Referencias científicas

Trabajos de investigación sometidos a revisión crítica sobre las propiedades antimicrobianas del cobre y sus aleaciones.

Esta colección de trabajos científicos publicados y pósteres de conferencias, recoge los estudios sobre las características antimicrobianas del cobre sólido y sus aleaciones realizados en laboratorio y en hospitales durante los últimos 20 años. Algunos están disponibles aquí en formato PDF, otros incluyen enlaces a entradas en varias bibliotecas científicas, donde se puede acceder a los documentos completos a través de una suscripción o por un coste.

Puedes navegar por toda la lista o utilizar los filtros que se incluyen más abajo.

 

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Physicochemical properties of copper important for its antibacterial activity and development of a unified model
Michael Hans, Salima Mathews, Frank Mücklich and Marc Solioz, Biointerphases 11, 018902 (2016); http://dx.doi.org/10.1116/1.4935853

Contact killing is a novel term describing the killing of bacteria when they come in contact with metallic copper or copper-containing alloys. In recent years, the mechanism of contact killing has received much attention and many mechanistic details are available. The authors here review some of these mechanistic aspects with a focus on the critical physicochemical properties of copper which make it antibacterial. Known mechanisms of contact killing are set in context to ionic, corrosive, and physical properties of copper. The analysis reveals that the oxidation behavior of copper, paired with the solubility properties of copper oxides, are the key factors which make metallic copper antibacterial. The concept advanced here explains the unique position of copper as an antibacterial metal. Based on our model, novel design criteria for metallic antibacterial materials may be derived.

Copper Surfaces are Associated with Significantly Lower Concentrations of Bacteria on Selected Surfaces within a Pediatric Intensive Care Unit
Michael G. Schmidt PhD; Bettina von Dessauer MD; Carmen Benavente MD; Dona Benadof MD; Paulina Cifuentes RN; Alicia Elgueta RN; Claudia Duran MS; Maria S. Navarrete MD MPH. American Journal of Infection Control, Corrected proof. doi:10.1016/j.ajic.2015.09

Background: Health careeassociated infections result in significant patient morbidity and mortality. Although cleaning can remove pathogens present on hospital surfaces, those surfaces may be inadequately
cleaned or recontaminated within minutes. Because of copper’s inherent and continuous antimicrobial properties, copper surfaces offer a solution to complement cleaning. The objective of this study was to quantitatively assess the bacterial microbial burden coincident with an assessment of the ability of antimicrobial copper to limit the microbial burden associated with 3 surfaces in a pediatric intensive care unit.

Methods: A pragmatic trial was conducted enrolling 1,012 patients from 2 high acuity care units within a 249-bed tertiary care pediatric hospital over 12 months. The microbial burden was determined from 3 frequently encountered surfaces, regardless of room occupancy, twice monthly, from 16 rooms, 8 outfitted normally and 8 outfitted with antimicrobial copper.

Results: Copper surfaces were found to be equivalently antimicrobial in pediatric settings to activities reported for adult medical intensive care units. The log10 reduction to the microbial burden from
antimicrobial copper surfaced bed rails was 1.996 (99%). Surprisingly, introduction of copper objects to 8 study rooms was found to suppress the microbial burden recovered from objects assessed in control
rooms by log10 of 1.863 (73%).

Conclusion: Copper surfaces warrant serious consideration when contemplating the introduction of no-touch disinfection technologies for reducing burden to limit acquisition of HAIs.

Human Coronavirus 229E Remains Infectious on Common Touch Surface Materials
Warnes SL, Little ZR, Keevil CW. 2015. Human coronavirus 229E remains infectious on common touch surface materials. mBio 6(6):e01697-15. doi:10.1128/mBio.01697-15.

The evolution of new and reemerging historic virulent strains of respiratory viruses from animal reservoirs is a significant threat to human health. Inefficient human-to-human transmission of zoonotic strains may initially limit the spread of transmission, but an infection may be contracted by touching contaminated surfaces. Enveloped viruses are often susceptible to environmental stresses, but the human coronaviruses responsible for severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) have recently caused increasing concern of contact transmission during outbreaks. We report here that pathogenic human coronavirus 229E remained infectious in a human lung cell culture model following at least 5 days of persistence on a range of common nonbiocidal surface materials, including polytetrafluoroethylene (Teflon; PTFE), polyvinyl chloride (PVC), ceramic tiles, glass, silicone rubber, and stainless steel. We have shown previously that noroviruses are destroyed on copper alloy surfaces. In this new study, human coronavirus 229E was rapidly inactivated on a range of copper alloys (within a few minutes for simulated fingertip contamination) and Cu/Zn brasses were very effective at lower copper concentration. Exposure to copper destroyed the viral genomes and irreversibly affected virus morphology, including disintegration of envelope and dispersal of surface spikes. Cu(I) and Cu(II) moieties were responsible for the inactivation, which was enhanced by reactive oxygen species generation on alloy surfaces, resulting in even faster inactivation than was seen with nonenveloped viruses on copper. Consequently, copper alloy surfaces could be employed in communal areas and at any mass gatherings to help reduce transmission of respiratory viruses from contaminated surfaces and protect the public health.

From Laboratory Research to a Clinical Trial: Copper Alloy Surfaces Kill Bacteria and Reduce Hospital-Acquired Infections
Michels, H.T. 2015. From Laboratory Research to a Clinical Trial: Copper Alloy Surfaces Kill Bacteria and Reduce Hospital-Acquired Infections. Health Environments Research & Design Journal. 1–16.

Documento original en inglés.

Bacteria die on copper alloy surfaces in both the laboratory and the hospital rooms. Infection rates were lowered in those hospital rooms containing copper components. Thus, based on the presented information, the placement of copper alloy components, in the built environment, may have the potential to reduce not only hospital-acquired infections but also patient treatment costs.

Antimicrobial Properties of Copper in Gram-Negative and Gram-Positive Bacteria
Meyer, T.J. 2015. Antimicrobial Properties of Copper in Gram-Negative and Gram-Positive Bacteria. International Journal of Biological, Biomolecular, Agricultural, Food and Biotechnological Engineering. Vol:9, No:3.

Documento original en inglés.

For centuries humans have used the antimicrobial properties of copper to their advantage. Yet, after all these years the underlying mechanisms of copper mediated cell death in various microbes remain unclear. We had explored the hypothesis that copper mediated increased levels of lipid peroxidation in the membrane fatty acids is responsible for increased killing in Escherichia coli.

In this study we show that in both gram positive (Staphylococcus aureus) and gram negative (Pseudomonas aeruginosa) bacteria there is a strong correlation between copper mediated cell death and increased levels of lipid peroxidation.

Interestingly, the non-spore forming gram positive bacteria as well as gram negative bacteria show similar patterns of cell death, increased levels of lipid peroxidation, as well as genomic DNA degradation, however there is some difference in loss in membrane integrity upon exposure to copper alloy surface.

Antimicrobial Activity of Copper Alloys Against Invasive Multidrug-Resistant Nosocomial Pathogens
Koseoglu Eser O, Ergin A, Hascelik G, Current Microbiology, 5 June 2015.

Documento original en inglés.

The emergence and spread of antibiotic resistance demanded novel approaches for the prevention of nosocomial infections, and metallic copper surfaces have been suggested as an alternative for the control of multidrug-resistant (MDR) bacteria in surfaces in the hospital environment.

This study aimed to evaluate the antimicrobial activity of copper material for invasive MDR nosocomial pathogens isolated over time, in comparison to stainless steel. Clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) (n:4), OXA-23 and OXA-58 positive, MDR Acinetobacter baumannii (n:6) and Pseudomonas aeruginosa (n:4) were evaluated.

The antimicrobial activity of coupons containing 99 % copper and a brass alloy containing 63 % copper was assessed against stainless steel. All the materials demonstrated statistically significant differences within each other for the logarithmic reduction of microorganisms. Among the three materials, the highest reduction of microorganisms was seen in 99 % copper and the least in stainless steel.

The result was statistically significant especially for 0, 2, and 4 h (P = 0.05). 99 % copper showed a bactericidal effect at less than 1 h for MRSA and at 2 h for P. aeruginosa. 63 % copper showed a bactericidal effect at 24 h for P. aeruginosa strains only. Stainless steel surfaces exhibited a bacteriostatic effect after 6 h for P. aeruginosa strains only.

99 % copper reduced the number of bacteria used significantly, produced a bactericidal effect and was more effective than 63 % copper.

The use of metallic copper material could aid in reducing the concentration of bacteria, especially for invasive nosocomial pathogens on hard surfaces in the hospital environment.

Destruction of the Capsid and Genome of GII.4 Human Norovirus Occurs During Exposure to Metal Alloys Containing Copper
C. S. Manuel, M. D. Moore and L.A. Jaykus, Applied and Environmental Microbiology, 15 May 2015.

Documento original en inglés.

Human norovirus (HuNoV) represents a significant public health burden worldwide and can be environmentally transmitted. Copper surfaces have been shown to inactivate the cultivable surrogate murine norovirus, but no such data exist for HuNoV.

The purpose of this study was to characterize the destruction of GII.4 HuNoV and virus-like particles (VLPs) when exposed to copper alloy surfaces. Fecal suspensions positive for a GII.4 HuNoV outbreak strain or GII.4 virus-like particles (VLPs) were exposed to copper alloys or stainless steel for 0 to 240 min and recovered by elution. HuNoV genome integrity was assessed by RT-qPCR (without RNase treatment), and capsid integrity was assessed by RT-qPCR (with RNase treatment), transmission electron microscopy (TEM), SDS-PAGE/Western blot analysis, and a histo-blood group antigen (HBGA) binding assay.

Exposing fecal suspensions to pure copper for 60 min reduced GII.4 HuNoV RNA copy number by approximately 3 log 10 when analyzed by RT-qPCR without RNase treatment, and 4 log 10 when a prior RNase treatment was used.

The rate of reduction in HuNoV RNA copy number was approximately proportional to the percent copper in each alloy. Exposing GII.4 HuNoV VLPs to pure copper surfaces resulted in noticeable aggregation and destruction within 240 min, an 80% reduction in VP1 major capsid protein band intensity in 15 min, and near complete loss of HBGA receptor binding within 8 min. In all experiments, HuNoV remained stable on stainless steel.

These results suggest that copper surfaces destroy HuNoV, and may be useful in preventing environmental transmission of the virus in at-risk settings.

Inactivation of murine norovirus on a range of copper alloy surfaces is accompanied by loss of capsid integrity
S. L. Warnes, E. N. Summersgill and C.W. Keevil, Applied and Environmental Microbiology, 1 December 2014.

Documento original en inglés.

Norovirus is one of the most common causes of acute viral gastroenteritis. The virus is spread via faecal oral route, most commonly from infected food and water, but several outbreaks have originated from contamination of surfaces with infectious virus.

In this study a close surrogate of human norovirus causing gastrointestinal disease in mice, murine norovirus type 1 (MNV-1), retained infectivity for more than 2 weeks following contact with a range of surface materials including Teflon (polytetrafluoroethylene, PTFE), polyvinyl chloride (PVC), ceramic tiles, glass, silicone rubber and stainless steel. Persistence was, slightly prolonged on ceramic surfaces.

A previous study in our laboratory observed that copper and copper alloy dry surfaces rapidly inactivated MNV-1 and destroyed the viral genome. In this new study we have observed that a relatively small change in percentage copper, between 70-80% in copper nickels and 60-70% in brasses, had significant influence on the ability of the alloy to inactivate norovirus. Nickel alone did not affect virus but zinc did have some antiviral effect which had a synergistic effect with copper and resulted in increased efficacy of brasses at lower percentage copper.

Electron microscopy of purified MNV-1 that had been exposed to copper and stainless steel surfaces suggested a massive breakdown of the viral capsid had occurred on copper. In addition, MNV-1 that had been exposed to copper and treated with RNase demonstrated a reduction in viral gene copy number. This suggests capsid integrity is compromised on contact with copper, allowing copper ion access to the viral genome.

Inactivation of Bacterial and Viral Biothreat Agents on Metallic Copper Surfaces
Pauline Bleichert, Christophe Espirito Santo, Matthias Hanczaruk, Hermann Meyer, Gregor Grass, BioMetals, International Biometals Society, 7 August 2014.

Documento original en inglés.

In recent years several studies in laboratory settings and in hospital environments have demonstrated that surfaces of massive metallic copper have intrinsic antibacterial and antiviral properties.  Microbes are rapidly inactivated by a quick, sharp shock known as contact killing.  The underlying mechanism is not yet fully understood; however, in this process the cytoplasmic membrane is severely damaged.  Pathogenic bacterial and viral high-consequence species able to evade the host immune system are among the most serious lethal microbial challenges to human health.  Here, we investigated contact-killing mediated by copper surfaces of Gram-negative bacteria (Brucella melitensis, Burkholderia mallei, Burkholderia pseudomallei, Francisella tularensis tularensis and Yersinia pestis) and of Gram-positive endospore-forming Bacillus anthracis.  Additionally, we also tested inactivation of monkeypox virus and vaccinia virus on copper.  This group of pathogens comprises biothreat species (or their close relatives) classified by the Center for Disease and Control and Prevention (CDC) as microbial select agents posing severe threats to public health and having the potential to be deliberately released.  All agents were rapidly inactivated on copper between 30 s and 5 min with the exception of B. anthracis endospores.  For vegetative bacterial cells prolonged contact to metallic copper resulted in the destruction of cell structure.

Enhancing Patient Safety through Strategic Placement of Copper Surfaces
M G Schmidt, C D Salgado, K A Sepkowitz, J F John, H H Attaway, III, R J Cantey, L L Steed, A A Estelle, H T Michels. Presented at the IPS Scottish Branch Conference 29 May 2014.

Documento original en inglés.

The implementation of Medicare’s Never Events policy and the passage of the Affordable Care Act have heightened the value of practices that increase patient safety. Healthcare Associated Infections (HAIs) continue to be one of the most common and significant complications associated with hospitalization across the globe. Microbes have an intrinsic ability to survive and ultimately colonize common touch surfaces where acquisition and transport from surfaces to humans is common. The inherent antimicrobial activity of metallic copper surfaces and its alloys containing greater than 60% copper offer an advantage to infection control as its action is continuous rather than episodic.

National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in England
H P Loveday, J A Wilson, R J Pratt, M Golsorkhi, A Tingle, A Baka, J Browne, J Prieto, M Wilcox. Journal of Hospital Infection 86S1 (2014) S1–S70.

Documento original en inglés.

National evidence-based guidelines for preventing healthcare-associated infections (HCAI) in National Health Service (NHS) hospitals in England were originally commissioned by the Department of Health and developed during 1998-2000 by a nurse-led multi-professional team of researchers and specialist clinicians. Following extensive consultation, they were  first published in January 2001 and updated in 2007. A cardinal feature of evidence-based guidelines is that they are subject to timely review in order that new research evidence and technological advances can be identified, appraised and, if shown to be effective for the prevention of HCAI, incorporated into amended guidelines.Periodically updating the evidence base and guideline recommendations is essential in order to maintain their validity and authority.

The Department of Health commissioned a review of new evidence and we have updated the evidence base for making infection prevention and control recommendations. A critical assessment of the updated evidence indicated that the epic2 guidelines published in 2007 remain robust, relevant and appropriate, but some guideline recommendations required adjustments to enhance clarity and a number of new recommendations were required. These have been clearly identified in the text.  In addition, the synopses of evidence underpinning the guideline recommendations have been updated.

These guidelines (epic3) provide comprehensive recommendations for preventing HCAI in hospital and other acute care settings based on the best currently available evidence. National evidence-based guidelines are broad principles of best practice that need to be integrated into local practice guidelines and audited to reduce variation in practice and maintain patient safety. Clinically effective infection prevention and control practice is an essential feature of patient protection. By incorporating these guidelines into routine daily clinical practice, patient safety can be enhanced and the risk of patients acquiring an infection during episodes of health care in NHS hospitals in England can be minimised.

See Section 2.2, Hospital Environmental Hygiene, under Emerging Technology.

Understanding the Role of Facility Design in the Acquisition and Prevention of Healthcare-associated Infections
Health Environments and Research Design Journal, Vol 7, Supplement, 2013.

Documento original en inglés:

This special issue focuses on healthcare-associated infections and is sponsored by the Agency for Healthcare Research and Quality (AHRQ), part of the US Department of Health and Human Services. The majority of articles are the result of a project sponsored by the AHRQ. The project was designed to assess the rigor of claims asserting that design interventions can decrease infection risk, and to identify design strategies grounded in evidence that appear to be effective in interrupting the transmission of HAIs. This project represents a multidisciplinary assessment of the current state of knowledge and identifies emerging trends in the field of infection prevention within the context of the built environment.  Copper touch surfaces are mentioned in several articles (p31, p46 and p127).

The Economic Assessment of an Environmental Intervention: Discrete Deployment of Copper for Infection Control in ICUs
M Taylor, S Chaplin, York Health Economics Consortium, York, UK, Antimicrobial Resistance and Infection Control 2013, 2(Suppl1):P368.

Documento original en inglés:

Health Economics evaluations are typically applied to medications or surgery costs, but this unique study has investigated the economic benefits of discrete deployment of antimicrobial copper alloy touch surfaces in ICUs. Copper/copper alloy surfaces have been shown to act as an adjunct to standard infection control practices in diverse clinical settings, continuously reducing contamination by over 90%.  Moreover, work reported by Dr Michael Schmidt at the first ICPIC revealed the link between reduced bioburden and significant reductions in the risk of acquiring an HCAI.

This study investigates the cost-effectiveness of this intervention, comparing expenditure with the improvements in patient outcomes and other tangible benefits.

Antimicrobial Copper (Cu+) Implementation and its Influence to the Epidemiological Data in Elementary School Population
P Efstathiou, E Kouskouni, K Karageorgou, M Tseroni, Z Manolidou, S Papanikolaou, E Logothetis, H Tzouma, C Petropoulou, I Agrafa. Antimicrobial Resistance and Infection Control 2013, 2(Suppl 1):P370.

Documento original en inglés.

Aim of this study was to evaluate the epidemiological data in elementary school students after implementing Cu+ in multi-touch surfaces. Antimicrobial copper alloy  (Cu 63% - Zn 37%, Low Lead) was used to cover or replace multi-touch surfaces (handrails, stair railings), in five elementary schools (N=1596 students).  Epidemiological surveillance of flu-like symptoms was conducted from the 40th week of 2011 to 15th week of 2012 and recorded absenteeism among students based on a specific protocol.

Evaluation of new in vitro efficacy test for antimicrobial surface activity reflecting UK hospital conditions
M Ojeila, C Jermannb, J Holahb, S P Denyera, J-Y Maillard.

Documento original en inglés:

The aim of this study was to develop a new antimicrobial surface test to replace the JISZ2801 that evaluates the activity of antimicrobial surfaces under parameters reflective of conditions in healthcare settings.

From Laboratory Research to a Clinical Trial: Copper Alloy Surfaces Kill Bacteria and Reduce Hospital-Acquired Infections
Michels, H.T. 2015. From Laboratory Research to a Clinical Trial: Copper Alloy Surfaces Kill Bacteria and Reduce Hospital-Acquired Infections. Health Environments Research & Design Journal. 1–16.

Bacteria die on copper alloy surfaces in both the laboratory and the hospital rooms. Infection rates were lowered in those hospital rooms containing copper components. Thus, based on the presented information, the placement of copper alloy components, in the built environment, may have the potential to reduce not only hospital-acquired infections but also patient treatment costs.

Antimicrobial Activity of Copper Alloys Against Invasive Multidrug-Resistant Nosocomial Pathogens
Koseoglu Eser O, Ergin A, Hascelik G, Current Microbiology, 5 June 2015

The emergence and spread of antibiotic resistance demanded novel approaches for the prevention of nosocomial infections, and metallic copper surfaces have been suggested as an alternative for the control of multidrug-resistant (MDR) bacteria in surfaces in the hospital environment.

This study aimed to evaluate the antimicrobial activity of copper material for invasive MDR nosocomial pathogens isolated over time, in comparison to stainless steel. Clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) (n:4), OXA-23 and OXA-58 positive, MDR Acinetobacter baumannii (n:6) and Pseudomonas aeruginosa (n:4) were evaluated.

The antimicrobial activity of coupons containing 99 % copper and a brass alloy containing 63 % copper was assessed against stainless steel. All the materials demonstrated statistically significant differences within each other for the logarithmic reduction of microorganisms. Among the three materials, the highest reduction of microorganisms was seen in 99 % copper and the least in stainless steel.

The result was statistically significant especially for 0, 2, and 4 h (P = 0.05). 99 % copper showed a bactericidal effect at less than 1 h for MRSA and at 2 h for P. aeruginosa. 63 % copper showed a bactericidal effect at 24 h for P. aeruginosa strains only. Stainless steel surfaces exhibited a bacteriostatic effect after 6 h for P. aeruginosa strains only.

99 % copper reduced the number of bacteria used significantly, produced a bactericidal effect and was more effective than 63 % copper.

The use of metallic copper material could aid in reducing the concentration of bacteria, especially for invasive nosocomial pathogens on hard surfaces in the hospital environment.

Destruction of the Capsid and Genome of GII.4 Human Norovirus Occurs During Exposure to Metal Alloys Containing Copper
C. S. Manuel, M. D. Moore and L.A. Jaykus, Applied and Environmental Microbiology, 15 May 2015

Human norovirus (HuNoV) represents a significant public health burden worldwide and can be environmentally transmitted. Copper surfaces have been shown to inactivate the cultivable surrogate murine norovirus, but no such data exist for HuNoV.

The purpose of this study was to characterize the destruction of GII.4 HuNoV and virus-like particles (VLPs) when exposed to copper alloy surfaces. Fecal suspensions positive for a GII.4 HuNoV outbreak strain or GII.4 virus-like particles (VLPs) were exposed to copper alloys or stainless steel for 0 to 240 min and recovered by elution. HuNoV genome integrity was assessed by RT-qPCR (without RNase treatment), and capsid integrity was assessed by RT-qPCR (with RNase treatment), transmission electron microscopy (TEM), SDS-PAGE/Western blot analysis, and a histo-blood group antigen (HBGA) binding assay.

Exposing fecal suspensions to pure copper for 60 min reduced GII.4 HuNoV RNA copy number by approximately 3 log 10 when analyzed by RT-qPCR without RNase treatment, and 4 log 10 when a prior RNase treatment was used.

The rate of reduction in HuNoV RNA copy number was approximately proportional to the percent copper in each alloy. Exposing GII.4 HuNoV VLPs to pure copper surfaces resulted in noticeable aggregation and destruction within 240 min, an 80% reduction in VP1 major capsid protein band intensity in 15 min, and near complete loss of HBGA receptor binding within 8 min. In all experiments, HuNoV remained stable on stainless steel.

These results suggest that copper surfaces destroy HuNoV, and may be useful in preventing environmental transmission of the virus in at-risk settings.

Antimicrobial Properties of Copper in Gram-Negative and Gram-Positive Bacteria
Meyer, T.J. 2015. Antimicrobial Properties of Copper in Gram-Negative and Gram-Positive Bacteria. International Journal of Biological, Biomolecular, Agricultural, Food and Biotechnological Engineering. Vol:9, No:3.

For centuries humans have used the antimicrobial properties of copper to their advantage. Yet, after all these years the underlying mechanisms of copper mediated cell death in various microbes remain unclear. We had explored the hypothesis that copper mediated increased levels of lipid peroxidation in the membrane fatty acids is responsible for increased killing in Escherichia coli.

In this study we show that in both gram positive (Staphylococcus aureus) and gram negative (Pseudomonas aeruginosa) bacteria there is a strong correlation between copper mediated cell death and increased levels of lipid peroxidation.

Interestingly, the non-spore forming gram positive bacteria as well as gram negative bacteria show similar patterns of cell death, increased levels of lipid peroxidation, as well as genomic DNA degradation, however there is some difference in loss in membrane integrity upon exposure to copper alloy surface.

Inactivation of murine norovirus on a range of copper alloy surfaces is accompanied by loss of capsid integrity
S. L. Warnes, E. N. Summersgill and C.W. Keevil, Applied and Environmental Microbiology, 1 December 2014

Norovirus is one of the most common causes of acute viral gastroenteritis. The virus is spread via faecal oral route, most commonly from infected food and water, but several outbreaks have originated from contamination of surfaces with infectious virus.

In this study a close surrogate of human norovirus causing gastrointestinal disease in mice, murine norovirus type 1 (MNV-1), retained infectivity for more than 2 weeks following contact with a range of surface materials including Teflon (polytetrafluoroethylene, PTFE), polyvinyl chloride (PVC), ceramic tiles, glass, silicone rubber and stainless steel. Persistence was, slightly prolonged on ceramic surfaces.

A previous study in our laboratory observed that copper and copper alloy dry surfaces rapidly inactivated MNV-1 and destroyed the viral genome. In this new study we have observed that a relatively small change in percentage copper, between 70-80% in copper nickels and 60-70% in brasses, had significant influence on the ability of the alloy to inactivate norovirus. Nickel alone did not affect virus but zinc did have some antiviral effect which had a synergistic effect with copper and resulted in increased efficacy of brasses at lower percentage copper.

Electron microscopy of purified MNV-1 that had been exposed to copper and stainless steel surfaces suggested a massive breakdown of the viral capsid had occurred on copper. In addition, MNV-1 that had been exposed to copper and treated with RNase demonstrated a reduction in viral gene copy number. This suggests capsid integrity is compromised on contact with copper, allowing copper ion access to the viral genome.

Inactivation of Bacterial and Viral Biothreat Agents on Metallic Copper Surfaces
Pauline Bleichert, Christophe Espirito Santo, Matthias Hanczaruk, Hermann Meyer, Gregor Grass, BioMetals, International Biometals Society, 7 August 2014

In recent years several studies in laboratory settings and in hospital environments have demonstrated that surfaces of massive metallic copper have intrinsic antibacterial and antiviral properties.  Microbes are rapidly inactivated by a quick, sharp shock known as contact killing.  The underlying mechanism is not yet fully understood; however, in this process the cytoplasmic membrane is severely damaged.  Pathogenic bacterial and viral high-consequence species able to evade the host immune system are among the most serious lethal microbial challenges to human health.  Here, we investigated contact-killing mediated by copper surfaces of Gram-negative bacteria (Brucella melitensis, Burkholderia mallei, Burkholderia pseudomallei, Francisella tularensis tularensis and Yersinia pestis) and of Gram-positive endospore-forming Bacillus anthracis.  Additionally, we also tested inactivation of monkeypox virus and vaccinia virus on copper.  This group of pathogens comprises biothreat species (or their close relatives) classified by the Center for Disease and Control and Prevention (CDC) as microbial select agents posing severe threats to public health and having the potential to be deliberately released.  All agents were rapidly inactivated on copper between 30 s and 5 min with the exception of B. anthracis endospores.  For vegetative bacterial cells prolonged contact to metallic copper resulted in the destruction of cell structure.

Enhancing Patient Safety through Strategic Placement of Copper Surfaces
M G Schmidt, C D Salgado, K A Sepkowitz, J F John, H H Attaway, III, R J Cantey, L L Steed, A A Estelle, H T Michels. Presented at the IPS Scottish Branch Conference 29 May 2014.

Poster presented on 29 May 2014 at the IPS Scottish Branch Conference 2014 - 'Get to Grips with SICPs' at Thistle Hotel, Glasgow, Scotland.

 

Surface Structure Influences Contact Killing of Bacteria by Copper
Marco Zeiger, Marc Solioz, Hervais Edongu, Eduard Arzt & Andreas S. Schneider. MicrobiologyOpen 2014; 3(3): 327–332.

Copper kills bacteria rapidly by a mechanism that is not yet fully resolved. The antibacterial property of copper has raised interest in its use in hospitals, in place of plastic or stainless steel. On the latter surfaces, bacteria can survive for days or even weeks. Copper surfaces could thus provide a powerful accessory measure to curb nosocomial infections. We here investigated the effect of the copper surface structure on the efficiency of contact killing of Escherichia coli, an aspect which so far has received very little attention. It was shown that electroplated copper surfaces killed bacteria more rapidly than either polished copper or native rolled copper. The release of ionic copper was also more rapid from electroplated copper compared to the other materials. Scanning electron microscopy revealed that the bacteria nudged into the grooves between the copper grains of deposited copper. The findings suggest that, in terms of contact killing, more efficient copper surfaces can be engineered.

epic3: National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in England
H P Loveday, J A Wilson, R J Pratt, M Golsorkhi, A Tingle, A Baka, J Browne, J Prieto, M Wilcox. Journal of Hospital Infection 86S1 (2014) S1–S70

National evidence-based guidelines for preventing healthcare-associated infections (HCAI) in National Health Service (NHS) hospitals in England were originally commissioned by the Department of Health and developed during 1998-2000 by a nurse-led multi-professional team of researchers and specialist clinicians. Following extensive consultation, they were  first published in January 2001 and updated in 2007. A cardinal feature of evidence-based guidelines is that they are subject to timely review in order that new research evidence and technological advances can be identified, appraised and, if shown to be effective for the prevention of HCAI, incorporated into amended guidelines.Periodically updating the evidence base and guideline recommendations is essential in order to maintain their validity and authority.

The Department of Health commissioned a review of new evidence and we have updated the evidence base for making infection prevention and control recommendations. A critical assessment of the updated evidence indicated that the epic2 guidelines published in 2007 remain robust, relevant and appropriate, but some guideline recommendations required adjustments to enhance clarity and a number of new recommendations were required. These have been clearly identified in the text.  In addition, the synopses of evidence underpinning the guideline recommendations have been updated.

These guidelines (epic3) provide comprehensive recommendations for preventing HCAI in hospital and other acute care settings based on the best currently available evidence. National evidence-based guidelines are broad principles of best practice that need to be integrated into local practice guidelines and audited to reduce variation in practice and maintain patient safety. Clinically effective infection prevention and control practice is an essential feature of patient protection. By incorporating these guidelines into routine daily clinical practice, patient safety can be enhanced and the risk of patients acquiring an infection during episodes of health care in NHS hospitals in England can be minimised.

See Section 2.2, Hospital Environmental Hygiene, under Emerging Technology.

Understanding the Role of Facility Design in the Acquisition and Prevention of Healthcare-associated Infections
Health Environments and Research Design Journal, Vol 7, Supplement, 2013

This special issue focuses on healthcare-associated infections and is sponsored by the Agency for Healthcare Research and Quality (AHRQ), part of the US Department of Health and Human Services. The majority of articles are the result of a project sponsored by the AHRQ. The project was designed to assess the rigor of claims asserting that design interventions can decrease infection risk, and to identify design strategies grounded in evidence that appear to be effective in interrupting the transmission of HAIs. This project represents a multidisciplinary assessment of the current state of knowledge and identifies emerging trends in the field of infection prevention within the context of the built environment.  Copper touch surfaces are mentioned in several articles (p31, p46 and p127).

El cobre y las aleaciones de cobre son materiales industriales duraderos, con una amplia paleta de colores y reciclables, y están disponibles en varias formas de producto adecuadas para diferentes fines de fabricación. El cobre y sus aleaciones ofrecen un conjunto de materiales para los diseñadores de productos funcionales, sostenibles y rentables.

El cobre y algunas aleaciones de cobre, que se engloban bajo el término Antimicrobial Copper (cobre antimicrobiano), tienen propiedades antimicrobianas intrínsecas y los productos hechos de estos materiales tienen el beneficio secundario adicional de contribuir al diseño higiénico. Los productos hechos con Antimicrobial Copper son un complemento y no un sustituto de las prácticas habituales para el control de infecciones. Es esencial continuar con las prácticas actuales de higiene, incluyendo aquellas relacionadas con la limpieza y desinfección de superficies ambientales.

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