BYDr Anjum HashmiMBBS,CCS(USA),MPHInfection Control Director Maternity & Children’s Hospital Najran.

• 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.

Infectious Diseases Society of America, as derived from data collected by the Centers for Disease Control and Prevention.

MRSA – MethecillinResistant StaphylococcusAureusVRE – VancomycinResistant EnterococcusFQRP –Fluoroquinolone ResistantPseudomonas Aeruginosa

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.

• When HCWs touch these surfaces, either their hands or gloves may be contaminated• In medical history many outbreaks have

been identified as a result this contamination.

BedPatient’sClothes

Non-invasivebloodpressuremeasuringcuffs

Bed Sheets

Food Table

Floor

The biggest campaign during the last decade!!

Even though healthcare surfaces aredesigned to be easily cleaned….

…..sanitizing chemicals might not kill all of the bacteria and recontamination can occur quickly.

Bacteria

Live bacteria in a 5 micron scratch on recently sanitized Stainless

• 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

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

• 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.

• 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.

• 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.

• 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.

• 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%.

• 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.

LABORATORY STUDIES• Articles published in journals around the world confirming the antimicrobial efficacy of copper.• Studies showed Copper has rapid, broad spectrum antimicrobial action effective against clinical pathogens.• Indirect verification of copper’s efficacy has been achieved via the US Environmental Protection Agency registration of more than 350 copper alloys as antimicrobial

Acinetobacter baumanniiAdenovirusAspergillus nigerCandida albicansCampylobacter jejuniClostridium difficileEnterobacter aerogenesEscherichia coli O157:H7Helicobacter PyloriInfluenza A (H1N1)Legionella pneumophilaListeria monocytogenesMRSAMycobacterium tuberculosisPoliovirusPseudomonas aeruginosaSalmonella enteritidisStaphylococcus aureusTubercle bacillusVancomycin-resistant enterococcus

For Clinical Studies in UK, USA & Chile • Push plates• Thumb turns• Cubicle locks• Grab rails• Hot & cold taps• Toilet seats• Switches & sockets• Bed table tops• Drip pole stand

• Sanitizer buttons• Light pulls• Cistern flush levers• Dressings trolleys• Soap dispensers• Apron dispensers• Towel dispensers• Commodes• Sink traps & wastes• Call buttons• Door handles

• 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

• 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.

Application of antimicrobial copper in school

Application of antimicrobial copper in school

Copperise Touch surface in ICU

Copper in Hospitals

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.

Healthcare Fixtures & Scrub Sinks

Hospital Protects Patients with Copper

Bed at WSSK Bed at VA Medical Hospital, Wroclaw, Center USA Poland

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...

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

• 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 > Data input device > IV pole

• 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.

In 2012 A historic moment: DNA imaged with electron microscope for the first

timecorkscrew thread of the DNA double helix

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