Antimicrobial copper has been introduced as a new technology to tackle pathogens of concern in disaster and military medicine at the recent 4th International Conference on Disaster and Military Medicine.
19 December 2016
Healthcare-associated infections are a major challenge to hospital hygiene but the spread of pathogens is also a problem in disaster and military medicine, where good hygiene measures are difficult to implement and maintain. The use of continuously-active antimicrobial copper surfaces can act as a supplement to standard practices, reducing microbial contamination and thus the spread of infection.
Scientific research on the efficacy of antimicrobial copper alloys, and their potential to boost hygiene in the management of highly contagious diseases such as Ebola, was presented for the first time at DiMiMED. The conference took place parallel to MEDICA, the world’s largest medical technology fair, in Düsseldorf.
Whether in military conflicts, terrorist attacks, natural catastrophes or epidemics, the global increase in crises requires sustainable medical care. DiMiMED is a forum for cooperation between civilian aid and military medical services to address these crises, and has participation from 50 internationally-renowned speakers and 200 participants from the fields of medicine, industry and logistics.
This year, a representative of the International Copper Association (ICA) participated in the exchange on innovations in disaster and military medicine, presenting antimicrobial copper as a building block for a sustainable hygiene concept.
Reduce infection risk, strengthen deployed operations
During the ‘Current Affairs’ session, Mark Tur, Technical Consultant at ICA, described copper’s antimicrobial properties. In his lecture, ‘Antimicrobial Copper—Continuously Active Antimicrobial Copper Surfaces’, Tur highlighted an important and unique feature of solid copper: its inherent and rapid antimicrobial effectiveness. He explained that antimicrobial copper is the collective term for copper alloys with antimicrobial efficacy—including familiar materials such as brass and bronze—the appropriate use of which can significantly reduce the risk of infection and thus improve the effectiveness of medical operations.
Tur summarised the laboratory research conducted at universities such as Southampton, UK (B. Keevil), Nebraska, USA (G. Grass), Bern, Switzerland (M. Solioz), Arizona, USA (C. Rensing) and Halle, Germany (Nies), saying it has been shown that alloys with a copper content of more than 60% have a broad spectrum of activity against a large number of bacteria and their spores, and also against fungi, yeasts and viruses.
Tur explained the progress made thus far in understanding the underlying kill mechanism of bacteria by direct contact with solid copper surfaces (‘contact killing’). On contact with metallic copper, catalytic reactions are immediately initiated, causing oxidative stress to the cytoplasmic membrane. Then, dissolved copper ions enter the cell and cause further lethal damage. The complex interactions are very rapid, leading to a breakdown of the cellular energy charge and the structural integrity of the microbe.
Efficacy Against High Threat Pathogens and Biothreat Agents
Tur reported on a large-scale study at the Bundeswehr Institute of Microbiology by Dr Gregor Grass. Grass demonstrated copper surfaces can rapidly inactivate highly pathogenic bacterial and viral agents of Risk Group 3 (Burkholderia pseudomallei and B. mallei, Brucella melitensis, Yersinia pestis, Francisella tularensis, vaccinia- and monkeypox-viruses). All of these pathogens cause high fatality rates in humans and thus have the potential to be used as bioweapons.
Using kill kinetics, Grass demonstrated a seven log kill within five minutes and confirmed that pathogens were destroyed rather than merely being put into a viable but non-culturable (VBNC) state.
On stainless steel surfaces, all strains survived throughout the course of the experiment. These results have made a major contribution to the wider recognition of copper’s antimicrobial efficacy.
From lab to practice—USAID Ebola Clinic ETU
Tur described a randomised, multi-centre study funded by the US Department of Defense in the intensive care units of three US hospitals, where the use of solid copper components reduced microbial burden by 83% and infections by 58%. According to Tur, this was a landmark study leading to the consideration of wider deployment including for isolation areas in which patients with highly contagious infections are treated.
Tur also introduced a project from US company Modula S, which used the research results as the basis for designing an isolation unit specifically targeted at the recent Ebola outbreak in western Africa. In the prototype of this rapid-deployable and self-contained emergency treatment unit, the inner walls and surfaces are made from antimicrobial copper alloys.
For this innovation, Modula S won the 2015 Ebola Grand Challenge, awarded jointly by the United States Agency for International Development (USAID), the White House/Office of Science and Technology Policy, the Center for Disease Control (CDC), and the US Department of Defense (DoD).
Protecting medical personnel and patients
Tur concluded by listing five points summarising the benefits of deploying antimicrobial copper surfaces to minimise the transfer of pathogens. These are:
- The unique, continuous and sustained efficacy.
- Verification by laboratory and clinical and field trials.
- Protection of medical staff and improvement of patient outcomes.
- A supplement to established hygiene measures (hand hygiene, cleaning and disinfection).
- Increased productivity and improved mission effectiveness.
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Copper and copper alloys are engineering materials that are durable, colourful and recyclable and are widely available in various product forms suitable for a range of manufacturing purposes. Copper and its alloys offer a suite of materials for designers of functional, sustainable and cost-effective products.
Copper and certain copper alloys have intrinsic antimicrobial properties (so-called ‘Antimicrobial Copper’) and products made from these materials have an additional, secondary benefit of contributing to hygienic design. Products made from Antimicrobial Copper are a supplement to, not a substitute for standard infection control practices. It is essential that current hygiene practices are continued, including those related to the cleaning and disinfection of environmental surfaces.