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Reduction of Environmental Contamination With Multidrug-Resistant Bacteria by Copper-Alloy Coating of Surfaces in a Highly Endemic Setting

Published online by Cambridge University Press:  05 May 2017

Maria Souli*
Affiliation:
4th Department of Internal Medicine, National and Kapodistrian University of Athens, School of Medicine, University General Hospital Attikon, Athens, Greece
Anastasia Antoniadou
Affiliation:
4th Department of Internal Medicine, National and Kapodistrian University of Athens, School of Medicine, University General Hospital Attikon, Athens, Greece
Ioannis Katsarolis
Affiliation:
4th Department of Internal Medicine, National and Kapodistrian University of Athens, School of Medicine, University General Hospital Attikon, Athens, Greece
Irini Mavrou
Affiliation:
2nd Department of Critical Care, National and Kapodistrian University of Athens, School of Medicine, University General Hospital Attikon, Athens, Greece
Elisabeth Paramythiotou
Affiliation:
2nd Department of Critical Care, National and Kapodistrian University of Athens, School of Medicine, University General Hospital Attikon, Athens, Greece
Evangelos Papadomichelakis
Affiliation:
2nd Department of Critical Care, National and Kapodistrian University of Athens, School of Medicine, University General Hospital Attikon, Athens, Greece
Maria Drogari-Apiranthitou
Affiliation:
4th Department of Internal Medicine, National and Kapodistrian University of Athens, School of Medicine, University General Hospital Attikon, Athens, Greece
Theofano Panagea
Affiliation:
4th Department of Internal Medicine, National and Kapodistrian University of Athens, School of Medicine, University General Hospital Attikon, Athens, Greece Present affiliation: Department of Microbiology, Sismanogleio-A. Fleming General Hospital, Division A. Fleming, Athens, Greece
Helen Giamarellou
Affiliation:
6th Department of Internal Medicine, Diagnostic and Therapeutic Center of Athens “Hygeia,”Athens, Greece.
George Petrikkos
Affiliation:
4th Department of Internal Medicine, National and Kapodistrian University of Athens, School of Medicine, University General Hospital Attikon, Athens, Greece
Apostolos Armaganidis
Affiliation:
2nd Department of Critical Care, National and Kapodistrian University of Athens, School of Medicine, University General Hospital Attikon, Athens, Greece
*
Address correspondence to Maria Souli, 4th Department of Internal Medicine, University General Hospital Attikon, 1 Rimini Str. 124 62 Chaidari, Athens, Greece (msouli@med.uoa.gr).

Abstract

OBJECTIVE

To evaluate the efficacy of copper-coating in reducing environmental colonization in an intensive-care unit (ICU) with multidrug-resistant-organism (MDRO) endemicity

DESIGN

Interventional, comparative crossover trial

SETTING

The general ICU of Attikon University hospital in Athens, Greece

PATIENTS

Those admitted to ICU compartments A and B during the study period

METHODS

Before any intervention (phase 1), the optimum sampling method using 2 nylon swabs was validated. In phase 2, 6 copper-coated beds (ie, with coated upper, lower, and side rails) and accessories (ie, coated side table, intravenous [i.v.] pole stands, side-cart handles, and manual antiseptic dispenser cover) were introduced as follows: During phase 2a (September 2011 to February 2012), coated items were placed next to noncoated ones (controls) in both compartments A and B; during phase 2b (May 2012 to January 2013), all copper-coated items were placed in compartment A, and all noncoated ones (controls) in compartment B. Patients were randomly assigned to available beds. Environmental samples were cultured quantitatively for clinically important bacteria. Clinical and demographic data were collected from medical records.

RESULTS

Copper coating significantly reduced the percentage of colonized surfaces (55.6% vs 72.5%; P<.0001), the percentage of surfaces colonized by MDR gram-negative bacteria (13.8% vs 22.7%; P=.003) or by enterococci (4% vs 17%; P=.014), the total bioburden (2,858 vs 7,631 cfu/100 cm2; P=.008), and the bioburden of gram-negative isolates, specifically (261 vs 1,266 cfu/100 cm2; P=.049). This effect was more pronounced when the ratio of coated surfaces around the patient was increased (phase 2b).

CONCLUSIONS

Copper-coated items in an ICU setting with endemic high antimicrobial resistance reduced environmental colonization by MDROs.

Infect Control Hosp Epidemiol 2017;38:765–771

Type
Original Articles
Copyright
© 2017 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

PREVIOUS PRESENTATION. These data were presented in part at the 52nd Interscience Conference of Antimicrobial Agents and Chemotherapy, San Francisco, California, on September 9, 2012 (Abstracts K245 and K246).

References

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Supplementary material: File

Souli supplementary material

Tables S1 and S2

Download Souli supplementary material(File)
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