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Antimicrobial copper-alloy touch surfaces can prevent frequently touched surfaces from serving as reservoirs for the spread of pathogenic microbes. This is especially true in healthcare facilities, where harmful viruses, bacteria, and fungi colonize and persist on doorknobs, push plates, handrails, tray tables, tap (faucet) handles, IV poles, HVAC systems, and other equipment. [1] These microbes can sometimes survive on surfaces for more than 30 days.[ citation needed ]
Coppertouch Australia commissioned the Doherty Institute at the Melbourne University Australia to test its Antimicrobial Copper adhesive film. Lab tests proved a 96% kill rate of Influenza A virus with the film as compared to non treated surfaces.[ citation needed ]
The surfaces of copper and its alloys, such as brass and bronze, are antimicrobial. They have an inherent ability to kill a wide range of harmful microbes relatively rapidly – often within two hours or less – and with a high degree of efficiency. These antimicrobial properties have been demonstrated by an extensive body of research. The research also suggests that if touch surfaces are made with copper alloys, the reduced transmission of disease-causing organisms can reduce patient infections in hospital intensive care units (ICU) by as much as 58%. [2] [3] Several companies have developed methods for utilizing the antimicrobial functionality of copper on existing high-touch surfaces. LuminOre and Aereus Technologies both utilize cold-spray antimicrobial copper coating technology to apply antimicrobial coatings to surfaces.
As of 2019 a number of studies have found that copper surfaces may help prevent infection in the healthcare environment. [4]
Microorganisms are known to survive on inanimate surfaces for extended periods of time. [5] Hand and surface disinfection practices are a primary measure against the spread of infection. Since approximately 80% of infectious diseases are known to be transmitted by touch, and pathogens found in healthcare facilities can survive on inanimate surfaces for days or months, [6] the microbial burden of frequently touched surfaces is believed to play a significant role in infection causality. [7]
On February 29, 2008, the United States Environmental Protection Agency (EPA) approved the registrations of five different groups of copper alloys as "antimicrobial materials" with public health benefits. [8] The EPA registrations now cover 479 different compositions of copper alloys within six groups (an up-to-date list of all approved alloys is available). All of the alloys have minimum nominal copper concentrations of 60%. The results of the EPA-supervised antimicrobial studies demonstrating copper's strong antimicrobial efficacies across a wide range of alloys have been published. [8] [9]
The bacteria destroyed by copper alloys in the EPA-supervised antimicrobial efficiency tests include:
The registrations are based on studies supervised by EPA which found that copper alloys kill more than 99.9% of disease-causing bacteria within just two hours when cleaned regularly (i.e., the metals are free of dirt or grime that may impede the bacteria's contact with the copper surface).
To attain the EPA registrations, the copper alloy groups had to demonstrate strong antimicrobial efficacies according to all of the following rigorous tests:
The alloy groups tested and approved were C11000, C51000, C70600, C26000, C75200, and C28000.
The EPA registration numbers for the six groups of alloys are as follows: [13]
Group | Copper % | EPA registration number |
---|---|---|
I | 95.2 to 99.99 | 82012-1 |
II | 87.3 to 95.0 | 82012-2 |
III | 78.1 to 87.09 | 82012-3 |
IV | 68.2 to 77.5 | 82012-4 |
V | 65.0 to 67.8 | 82012-5 |
VI | 60.0 to 64.5 | 82012-6 |
The following claims are now legally permitted when marketing EPA-registered antimicrobial copper alloys in the U.S.:
Laboratory testing has shown that when cleaned regularly:
- Antimicrobial Copper Alloys continuously reduce bacterial contamination, achieving 99.9% reduction within two hours of exposure.
- Antimicrobial Copper Alloy surfaces kill greater than 99.9% of Gram-negative and Gram-positive bacteria within two hours of exposure.
- Antimicrobial Copper Alloy surfaces deliver continuous and ongoing antibacterial action, remaining effective in killing greater than 99% of bacteria within two hours.
- Antimicrobial Copper Alloys surfaces kill greater than 99.9% of bacteria within two hours, and continue to kill 99% of bacteria even after repeated contamination.
- Antimicrobial Copper Alloys surfaces help inhibit the buildup and growth of bacteria within two hours of exposure between routine cleaning and sanitizing steps.
- Testing demonstrates effective antibacterial activity against Staphylococcus aureus, Enterobacter aerogenes, Methicillin-resistant Staphylococcus aureus (MRSA), Escherichia coli O157:H7, and Pseudomonas aeruginosa
The registrations state that "antimicrobial copper alloys may be used in hospitals, other healthcare facilities, and various public, commercial and residential buildings."
As a condition of registration established by EPA, the Copper Development Association (CDA) in the U.S. is responsible for the product stewardship of antimicrobial copper alloy products. CDA must ensure that manufacturers promote these products in an appropriate manner. Manufacturers must only promote the proper use and care of these products and must specifically emphasize that the use of these products is a supplement and not a substitute to routine hygienic practices.
EPA mandated that all advertising and marketing materials for antimicrobial copper products contain the following statement:
The use of a Copper Alloy surface is a supplement to and not a substitute for standard infection control practices; users must continue to follow all current infection control practices, including those practices related to cleaning and disinfection of environmental surfaces. The Copper Alloy surface material has been shown to reduce microbial contamination, but it does not necessarily prevent cross-contamination.
Antimicrobial copper alloys are intended to provide supplemental antimicrobial action in between routine cleaning of environmental or touch surfaces in healthcare settings, as well as in public buildings and the home. Users must also understand that in order for antimicrobial copper alloys to remain effective, they cannot be coated in any way.
CDA is currently implementing an outreach program through written communications, a product stewardship website, [14] and through a Working Group which meets periodically to expand educational efforts.
More than 100 different potential product applications were cited in the registrations for their potential public health benefits.
The EPA warranty statement is worded as follows:
If used as intended, ANTIMICROBIAL COPPER ALLOYS are wear-resistant and the durable antibacterial properties will remain effective for as long as the product remains in place and is used as directed.
Note: With the exception of the product name and the percentage of active ingredient, the EPA-approved Master Labels for the six groups of registered alloys are identical.
Many antimicrobial copper alloy products have been approved for registration in healthcare facilities, public and commercial buildings, residences, mass transit facilities, laboratories, and play area equipment in the US. A complete list of registered products is available from EPA. [15]
Staphylococcus aureus is a gram-positive spherically shaped bacterium, a member of the Bacillota, and is a usual member of the microbiota of the body, frequently found in the upper respiratory tract and on the skin. It is often positive for catalase and nitrate reduction and is a facultative anaerobe that can grow without the need for oxygen. Although S. aureus usually acts as a commensal of the human microbiota, it can also become an opportunistic pathogen, being a common cause of skin infections including abscesses, respiratory infections such as sinusitis, and food poisoning. Pathogenic strains often promote infections by producing virulence factors such as potent protein toxins, and the expression of a cell-surface protein that binds and inactivates antibodies. S. aureus is one of the leading pathogens for deaths associated with antimicrobial resistance and the emergence of antibiotic-resistant strains, such as methicillin-resistant S. aureus (MRSA). The bacterium is a worldwide problem in clinical medicine. Despite much research and development, no vaccine for S. aureus has been approved.
Methicillin-resistant Staphylococcus aureus (MRSA) is a group of gram-positive bacteria that are genetically distinct from other strains of Staphylococcus aureus. MRSA is responsible for several difficult-to-treat infections in humans. It caused more than 100,000 deaths worldwide attributable to antimicrobial resistance in 2019.
Triclosan is an antibacterial and antifungal agent present in some consumer products, including toothpaste, soaps, detergents, toys, and surgical cleaning treatments. It is similar in its uses and mechanism of action to triclocarban. Its efficacy as an antimicrobial agent, the risk of antimicrobial resistance, and its possible role in disrupted hormonal development remains controversial. Additional research seeks to understand its potential effects on organisms and environmental health.
Bloodstream infections (BSIs) are infections of blood caused by blood-borne pathogens. The detection of microbes in the blood is always abnormal. A bloodstream infection is different from sepsis, which is characterized by severe inflammatory or immune responses of the host organism to pathogens.
A disinfectant is a chemical substance or compound used to inactivate or destroy microorganisms on inert surfaces. Disinfection does not necessarily kill all microorganisms, especially resistant bacterial spores; it is less effective than sterilization, which is an extreme physical or chemical process that kills all types of life. Disinfectants are generally distinguished from other antimicrobial agents such as antibiotics, which destroy microorganisms within the body, and antiseptics, which destroy microorganisms on living tissue. Disinfectants are also different from biocides—the latter are intended to destroy all forms of life, not just microorganisms. Disinfectants work by destroying the cell wall of microbes or interfering with their metabolism. It is also a form of decontamination, and can be defined as the process whereby physical or chemical methods are used to reduce the amount of pathogenic microorganisms on a surface.
A hospital-acquired infection, also known as a nosocomial infection, is an infection that is acquired in a hospital or other healthcare facility. To emphasize both hospital and nonhospital settings, it is sometimes instead called a healthcare-associated infection. Such an infection can be acquired in a hospital, nursing home, rehabilitation facility, outpatient clinic, diagnostic laboratory or other clinical settings. A number of dynamic processes can bring contamination into operating rooms and other areas within nosocomial settings. Infection is spread to the susceptible patient in the clinical setting by various means. Healthcare staff also spread infection, in addition to contaminated equipment, bed linens, or air droplets. The infection can originate from the outside environment, another infected patient, staff that may be infected, or in some cases, the source of the infection cannot be determined. In some cases the microorganism originates from the patient's own skin microbiota, becoming opportunistic after surgery or other procedures that compromise the protective skin barrier. Though the patient may have contracted the infection from their own skin, the infection is still considered nosocomial since it develops in the health care setting. Nosocomial infection tends to lack evidence that it was present when the patient entered the healthcare setting, thus meaning it was acquired post-admission.
An antimicrobial is an agent that kills microorganisms (microbicide) or stops their growth. Antimicrobial medicines can be grouped according to the microorganisms they act primarily against. For example, antibiotics are used against bacteria, and antifungals are used against fungi. They can also be classified according to their function. The use of antimicrobial medicines to treat infection is known as antimicrobial chemotherapy, while the use of antimicrobial medicines to prevent infection is known as antimicrobial prophylaxis.
Staphylococcal enteritis is an inflammation that is usually caused by eating or drinking substances contaminated with staph enterotoxin. The toxin, not the bacterium, settles in the small intestine and causes inflammation and swelling. This in turn can cause abdominal pain, cramping, dehydration, diarrhea and fever.
Vancomycin-resistant Staphylococcus aureus (VRSA) are strains of Staphylococcus aureus that have acquired resistance to the glycopeptide antibiotic vancomycin. Bacteria can acquire resistant genes either by random mutation or through the transfer of DNA from one bacterium to another. Resistance genes interfere with the normal antibiotic function and allow bacteria to grow in the presence of the antibiotic. Resistance in VRSA is conferred by the plasmid-mediated vanA gene and operon. Although VRSA infections are uncommon, VRSA is often resistant to other types of antibiotics and a potential threat to public health because treatment options are limited. VRSA is resistant to many of the standard drugs used to treat S. aureus infections. Furthermore, resistance can be transferred from one bacterium to another.
Infection prevention and control is the discipline concerned with preventing healthcare-associated infections; a practical rather than academic sub-discipline of epidemiology. In Northern Europe, infection prevention and control is expanded from healthcare into a component in public health, known as "infection protection". It is an essential part of the infrastructure of health care. Infection control and hospital epidemiology are akin to public health practice, practiced within the confines of a particular health-care delivery system rather than directed at society as a whole.
Lysostaphin is a Staphylococcus simulans metalloendopeptidase. It can function as a bacteriocin (antimicrobial) against Staphylococcus aureus.
Ceftobiprole, sold under the brand name Zevtera among others, is a fifth-generation cephalosporin antibacterial used for the treatment of hospital-acquired pneumonia and community-acquired pneumonia. It is marketed by Basilea Pharmaceutica under the brand names Zevtera and Mabelio. Like other cephalosporins, ceftobiprole exerts its antibacterial activity by binding to important penicillin-binding proteins and inhibiting their transpeptidase activity which is essential for the synthesis of bacterial cell walls. Ceftobiprole has high affinity for penicillin-binding protein 2a of methicillin-resistant Staphylococcus aureus strains and retains its activity against strains that express divergent mecA gene homologues. Ceftobiprole also binds to penicillin-binding protein 2b in Streptococcus pneumoniae (penicillin-intermediate), to penicillin-binding protein 2x in Streptococcus pneumoniae (penicillin-resistant), and to penicillin-binding protein 5 in Enterococcus faecalis.
Contamination control is the generic term for all activities aiming to control the existence, growth and proliferation of contamination in certain areas. Contamination control may refer to the atmosphere as well as to surfaces, to particulate matter as well as to microbes and to contamination prevention as well as to decontamination.
Arbekacin (INN) is a semisynthetic aminoglycoside antibiotic which was derived from kanamycin. It is primarily used for the treatment of infections caused by multi-resistant bacteria including methicillin-resistant Staphylococcus aureus (MRSA). Arbekacin was originally synthesized from dibekacin in 1973 by Hamao Umezawa and collaborators. It has been registered and marketed in Japan since 1990 under the trade name Habekacin. Arbekacin is no longer covered by patent and generic versions of the drug are also available under such trade names as Decontasin and Blubatosine.
Ceftaroline fosamil (INN), brand name Teflaro in the US and Zinforo in Europe, is a cephalosporin antibiotic with anti-MRSA activity. Ceftaroline fosamil is a prodrug of ceftaroline. It is active against methicillin-resistant Staphylococcus aureus (MRSA) and other Gram-positive bacteria. It retains some activity of later-generation cephalosporins having broad-spectrum activity against Gram-negative bacteria, but its effectiveness is relatively much weaker. It is currently being investigated for community-acquired pneumonia and complicated skin and skin structure infection.
Copper and its alloys are natural antimicrobial materials. Ancient civilizations exploited the antimicrobial properties of copper long before the concept of microbes became understood in the nineteenth century. In addition to several copper medicinal preparations, it was also observed centuries ago that water contained in copper vessels or transported in copper conveyance systems was of better quality than water contained or transported in other materials.
Sophoraflavanone G is a volatile phytoncide, released into the atmosphere, soil and ground water, by members of the Sophora genus. Sophora pachycarpa, and Sophora exigua; all found to grow within the United States in a variety of soil types, within temperate conditions, no lower than 0 °F. Sophoraflavanone G is released in order to protect the plant against harmful protozoa, bacteria, and fungi. Sophoraflavanone G, also called kushenin, is a flavonoid compound.
An antimicrobial surface is coated by an antimicrobial agent that inhibits the ability of microorganisms to grow on the surface of a material. Such surfaces are becoming more widely investigated for possible use in various settings including clinics, industry, and even the home. The most common and most important use of antimicrobial coatings has been in the healthcare setting for sterilization of medical devices to prevent hospital associated infections, which have accounted for almost 100,000 deaths in the United States. In addition to medical devices, linens and clothing can provide a suitable environment for many bacteria, fungi, and viruses to grow when in contact with the human body which allows for the transmission of infectious disease.
Silane-Quats are a class of antimicrobials developed by Dow Corning and first patented in the United States of America in February 1971 . Subsequent patents were filed in the 1970s by Dow Corning for utilizing its silane-quat as an effective antimicrobial. In doing so, Dow Corning had invented a durable, non-leaching, persistent, surface bonding antimicrobial effective against a wide range of unicellular microorganisms on a variety of surfaces.
Decolonization, also bacterial decolonization, is a medical intervention that attempts to rid a patient of an antimicrobial resistant pathogen, such as methicillin-resistant Staphylococcus aureus (MRSA) or antifungal-resistant Candida.