Washing

“…In addition, silver textiles were shown to be antimicrobial against S. aureus in vitro [8,9] and in vivo [2,10] , as this pathogen is substantially involved in triggering, sustaining and exacerbating the inflammatory process in the skin of the patients [10][11][12][13][14][15] . An additional underestimated aspect of antistaphylococcal treatment by wearing silver-impregnated textiles in AD is given by their ability to prevent the release of ecotoxically relevant agents.…”

“…Wearing such silver textiles was shown to reduce especially pruritus, but reduced also colonization with bacteria including Staphylococcus aureus in skin lesions [1][2][3] . Substantial bacterial colonization including that of the skin, mucosa and active neurodermitis lesions with S. aureus is typical of patients with AD [4][5][6] .…”

A simple and rapid method for optical visualization and quantification of bacteria on textiles

“…Therefore, many efforts have been dedicated to develop anti-bacterial textiles. Most coatings make use of biocidal substances, which kill bacteria891011, but raise environmental and health concerns. More attractive approaches include usage of anti-adhesive textiles, which prevent the binding of bacteria12.…”