Environmental infection control

1. BY
Dr Anjum Hashmi
MBBS,CCS(USA),MPH
Infection Control Director
Maternity & Children’s
Hospital Najran.

3. • Ancient Indian store water in copper vessels
due their knowledge that water remain safe.
• In the mid 1800’s, the Cholera epidemic did
not affect copper workers in France which
reflects preventive role of copper.
• Thus we can validate that Copper has played
an essential role in humans history.

5. MRSA – Methecillin
Resistant Staphylococcus
Aureus
VRE – Vancomycin
Resistant Enterococcus
FQRP –
Fluoroquinolone Resistant
Pseudomonas Aeruginosa
Infectious Diseases Society of America, as derived from
data collected by the Centers for Disease Control and
Prevention.
Even though hospitals have strict protocols for staff and visitors to
wash their hands and to use antimicrobial soaps, sanitizer gels and
disinfectants.
DRUG RESISTANT HOSPITAL INFECTIONS ARE STEADILY INCREASING.

6. • When HCWs touch these surfaces, either Bed
their hands or gloves may be contaminated Patient’s
• In medical history many outbreaks have Clothes
been identified as a result this contamination.
Non-invasive
blood
pressure
measuring
cuffs
Bed Sheets
Food Table
Floor

7. The biggest campaign during the last decade!!

8. Even though healthcare surfaces are
designed to be easily cleaned….
Bacteria
Live bacteria in a 5 micron scratch on
recently sanitized Stainless
…..sanitizing chemicals might not kill all
of the bacteria and recontamination can
occur quickly.

9. • Bacteria can survive in scratches on many
surfaces
• It is a stainless steel surface that was just
thoroughly cleaned...
• Photo taken from
an electron microscope
tells the story

10. ANTIBIOTICS ARE NOT OUR ONLY ALLIES
IN THE WAR AGAINST INFECTIONS.

11. • The discovery of copper alloy with antimicrobial activity and it
has been use as a measure for microbial flora reduction in the
environment during recent years.
• In addition to killing bacteria, Anti-microbial Copper Touch
Surfaces are environmental friendly because these can be
completely recyclable.
• The Copper Surfaces are inherently anti-microbial so, no
chemicals are added, this makes them safe for people and the
environment.

13. • Fixtures and Sinks produced with Antimicrobial Copper are
attractive, safe to use and never wear or wash away.
• Extensive laboratory testing has shown that when cleaned
regularly, sinks and other products made from Antimicrobial
Copper:
• Kills bacteria more than 99.9% * within 2 hours, and
continues to kill 99% of bacteria* even after repeated
recontamination.
• Delivers continuous and ongoing antibacterial action,
killing more than 99.9% of bacteria* within 2 hours.
*Testing demonstrates effective antibacterial activity against Staphylococcus aureus, Enterobacter
aerogenes, Methicillin Resistant Staphylococcus aureus (MRSA), Escherichia coli O157:H7, and
Pseudomonas aeruginosa.

14. • Copper helps inhibit bacterial buildup and growth*
within 2 hours of exposure between routine
cleaning and sanitizing steps.
• Copper kills more than 99.9% of Gram-negative and
Gram-positive bacteria* within 2 hours of exposure.
• Continuously reduces both types of bacterial*
contamination, achieving 99.9% reduction within 2
hours of exposure.
*Testing demonstrates effective antibacterial activity against Staphylococcus
aureus, Enterobacter aerogenes, Methicillin Resistant Staphylococcus aureus
(MRSA), Escherichia coli O157:H7, and Pseudomonas aeruginosa.

15. • In 19th Century tests
to control cholera.
• In 20th Century early
work on the use of copper to combat Legionella
• Form 2000 up to now investigations carried out
at Southampton University, Aston University,
Stellenbosch University which verified the
broad spectrum efficacy of copper against micro
organisms including E.coli and MRSA.

17. • More than 350 copper alloys registered by EPA
to be marketed with public health claims.
• Copper content of antimicrobial alloys ranges
from 60% to 100%.

18. • Copper surfaces affect bacteria in two steps:
• The first direct interaction between the surface
and the bacterial outer membrane, causing the
membrane to rupture.
• The second related to causing holes in the outer
membrane, thus the cell loses vital nutrients and
water, resulting in a general
weakening of the cell.

20. LABORATORY STUDIES
Acinetobacter baumannii
• Articles published in journals Adenovirus
Aspergillus niger
around the world confirming the Candida albicans
antimicrobial efficacy of copper. Campylobacter jejuni
Clostridium difficile
• Studies showed Copper has rapid, Enterobacter aerogenes
broad spectrum antimicrobial action Escherichia coli O157:H7
Helicobacter Pylori
effective against clinical pathogens. Influenza A (H1N1)
• Indirect verification of Legionella pneumophila
Listeria monocytogenes
copper’s efficacy has been MRSA
achieved via the US Environmental Mycobacterium tuberculosis
Poliovirus
Protection Agency registration Pseudomonas aeruginosa
of more than 350 copper alloys as Salmonella enteritidis
Staphylococcus aureus
antimicrobial Tubercle bacillus
Vancomycin-resistant
enterococcus

26. For Clinical Studies in • Sanitizer buttons
UK, USA & Chile • Light pulls
• Push plates • Cistern flush levers
• Thumb turns • Dressings trolleys
• Cubicle locks • Soap dispensers
• Grab rails • Apron dispensers
• Hot & cold taps • Towel dispensers
• Toilet seats • Commodes
• Switches & sockets • Sink traps & wastes
• Bed table tops • Call buttons
• Drip pole stand • Door handles

27. • Selly Oak Hospital, UK
• All Cu items harbored 90%-100% less microorganisms than
control non copper items at both 7am and 5pm (1)
• Hospital del Cobre, Chile
• Copper was effective in reducing the microbial burden on all
surfaces, and average microbial count was significantly lower in
rooms with copper (2)
• Medical University of South Carolina, USA
• Copper significantly reduced the total microbial load in rooms by
87.4% (3)
• 1. Casey AL, Lambert PA, Miruszenko L, Elliott TSJ. Copper for preventing microbial environmental
contamination. 48th Annual ICAAC/IDSA 46th Annual meeting, Washington DC, 25-28th October 2008.
• 2. Casey AL et al., Role of Copper in reducing hospital environment contamination. J of Hospital Infection
2010; 74, 72 -77 2Prado V et al., 2010
• 3. Salgado et al. A pilot study to determine effectiveness of Cu in reducing the microbial burden in the ICU.
• Poster presentation at the 5th Decennial Int. Conf. Atlanta Georgia 2010

28. • Three Intensive Care Units are copperised in
the main hospitals of Athens.
• A large private school of 2500 students has
installed antimicrobial copper door handles
and staircase hand railings.

29. Application of antimicrobial copper
in school

30. Application of antimicrobial copper
in school

31. Copperise Touch surface in ICU

33. Copper in Hospitals

35. Infection Control at your Fingertips
• A company has produced the world's first
commercially-available Antimicrobial Copper
keyboard, bearing the Cu+ mark that
confirms rapid and continuous efficacy
against disease-causing pathogens.

36. Healthcare Fixtures & Scrub Sinks

38. Hospital Protects Patients with
Copper
Bed at WSSK Bed at VA Medical
Hospital, Wroclaw, Center USA
Poland

39. Catch Planes, Not Diseases
• A study in scientific journal PLOS One has ranked
America's 40 largest airports in order of which
would play the largest role in the spread of a global
disease pandemic.
• John F Kennedy Airport top of the 'super-spreaders'
so they remodeling with antimicrobial copper.
• One of Brazil's busiest airports also copperised...

40. Bio burden trials touch surfaces of
key item were change to copper

41. • Data from international investigations indicate:
• Touch surfaces even in regularly cleaned ICU’s
may serve as significant microbiological reservoirs
that could transfer microbes to patients, health
care workers and visitors.
• Objects closest to patients had a higher
staphylococcal Burden
• Bed railings has the highest concentrations.
• Other objects had lower total staph and MRSA i.e.,
▪ Call button > Chair arms > Over bed tray table
>

42. • Copper reduces microbial burden on common touch
surfaces in ICU’s.
• Reduction is significant and constant, Microbial
reduction in clinical setting matches with reduction
observed under ideal laboratory conditions (i.e.
99.9%).
• Microbial burden decreases to target levels and
cleaning achieved.
• Random sampling supports hypothesis that copper
surfaces continuously reduce bacterial burdens
between cleanings.

46. In 2012 A historic moment:
DNA imaged with electron microscope for the first
time
corkscrew thread of the DNA double helix

47. Reflections is a two-million-square-foot
residential development in Singapore THANK YOU