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

预防卫生保健获得性感染(HAI)是一项优先挑战。医院在多大程度上 表面对HAI传播的影响还不是很清楚。当前的清洁程序，如 用稀释的次氯酸钠(漂白剂)和紫外线对医院房间的表面进行卫生， 虽然在偶尔减少表面污染方面是有效的，但不提供持续的抗菌剂 活动。此外，由于人工清洁不足，抗药性病原体，如甲氧西林- 耐药金黄色葡萄球菌(MRSA)和艰难梭菌(C.diff)可在表面存活数年 月份。铜对重要的抗生素耐药病原体具有抗菌性能。实施 表面的铜和铜合金有望在背景中持续杀灭微生物 作为当前有效(虽然时断时续)战略的补充。 这项实施研究将探索将病房中的高触摸面转换为 由EOSCu表面制备的新型自消毒浸渍铜固体表面(SSS-Cu) 有限责任公司，诺福克，弗吉尼亚州。SSS-Cu的氧化铜含量为16%~20%，分布均匀。SSS-Cu已经证明 在实验室环境下，在2小时内杀菌99.9%，已在环境保护局注册 环境保护局(EPA)被认为是环境安全的，并与人类健康指数的显著下降有关 在弗吉尼亚州诺福克市森塔拉·利医院之前的一项研究中。我们建议进行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现实有效性 病室；(2)确定SSS-铜作为标准消毒方案的附件对HAI率的影响 对于住院的患者；和(3)确定在研究医院使用SSS-Cu的经济影响 医院环境。 提出了一项前瞻性的研究前设计，以比较医院表面的生物负荷和HAI率。 在有和没有SSS-Cu表面的病房环境之间。随着SSS-Cu的安装在 急症室和重症监护室，环境生物负荷将在铜面安装前进行比较 铜板表面安装后。将在18个月和36个月内再抽取更多样本 评估铜随时间的持续有效性。HAI在所有住院患者中的比率 安装SSS-Cu之前的三年时间将与所有入院患者的HAI率进行比较。 医院在所有急危重症患者完成SSS-Cu安装后的三年内 护理室。这项研究的背景是一个拥有120张床位的住院设施，它是退伍军人管理局综合医疗保健的一部分 德克萨斯州坦普尔的系统。我们预计SSS-Cu材料将降低环境生物负荷，降低HAI 比率，并导致与感染相关的住院医疗支出显著减少 与标准的非SSS-Cu型病房相比。

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.