A Trial to Explore the Benefits of Antimicrobial Self-Sanitizing Surfaces on Bio-Burden Levels and Healthcare-Acquired Infections.

预防保健获得性感染是一项优先挑战。医院在多大程度上 表面影响HAI的传输还没有很好的理解。目前的清洁程序，如 用稀释的次氯酸钠（漂白剂）和紫外线灯对医院房间的表面进行消毒， 虽然在减少表面污染方面是有效的，但不能提供连续的抗菌作用， 活动此外，由于人工清洁不充分，耐药病原体，如甲氧西林， 耐药金黄色葡萄球菌（MRSA）和艰难梭菌（C. diff）可以在表面上存活几个小时 个月铜对重要的耐药性病原体具有抗菌特性。实施 表面的铜和铜合金具有在背景中持续杀灭微生物的能力 作为当前有效（尽管是间歇性的）战略的辅助手段。 本实施研究将探讨将病房中的高触摸表面转换为 由EOSCu Surfaces制造的新型自消毒氧化铜浸渍固体表面（SSS-Cu） 弗吉尼亚州诺福克有限责任公司。SSS-Cu具有16%-20%的氧化铜的均匀分布。SSS-Cu已经证明 在实验室环境中2小时内杀菌率为99.9%，已在环境保护局注册。 美国环保署（EPA）的环境安全，并已与HAI显着下降 在弗吉尼亚州诺福克的Sentara Leigh医院的一项先前研究中。我们建议的研究的具体目的是 (1)建立SSS-Cu在防止被占领地区生物负荷积累方面的真实的世界有效性 （2）确定SSS-Cu作为标准消毒方案的辅助剂对HAI率的影响 对于入住研究医院的患者;和（3）确定SSS-Cu在 医院设置。 提出了一项前瞻性的前后研究设计，以比较医院表面生物负荷和HAI率 有和没有SSS-Cu表面的病房环境之间的差异。随着SSS-Cu在 急性和重症监护室，在铜表面安装之前将比较环境生物负载， 铜表面安装后。将在18个月和36个月时进一步采集额外样本， 评估铜随时间的持续功效。所有入院患者的HAI率为 将SSS-Cu安装前三年的时间与所有入院患者的HAI率进行比较， 在完成SSS-Cu在所有急性和危重患者中的安装后， 护理室这项研究的设置是一个120张病床的住院设施，是一个综合VA医疗保健的一部分 在坦普尔，德克萨斯州。我们预计SSS-Cu材料将降低环境生物负荷，降低HAI 率，并导致感染相关的住院医疗费用显着下降时， 与标准的非SSS-Cu病房相比。

Prevention of healthcare-acquired infections (HAIs) is a priority challenge. The exact degree to which hospital surfaces influence the transmission of HAIs is not well understood. Current cleaning procedures such as sanitation of surfaces in hospital rooms with dilute sodium hypochlorite (bleach) and the use of ultraviolet light, while efficacious in reducing surface contamination episodically, do not provide continuous antibacterial activity. Furthermore, due to inadequate manual cleaning, antibiotic-resistant pathogens, such as methicillin- resistant Staphylococcus aureus (MRSA) and Clostridium difficile (C. diff) can live on surfaces for several months. Copper has antimicrobial properties against important antibiotic-resistant pathogen. Implementing copper and copper alloys in surfaces has the promise of continuous microbial killing power in the background as adjunct to current effective (although intermittent) strategies. This implementation study will explore the benefit of converting high touch surfaces in patient rooms to a novel self-sanitizing copper oxide-impregnated solid surface (SSS-Cu) manufactured by EOSCu Surfaces LLC, Norfolk, Virginia. The SSS-Cu has a uniform distribution of 16%-20% copper oxide. SSS-Cu has proven to be 99.9% bactericidal within 2 hours in a laboratory setting, has been registered with the Environmental Protection Agency (EPA) as environmentally safe, and has been associated with a significant decline in HAIs in a prior study at the Sentara Leigh Hospital, Norfolk, Virginia. The specific aims of our proposed study are to (1) establish real world effectiveness of SSS-Cu in the prevention of bio-burden accumulation in occupied patient rooms; (2) establish the effect of SSS-Cu as an adjunct to standard disinfection protocols on HAI rates for patients admitted to the study hospital; and (3) determine the economic impact of the use of SSS-Cu in the hospital setting. A prospective pre-post study design is proposed to compare hospital surface bio-burden and HAI rates between patient room environments with and without SSS-Cu surfaces. With the installation of SSS-Cu in acute and critical care rooms, environmental bioburden will be compared before copper surface installation to after copper surface installation. Further additional samples will be taken at 18 months and 36 months to evaluate continued efficacy of copper over time. HAI rates among all patients admitted to the hospital for a three-year period prior to installation of SSS-Cu will be compared to HAI rates among all patients admitted to the hospital for a three-year period following the completion of installation of SSS-Cu in all acute and critical care rooms. The setting for this study is a 120-bed inpatient facility that is part of an integrated VA health care system in Temple, Texas. We expect that SSS-Cu materials will lower environmental bio-burden, lower HAI rates, and result in significant decreases in infection-associated inpatient healthcare expenditures when compared to standard, non-SSS-Cu hospital rooms.