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      Antimicrobial Properties of Selected Copper Alloys on Staphylococcus aureus and Escherichia coli in Different Simulations of Environmental Conditions: With vs. without Organic Contamination

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          Abstract

          Background: Hospital equipment made from copper alloys can play an important role in complementing traditional methods of disinfection. Aims of the study: The aim of this study was to assess the dynamics of the antimicrobial properties of selected copper alloys in different simulations of environmental conditions (with organic contamination vs. without organic contamination), and to test alternatives to the currently used testing methods. Materials and Methods: A modification of Japanese standard JIS Z 2801 as well as Staphylococcus aureus (SA) and Escherichia coli (EC) suspended in NaCl vs. tryptic soy broth (TSB) were used in tests performed on seven commonly used copper alloys, copper, and stainless steel. Results: A much faster reduction of the bacterial suspension was observed for the inoculum prepared in NaCl than in TSB. A faster reduction for EC than for SA was observed in the inoculum prepared in NaCl. The opposite results were found for the inoculum based on TSB. A significant correlation between the copper concentration in the copper alloys and the time and degree of bacterial suspension reduction was only observed in the case of EC. Conclusions: This study confirmed the antimicrobial properties of copper alloys, and additionally showed that Staphylococcus aureus was more resistant than Escherichia coli in the variant of the experiment without organic contamination. However, even for SA, a total reduction of the bacterial inoculum’s density took no longer than 2 h. Under conditions simulating organic contamination, all of the tested alloys were shown to have bactericidal or bacteriostatic properties, which was contrary to the results from stainless steel.

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          Bacterial killing by dry metallic copper surfaces.

          Metallic copper surfaces rapidly and efficiently kill bacteria. Cells exposed to copper surfaces accumulated large amounts of copper ions, and this copper uptake was faster from dry copper than from moist copper. Cells suffered extensive membrane damage within minutes of exposure to dry copper. Further, cells removed from copper showed loss of cell integrity. Acute contact with metallic copper surfaces did not result in increased mutation rates or DNA lesions. These findings are important first steps for revealing the molecular sensitive targets in cells lethally challenged by exposure to copper surfaces and provide a scientific explanation for the use of copper surfaces as antimicrobial agents for supporting public hygiene.
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            Copper surfaces reduce the rate of healthcare-acquired infections in the intensive care unit.

            OBJECTIVE. Healthcare-acquired infections (HAIs) cause substantial patient morbidity and mortality. Items in the environment harbor microorganisms that may contribute to HAIs. Reduction in surface bioburden may be an effective strategy to reduce HAIs. The inherent biocidal properties of copper surfaces offer a theoretical advantage to conventional cleaning, as the effect is continuous rather than episodic. We sought to determine whether placement of copper alloy-surfaced objects in an intensive care unit (ICU) reduced the risk of HAI. DESIGN. Intention-to-treat randomized control trial between July 12, 2010, and June 14, 2011. SETTINg. The ICUs of 3 hospitals. PATIENTS. Patients presenting for admission to the ICU. METHODS. Patients were randomly placed in available rooms with or without copper alloy surfaces, and the rates of incident HAI and/or colonization with methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE) in each type of room were compared. RESULTS. The rate of HAI and/or MRSA or VRE colonization in ICU rooms with copper alloy surfaces was significantly lower than that in standard ICU rooms (0.071 vs 0.123; P = .020). For HAI only, the rate was reduced from 0.081 to 0.034 (P = .013). CONCLUSIONs. Patients cared for in ICU rooms with copper alloy surfaces had a significantly lower rate of incident HAI and/or colonization with MRSA or VRE than did patients treated in standard rooms. Additional studies are needed to determine the clinical effect of copper alloy surfaces in additional patient populations and settings.
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              Potential use of copper surfaces to reduce survival of epidemic meticillin-resistant Staphylococcus aureus in the healthcare environment.

              Epidemic meticillin-resistant Staphylococcus aureus (EMRSA) emerged in the early 1980s with EMRSA-15 and -16 being the most prevalent strains within the UK. MRSA transmission between patients is largely via the hands of healthcare workers, and contamination of the hospital environment may occur. The objective of this study was to evaluate the effectiveness of copper and brass to reduce the viability of air-dried deposits of three MRSA strains [MRSA (NCTC 10442), EMRSA-1 (NCTC 11939) and EMRSA-16 (NCTC 13143)] compared with stainless steel. MRSA and EMRSA [10(7)colony-forming units (CFU)] were inoculated on to coupons (1 cm x 1 cm) of copper, brass or stainless steel and incubated at either 22 degrees C or 4 degrees C for various time periods. Viability was determined by resuspending removed CFUs and plating out on tryptone soy agar plates in addition to staining with the respiratory indicator fluorochrome 5-cyano-2,3-ditolyl tetrazolium. On pure copper surfaces, 10(7) MRSA, EMRSA-1 and EMRSA-16 were completely killed after 45, 60 and 90 min, respectively, at 22 degrees C. In contrast, viable organisms for all three strains were detected on stainless steel (grade 304) after 72 h at 22 degrees C. At 4 degrees C, complete kill was achieved on copper for all three strains within 6 h. The results demonstrate an antimicrobial effect of copper on MRSA, EMRSA-1 and -16 in contrast to stainless steel. Consequently, the contemporary application of stainless steel in hospital environments for work surfaces and door furniture is not recommended.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                20 July 2017
                July 2017
                : 14
                : 7
                : 813
                Affiliations
                [1 ]Faculty of Medicine, Chair of Microbiology, Jagiellonian University Medical College, Czysta str. 18, 31-121 Kraków, Poland; agnieszka.chmielarczyk@ 123456uj.edu.pl (A.C.); d.romaniszyn@ 123456uj.edu.pl (D.R.); a.sroka88@ 123456gmail.com (A.S.-O.); mbulanda@ 123456post.pl (M.B.)
                [2 ]Faculty of Non-Ferrous Metals, Department of Metal Working and Physical Metallurgy of Non-Ferrous Metals, AGH University of Science and Technology, Al. A. Mickiewicza 30, 30-059 Krakow, Poland; mwa@ 123456agh.edu.pl (M.W.); piosuch@ 123456agh.edu.pl (P.O.); tknych@ 123456agh.edu.pl (T.K.)
                Author notes
                [* ]Correspondence: a.rozanska@ 123456uj.edu.pl ; Tel.: +48-126-332-567
                Article
                ijerph-14-00813
                10.3390/ijerph14070813
                5551251
                28726753
                f6ab956e-175d-4fd3-ad2f-d99362265a31
                © 2017 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 16 May 2017
                : 14 July 2017
                Categories
                Article

                Public health
                antimicrobial copper,hospital environment,staphylococcus aureus,escherichia coli,environmental disinfection,patient safety

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