Self-Disinfecting Copper Beds Sustain Terminal Cleaning and Disinfection Effects throughout Patient Care

Abstract

Microbial burden associated with near-patient touch surfaces results in a greater risk of health care-associated infections (HAIs). Acute care beds may be a critical fomite, as traditional plastic surfaces harbor the highest concentrations of bacteria associated with high-touch surfaces in a hospital room’s patient zone. Five high-touch intensive care unit (ICU) bed surfaces encountered by patients, health care workers, and visitors were monitored by routine culture to assess the effect U.S. Environmental Protection Agency (U.S. EPA)-registered antimicrobial copper materials have on the microbial burden. Despite both daily and discharge cleaning and disinfection, each control bed’s plastic surfaces exceeded bacterial concentrations recommended subsequent to terminal cleaning and disinfection (TC&D) of 2.5 aerobic CFU/cm2. Beds with self-disinfecting (copper) surfaces harbored significantly fewer bacteria throughout the patient stay than control beds, at levels below those considered to increase the likelihood of HAIs. With adherence to routine daily and terminal cleaning regimes throughout the study, the copper alloy surfaces neither tarnished nor required additional cleaning or special maintenance. Beds encapsulated with U.S. EPA-registered antimicrobial copper materials were found to sustain the microbial burden below the TC&D risk threshold levels throughout the patient stay, suggesting that outfitting acute care beds with such materials may be an important supplement to controlling the concentration of infectious agents and thereby potentially reducing the overall HAI risk. IMPORTANCE Despite cleaning efforts of environmental service teams and substantial compliance with hand hygiene best practices, the microbial burden in patient care settings often exceeds concentrations at which transfer to patients represents a substantial acquisition risk for health care-associated infections (HAIs). Approaches to limit HAI risk have relied on designing health care equipment and furnishings that are easier to clean and/or the use of no-touch disinfection interventions such as germicidal UV irradiation or vapor deposition of hydrogen peroxide. In a clinical trial evaluating the largest fomite in the patient care setting, the bed, a bed was encapsulated with continuously disinfecting antimicrobial copper surfaces, which reduced the bacteria on surfaces by 94% and sustained the microbial burden below the terminal cleaning and disinfection risk threshold throughout the patient’s stay. Such an intervention, which continuously limits microbes on high-touch surfaces, should be studied in a broader range of health care settings to determine its potential long-range efficacy for reducing HAI.

A Metatranscriptomics Survey of Microbial Diversity on Surfaces Post-Intervention of cleanSURFACES® Technology in an Intensive Care Unit

“…The same trend of decreased observed richness also holds when individual time points (Day 1, Day 7, and Day 28) are compared to Baseline ( Supplemental Figure 1 ). After cleanSURFACES ® intervention, there is a global reduction of ~30% in the number of unique microbial species detected, which is concordant with previous terminal cleaning literature ( Attaway et al., 2012 ; Schmidt et al., 2016 ; Koscova et al., 2018 ; Schmidt et al., 2019 ).…”

Brass Alloys: Copper-Bottomed Solutions against Hospital-Acquired Infections?

“…The authors also pointed out a lower frequency of bacterial contamination above the threshold of 2.5 CFUs/cm² on the copper surface. The same team afterwards worked on active care beds with surfaces close to the patient encapsulated in copper [ 104 ]. Their findings included a bacterial contamination of these surfaces correlated with the patients’ length of stay, a significant reduction in the bacterial contamination on copper-bed surfaces, and once more a lower frequency of bacterial bioburden above the 2.5 CFUs/cm² threshold for the same beds [ 104 ].…”

Leading Change in Response to COVID-19

“…For example, accommodation providers will need ways of cleaning and certifying that their locations are virus-free. Protocols and building materials used in medical institutions, such as virus-killing copper (Schmidt et al, 2019) and hydrostatic disinfectant sprayers, along with innovations such as touchless bathrooms (Visontay, 2020), may be useful; a rapidly enacted government cleanliness certification process developed in concert with industry leaders would again be valuable.…”