Potential effectiveness of copper surfaces in reducing health care-associated infection rates in a pediatric intensive and intermediate care unit: A nonrandomized controlled trial.
Studies have consistently shown that copper alloyed surfaces decrease the burden of microorganisms in health care environments. This study assessed whether copper alloy surfaces decreased hospital-associated infections in pediatric intensive and intermediate care units.



Admitted infants were assigned sequentially to a room furnished with or without a limited number of copper alloyed surfaces. Clinical and exposure to intervention data were collected on a daily basis. To avoid counting infections present prior to admission, patients who stayed in the hospital <72 hours were excluded from analysis. Health care-associated infections (HAIs) were confirmed according to protocol definitions.



Clinical outcomes from 515 patients were considered in our analysis: 261 patients from the intervention arm of the study, and 254 from the control arm. Crude analysis showed an HAI rate of 10.6 versus 13.0 per 1,000 patient days for copper- and non-copper-exposed patients, respectively, for a crude relative risk reduction (RRR) of 0.19 (90% confidence interval, 0.46 to -0.22). Conducting clinical trials to assess interventions that may impact HAI rates is very challenging. The results here contribute to our understanding and ability to estimate the effect size that copper alloy surfaces have on HAI acquisition.



Exposure of pediatric patients to copper-surfaced objects in the closed environment of the intensive care unit resulted in decreased HAI rates when compared with noncopper exposure; however, the RRR was not statistically significant. The clinical effect size warrants further consideration of this intervention as a component of a systems-based approach to control HAIs.
Paediatric Intensive and Intermediate Care, Roberto del Rio Hospital, Santiago, Chile.
Bettina
B
von Dessauer
School of Public Health, Faculty of Medicine, University of Chile, Santiago, Chile.
Maria S
MS
Navarrete
Microbiology and Diagnostic Tests Laboratory, Roberto del Rio Hospital, Santiago, Chile.
Dona
D
Benadof
Paediatric Intensive and Intermediate Care, Roberto del Rio Hospital, Santiago, Chile.
Carmen
C
Benavente
Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC. Electronic address: schmidtm@musc.edu.
Michael G
MG
Schmidt
D000890:Anti-Infective Agents / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D003300:Copper / Q000494:pharmacology*; D003428:Cross Infection / Q000517:prevention & control*; D005260:Female; D050456:Fomites / Q000382:microbiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D007380:Intermediate Care Facilities; D008297:Male
D000890:Anti-Infective Agents; D003300:Copper
Antimicrobial copper; HAI; PICU; bacterial burden; built environment; health care–associated infections; infection control; multibed; pediatrics; surfaces