Copper-based fabric for healthcare professionals to prevent healthcare-associated infections: A futuristic/dreamed uniform

Megha Sharma; Shatrughan Pareek

doi:10.4103/mgmj.mgmj_44_22

REVIEW ARTICLE

Year : 2022 | Volume : 9 | Issue : 3 | Page : 406-409

Copper-based fabric for healthcare professionals to prevent healthcare-associated infections: A futuristic/dreamed uniform

Megha Sharma¹, Shatrughan Pareek²
¹ Department of Nursing, All India Institute of Medical Sciences (AIIMS), Jodhpur, India
² Department of Nursing, Indian Railway Health Services, Bikaner, Rajasthan, India

Date of Submission	08-Apr-2022
Date of Acceptance	23-Jun-2022
Date of Web Publication	29-Sep-2022

Correspondence Address:
Dr. Shatrughan Pareek
Department of Nursing, Indian Railway Health Services, Bikaner, Rajasthan 334005
India

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mgmj.mgmj_44_22

Abstract

Healthcare-associated infections (HAIs) have a major impact on public health worldwide. Till now, we are relying on hand washing and environmental disinfection, but the compliance rate of hand washing and adequate supply of materials is always a catch. Alongside patients, surfaces and supplies act as reservoirs of microorganisms in healthcare settings. The reduction in organisms may prove to be an effective strategy to decline HAIs. The use of gold and silver in commercial textiles is prohibited because of the high cost rather than having excellent antibacterial and antimicrobial properties, so copper has become the best choice for researchers as it possesses similar properties to gold and silver and has other characteristics such as its durability, corrosion resistance, prestigious appearance, and ability to form complex shapes. It has been found that copper brings down the microbial burden of high-touch surfaces in healthcare settings. The fundamental properties of copper offer a theoretical advantage to regular cleaning, as the effect is continuous rather than episodic. So the use of copper-impregnated textiles in hospital areas whether in form of bed linen or uniforms for health professionals, as well as patients, can be a viable alternative to decline the levels of infection in healthcare settings, and with the discovery of copper-encapsulated hospital beds and fabrics, dividends will likely be paid in improved patient outcomes, lives saved, and healthcare cost saved. The application of copper in fabrics for healthcare professionals will be a sound initiative to prevent HAIs. The fabric may help decline the infection rate and mortality among hospitalized patients.

Keywords: Copper-based fabric, dreamed uniform, healthcare professionals, healthcare-associated infections

How to cite this article:
Sharma M, Pareek S. Copper-based fabric for healthcare professionals to prevent healthcare-associated infections: A futuristic/dreamed uniform. MGM J Med Sci 2022;9:406-9

How to cite this URL:
Sharma M, Pareek S. Copper-based fabric for healthcare professionals to prevent healthcare-associated infections: A futuristic/dreamed uniform. MGM J Med Sci [serial online] 2022 [cited 2023 Feb 6];9:406-9. Available from: http://www.mgmjms.com/text.asp?2022/9/3/406/357469

Introduction

History indicates that many ancient civilizations, viz., the ancient Egyptians, the Greeks (400 BC), and the Indians used copper for sterilizing water and for many treatment purposes, even though they were not aware of the microbial world.^[1] Copper has been the subject of recent microbiology research. The biocidal properties of copper on a wide range of pathogens, such as bacteria, fungi, and viruses, have been revealed by many laboratory studies.^[1],[2] The potency of copper extends to methicillin-resistant Staphylococcus aureus (S. aureus)^[3] and vancomycin-resistant enterococci.^[4] Apart from being an effective antimicrobial agent, the exposure to copper has been correlated with enhanced wound healing.^[5] Bacterial colonization is greatly reduced when copper alloys are used on external surfaces in a therapeutic context,^[6],[7] and in recent times, copper-laden fabrics have also been studied.^[8] When compared with noncopper exposure, a study found that pediatric patients exposed to copper-surfaced objects in the controlled environment of the intensive care unit had lower healthcare-associated infection (HAI) rates.^[9],[10] In this sense, it is vital to pay consideration to the various fabrics used in healthcare settings, worn by personnel, such as coats and uniforms, as well as those worn by patients, such as bed and bath linens and gowns, which play a chief role in microbial contamination and dissemination.

It has been reported that out of every 100 inpatients in a healthcare setting, 10 and seven patients get infected by HAI in developing and developed countries, respectively.^[11] Various multicentric studies around the globe showed the prevalence of hospitalized patients acquiring at least one HAI ranged from 3.5% to 12%.^[12],[13] A narrative review from India reported the incidence of HAI within the range of 4.4%–83.09%. A compilation of various studies indicated that the overall incidence of surgical site infection and catheter-related bloodstream infection in India ranged from 2% to 21% and 0.2% to 28%, respectively, with a rate of 0.5–47 per 1000 catheter days.^[14],[15] Infectious agents continue to shed from infected or carrier patients or healthcare professionals and settle at various locations across healthcare facilities, where they remain viable for days, posing a risk of infection to other patients and staff. So we can consider the role of some of our traditional metals along with new technology.

HISTORY OF COPPER’S ANTIMICROBIAL EFFECTS

The Egyptians were the first to mention the antimicrobial outcome of copper in 2600 BC. Drinking water was disinfected with copper vessels, and chest wounds were also treated with the same. In papyrus circa 1500 BC, it was stated that various adaptations of copper were used to treat infections, scalds, and itching.^[16] Copper was found in significant quantities on Cyprus, a Greek island, and the ancient Greeks utilized it often. This is also the basis from which the Latin name for copper, cuprus, was derived. In the Hippocratic Collection, which was written in part by Hippocrates (460 to 377 BC), it was described that copper-containing wound dressings were recommended to treat leg ulcers.^[5]

Mechanism of action

The mechanism of action is postulated that the toxic effect of copper involves the rupture of the cell membrane, the production of reactive oxygen species, and the breakdown of bacterial DNA, resulting in cell death.^[11] Copper resistance and the spread of antibiotic-resistant organisms are thought to be improbable because of this multitargeted method of action and the fast destruction of bacterial DNA.^[6]

Application of copper in hospitals

Hard surfaces

Copper Armour is a unique self-sanitizing coating that has bactericidal activity against key human diseases and considerably decreases the microbial burden on hospital surfaces, according to previous research. This compound could be utilized as a self-sanitizing coating in healthcare institutions to help with infection control.^[17],[18] Another study found to support this evidence shows Staphylococcus and Micrococcus were two predominantly found species on touch surfaces, respectively, occurring 51.8% and 48.0%. In these facilities with low bioburden, copper surfaces effectively reduced the occurrence frequencies of three genera: Staphylococcus, Streptococcus, and Roseomonas. In only a few samples, pathogenic bacteria such as S. aureus, Enterococcus faecalis, and Enterococcus faecium were found. Methicillin-resistant S. aureus was also found on five of the control surfaces and one of the copper surfaces.^[19]

Copper-impregnated products for skin pathologies

An improvement in skin appearance was documented in a preliminary clinical investigation on the safety of adult diapers treated with copper oxide in older patients.^[20] For a half year, 16 patients wore copper diapers every day. There were no skin irritations or adverse responses regarding diapers during the trial period.

Future approach for the dreamed uniform

Some of the studies reported that copper oxide-impregnated materials, namely, bed sheets and patient apparel, are efficacious at reducing microbial load, resulting in a lower risk of HAIs.^{[21],[22],[23]} Material scientists from the University of Manchester, working in conjunction with universities in China, have developed a “durable and washable, concrete-like composite material constructed from antibacterial copper nanoparticles” to deploy copper-impregnated fabric HAIs’ preventive measures. They have also found out how to attach the composite to wearable textiles such as cotton and polyester, which has previously been a stumbling hurdle for scientists. Techniques for attaching copper to materials such as cotton for medicinal and antimicrobial textile manufacture had limits before this discovery. The study team has now used a procedure called “polymer surface grafting” to anchor copper nanoparticles to cotton and polyester using a polymer brush, forming a strong chemical bond. This link, according to the experts, has resulted in exceptional washability and durability. The team also found their cotton and polyester-coated copper fabrics showed excellent antibacterial resistance against S. aureus and E. coli, even after being washed 30 times.^[24]

Clinical application in various units of the hospital

The levels of bacteria and fungi found in air and surface samples from an operating block (operating rooms, intensive care units, surgery recovery rooms, and annexes corridors) were evaluated in survey research that followed the occurrence of numerous postsurgery infections at a transplant center of a hospital in Rome. Low concentrations of fungi were found in air and surface samples (ranging from 0 to 70 colony forming units (CFU)/m³ and from 0 to 21 CFU/cm², respectively).^[25]

Another study found that using copper oxide–impregnated biocidal fabrics in ventilator-dependent patients’ long-term care wards was linked to a considerable reduction in HAI indicators and antibiotic use.^[21] Infected patients spread microorganisms in hospitals not only by releasing expectorating drops, fluids from infected wounds, excrement, urine, blood, and other corporeal fluids, but also through clothing and blankets, and healthcare workers are in constant contact with patients, so they require a barrier to prevent infection after repeated hand washing and disinfection. Using engineering and environmental control measures, disease spread could be avoided. In addition to regular cleaning and disinfection techniques, lasting antimicrobial materials such as copper can be used to maintain suitable hygienic standards, particularly on high-touch surfaces,^[25] bed linen, and uniform of healthcare professionals.

Conclusion

The antibacterial application of copper in health care is becoming increasingly apparent as research progresses toward clinical testing. The continuous and rapid broad-spectrum biocidal properties of both copper-containing hard surfaces and soft surfaces such as textiles and polymers may offer a novel and innovative advancement in the battle against HAIs. Traditional infection–prevention methods should not be abandoned; nevertheless, copper-coated surfaces and fabrics may improve their efficacy. The employment of these materials in the production of healthcare uniforms, on the other hand, requires more research to confirm their efficacy in reducing the microbial load in clinical practice. The application of copper in fabric for healthcare professionals will be a sound initiative to prevent HAIs. The fabric may help decline the infection rate and mortality among hospitalized patients.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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