Επιστημονικές Μελέτες

Warnes SL, Little ZR, Keevil CW. 2015. Human coronavirus 229E remains infectious on common touch surface materials. mBio 6(6):e01697-15. doi:10.1128/mBio.01697-15.

The evolution of new and reemerging historic virulent strains of respiratory viruses from animal reservoirs is a significant threat to human health. Inefficient human-to-human transmission of zoonotic strains may initially limit the spread of transmission, but an infection may be contracted by touching contaminated surfaces. Enveloped viruses are often susceptible to environmental stresses, but the human coronaviruses responsible for severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) have recently caused increasing concern of contact transmission during outbreaks. We report here that pathogenic human coronavirus 229E remained infectious in a human lung cell culture model following at least 5 days of persistence on a range of common nonbiocidal surface materials, including polytetrafluoroethylene (Teflon; PTFE), polyvinyl chloride (PVC), ceramic tiles, glass, silicone rubber, and stainless steel. We have shown previously that noroviruses are destroyed on copper alloy surfaces. In this new study, human coronavirus 229E was rapidly inactivated on a range of copper alloys (within a few minutes for simulated fingertip contamination) and Cu/Zn brasses were very effective at lower copper concentration. Exposure to copper destroyed the viral genomes and irreversibly affected virus morphology, including disintegration of envelope and dispersal of surface spikes. Cu(I) and Cu(II) moieties were responsible for the inactivation, which was enhanced by reactive oxygen species generation on alloy surfaces, resulting in even faster inactivation than was seen with nonenveloped viruses on copper. Consequently, copper alloy surfaces could be employed in communal areas and at any mass gatherings to help reduce transmission of respiratory viruses from contaminated surfaces and protect the public health.

Διαβάστε περισσότερα mBio-2015-Warnes-e01697-15.full

Panos A. Efstathiou

Abstract
Aim of this study was to evaluate the reduction on Intensive Care Unit (ICU) microbial flora after the antimicrobial copper alloy (Cu+) implementation as well as the effect on financial – epidemiological operation parameters.

Methods
Medical, epidemiological and financial data into two time periods, before and after the implementation of copper (Cu 63 % – Zn 37 %, Low Lead) were recorded and analyzed in a General ICU. The evaluated parameters were: the importance of patients’ admission (Acute Physiology and Chronic Health Evaluation – APACHE II and Simplified Acute Physiology Score – SAPS), microbial flora’s record in the ICU before and after the implementation of Cu+ as well as the impact on epidemiological and ICU’s operation financial parameters.

Results
During December 2010 and March 2011 and respectively during December 2011 and March 2012 comparative results showed statistically significant reduction on the microbial flora (CFU/ml) by 95 % and the use of antimicrobial medicine (per day per patient) by 30 % (p = 0.014) as well as patients hospitalization time and cost.

Conclusions
The innovative implementation of antimicrobial copper in ICUs contributed to their microbial flora significant reduction and antimicrobial drugs use reduction with the apparent positive effect (decrease) in both patients’ hospitalization time and cost. Under the present circumstances of economic crisis, survey results are of highest importance and value.

Διαβάστε περισσότερα: https://link.springer.com/chapter/10.1007/978-3-319-08057-4_8

Π. Ευσταθίου, Ε. Κουσκούνη, Σ. Παπανικολάου, Κ. Καραγιώργου, Ζ. Μανωλίδου, Μ. Τσερώνη, Ε. Λογοθέτης, Επιθεώρηση ΥΓΕΙΑΣ, Τεύχος 140, Ιανουάριος – Φεβρουάριος 2013

ΕΙΣΑΓΩΓΗ
Είναι γνωστό ότι οι παθογόνοι μικροοργανισμοί συσσωρεύονται σε επιφάνειες του περιβάλλοντος, πολλαπλασιάζονται και σχηματίζουν μία δεξαμενή μικροβίων που μεταδίδονται εξ εnαφής (με τα χέρια 11 μέσω άλλων αντικειμένων). Οι κατεξοχήν χώροι ανάπτυξης μικροβιακών στελεχών είναι τα νοσοκομεία και κυρίως οι Μονάδες Εντατικής θεραπείαs (ΜΕθ). Αυτό, σε συνδυασμό με τnν υπερβολική χρήση των αντιβιοτικών, καθιστά δύσκολη τnν αντιμετώπιση των λοιμώξεων ¹.

Στο πλαίσιο αυτό n εφαρμογή των κραμάτων αντιμικροβιακού χαλκού Cu+ (Cu63%, Zn37% Lead Free.) σε καθορισμένεs
επιφάνεια και n περαιτέρω έρευνα τns δράσης του αποτελεί μια πρωτότυπη παγκόσμια καινοτόμο εφαρμογή ² .
Παράλληλα υπάρχουν αρκετέs μελέτες ³ σχετικέs με τnν αντιμικροβιακή δράση του χαλκού και συγκεκριμένων κραμάτων του, που επισημαίνουν τιs δυνητικέs θετικέs επιπτώσεις στουs χώρουs των νοσοκομείων ^4.5. παρόμοια με τnν δράση των αντιβιοτικών, όπως και στη δημόσια υγεία ⁶ από τnν εφαρμογή αντιμικροβιακού χαλκού σε επιφάνειες δημόσιων χώρων (σχολεία, ξενοδοχεία, μέσα μαζικής μεταφοράs, εγκαταστάσεις μετρό) ⁹.

Εργαστηριακές δοκιμασίες ^7·8 έχουν δείξει αδιαμφισβήτητα ότι ο αντιμικροβιακός χαλκόs εξοντώνει αδιάλειπτα τα βακτηρίδια που προκαλούν λοιμώξεις και ότι είναι n αποτελεσματικότερη επιφάνεια εnαφής. Κλινικέs δοκιμασίες που είναι σε εξέλιξη σε όλο τον κόσμο δείχνουν το όφελος του αντιμικροβιακού χαλκού σε πραγματικέs συνθήκες χρήσnς.

Τα αποτελέσματα δείχνουν ότι n μικροβιακή χλωρίδα μειώνεται σε σnμαντικό ποσοστό και σε συνεχή βάση, σε σύγκριση με τιs τυπικές επιφάνειες σε ποσοστό περισσότερο από 90%⁴.

Αποτελέσματα από μια κλινική δοκιμασία στις ΗΠΑ, n οποία χρηματοδοτήθηκε από το Υπουργείο Άμυναs, φέρνουν τα αποδεικτικά
δεδομένα σε νέα επίπεδα, με τnν αξιολόγηση της σύνδεσης μεταξύ τns ανάπτυξης μικροβίων σε συχνά αγγιζόμενες επιφάνειες και τnν προσβολή ασθενών από λοιμώξεις. Από τα ευρήματα φαίνεται ότι για ασθενείs που παρέμειναν για θεραπεία σε ΜΕθ, στις οποίες είχαν τοποθετηθεί εξαρτήματα από κράματα αντιμικροβιακού χαλκού, ο κίνδυνοs προσβολής από λοίμωξη μειώθηκε περισσότερο από 40% ⁴.

Διαβάστε περισσότερα Εφαρμογές Αντιμικροβιακού Χαλκού στις ΜΕΘ

Efstathiou, Panos & Kouskouni, Evangelia & Manolidou, Z. & Tseroni, Maria & Karageorgou, Katerina & Maltezou, Helena & Chalkias, Athanasios & Papanikolaou, Seraphim & Efstathiou, Andreas & Logothetis, Emmanouil. (2015). Copper-coated thermometer for the prevention of cross-infections: Preliminary results. The American Journal of Emergency Medicine. 34. 10.1016/j.ajem.2015.12.028.

To the Editor,
Research has shown that axillary thermometers are contaminated at a rate of 80% to 100% [1–3]. Although the common digital thermometer is always disinfectedwith an alcohol solution after each use, disinfection is only partially achieved or fails, potentially leading to resistant bacteria and sepsis [4–6].

Considering that antimicrobial copper reduces the microbial load on surfaces made from special alloys, copper-coated thermometers may potentially reduce cutaneous pathogens [7]. Thismay be of great importance; a novel method for reducing contamination is always a significant step in the prevention of hospital-acquired infections. The aim of this study is to evaluate the reduction of microbial flora on the surface of an axillary digital thermometer coated with antimicrobial copper.

A newdigital thermometerwasmanufactured and coatedwith antimicrobial copper (Cu 70%, Nic 30%, lowlead) at its two ends (probe and base). Our thermometer and its antimicrobial technology (C-T) has been patented (World Patent Number WO2013064847) and received Certification by the Hellenic Copper Development Institute (register no. 11/2012). In our study, 9 C-T and 9 common digital thermometers were used in accordance with the manufacturer’s guidelines.

Until now, 9 randomly selected nonseptic patientswhowere hospitalized for at least 3 days in the intensive care unit (ICU) have been included. Written consent was obtained from patients or next of kin, whereas the study was approved by the ethics committee of the hospitals. The samples were collected frompatients’ axillae at 14:00 PM, to ensure that sufficient time had elapsed fromthe matutinal patient care. All samples were taken by the same physician to avoid interindividual variation and were immediately analyzed (Api System Biomereaux, Durham, NC). Axillary temperature was measured immediately after collection of the first sample and then every 2 hours for a total of 24 hours. After eachmeasurement, the common thermometerwas sterilized according to the ICU’s protocol, whereas the C-T was placed onto sterile gauze. After 24 hours, swab cultures were collected from the axillary regions as well as from both common thermometer and C-T (Figure). The last temperaturemeasurementwas performed 1 hour before final sampling. Patientswere not cleaned during the sampling period. The “Halo effect” (also known as phenomenon “Stefanis”) on the noncopper parts of the C-T was also evaluated.

Until now, 216 samples have been collected (72 axillary, 72 fromthe 4 points of the common thermometer, and 72 from the 4 points of C-T (Table).Wefound a significant decrease (95%-99%) in isolatedbacteriabetween the first and second axillary C-T sample and a 95% decrease of bacterial flora at the uncoated points B and C on the C-Ts (P b .001).

Thermometer is one of the most frequently used medical equipment in hospitals and a potent source of infection [3–6,8–11]. Of note, thermometers have been implicated in the development of sepsis due to vancomycin-resistant Enterococcus faecium and Enterobacter cloacae [4–6]. Interestingly, common disinfectionmethods have not been proved to be 100% effective in thermometers colonized by E cloacae [4,10]. On the other hand, antimicrobial copper may reduce cross-infections, especially when combined with other rigorous preventable measures. Based on our preliminary results, C-T may be a promising method for decreasing nosocomial cross-infections and health care cost. Regardless of our final results, additional studies would be required to validate C-T.

Διαβάστε περισσότερα https://www.researchgate.net/publication/291017161_Copper-coated_thermometer_for_the_prevention_of_cross-infections_Preliminary_results

Mιχαήλ Σεµιλιέτωφ 1, Αικατερίνη Χαρανά 2, Χρήστος Βαφειάδης 3, Σπυρίδων Νόνης 3, Βασιλική Σούλια 4, Αγγελική Βαλωτή 5, ∆ρ Αντιγόνη Καραθάνου 6
1.Υποδιευθυντής Ν.Υ. Χειρουργικού Τοµέα, Γ.Ν. Βόλου, 2.∆ιευθύντρια Ν.Υ., Γ.Ν. Βόλου, 3.Νοσηλευτής ΜΕΘ, Γ.Ν. Βόλου, 4. Νοσηλεύτρια ΜΕΘ, Msc, Γ.Ν. Βόλου, 5.Προϊσταµένη ΜΕΘ, Γ.Ν. Βόλου, 6.∆ιευθύντρια MEΘ, M.D., Αναισθησιολόγος – Εντατικολόγος, Γ.Ν. Βόλου

Η αύξηση της µικροβιακής αντοχής στα αντιβιοτικά και η εκτεταµένη εµφάνιση των νοσοκοµειακών λοιµώξεων αποτελεί ένα διεθνές φαινόµενο και έχει προκαλέσει την άµεση κινητοποίηση της επιστηµονικής κοινότητας και των φορέων υγείας. Οι κατεξοχήν χώροι ανάπτυξης του µικροβιακού φορτίου είναι οι Μονάδες Εντατικής Θεραπείας (ΜΕΘ), κυρίως λόγω της αυξηµένης χρήσης αντιβιοτικών, της ανάπτυξης της τεχνολογίας και της βαρύτητας της υγείας των νοσηλευόµενων στις ΜΕΘ. Στην προσπάθεια αντιµετώπισης των νοσοκοµειακών λοιµώξεων φαίνεται ότι έχει θέση πλέον και ο αντιµικροβιακός χαλκός, αφού η βιβλιογραφία επιβεβαιώνει την αντιµικροβιακή δράση του σε εργαστηριακό επίπεδο, τόσο για κοινά µικρόβια όσο και για τα δύσκολα και πολυανθεκτικά ενδονοσοκοµειακά µικρόβια (von Dessauer et al 2016) .

Διαβάστε περισσότερα efarmogi-entimikroviakou-xalkou

Panos A Efstathiou, European Infectious Disease, 2011;5(2):125-8

Abstract
Recent work investigating the antimicrobial characteristics of copper has led to a re-evaluation of the role of this essential metal in healthcare. While ancient civilisations used copper for its health benefits it seems its usefulness has been forgotten. The requirement for evidence-based interventions for infection control has been the driver behind recent scientific assessments of the benefits of copper. Ten years of laboratory research has led to clinical trials confirming a very significant and continuous reduction in environmental bioburden in a number of healthcare settings globally. The newest and most comprehensive clinical research has now reported an impressive 40 % reduction in healthcare-associated infections in intensive care units (ICUs) where copper was incorporated in key touch surfaces. The deployment of copper touch surfaces should be considered as an additional infection control measure to reduce care costs and improve bed availability and patient outcomes.

Διαβάστε περισσότερα https://www.researchgate.net/publication/233387430_Healthcare-associated_Infections_The_Role_of_Antimicrobial_Copper_Surfaces_in_Reducing_Healthcare-associated_Infections

Maria Souli1*, Irene Galani1, Diamantis Plachouras1, Theofano Panagea1†, Apostolos Armaganidis2, George Petrikkos1 and Helen Giamarellou1‡ 14th Department of Internal Medicine, Athens University School of Medicine, University General Hospital ‘Attikon’, 1 Rimini Str. 124 62, Chaidari, Athens, Greece; 22nd Department of Critical Care Medicine, Athens University School of Medicine, University General Hospital ‘Attikon’, 1 Rimini Str. 124 62, Chaidari, Athens, Greece

Objectives: The antimicrobial activity of copper surfaces against a variety of contemporary carbapenemase- producing Gram-negative bacteria representative of the most problematic nosocomial pathogens worldwide was evaluated.

Methods: Twenty-four clinical isolates, comprising four of Escherichia coli, two of Enterobacter spp., eight of Klebsiella pneumoniae and five each of Pseudomonas aeruginosa and Acinetobacter baumannii producing either VIM-1 and/or KPC-2 or VIM-2 or OXA-type carbapenemases, were studied. The antimicrobial activity of 99% copper (Cu99%) and a 63% alloy (Cu63%) was evaluated in comparison with that of stainless steel (SS) and polyvinylchloride (PVC) by incubating ×106 cfu/cm2 of the tested strains on each surface at room temperature.

Results: Copper demonstrated antimicrobial activity against all studied isolates. This effect was observed earlier and was more pronounced for Cu99% than for Cu63%. Cu99% showed a bactericidal effect after ,2 h for A. baumannii, 3 h for Enterobacter spp., 5 h for K. pneumoniae and 6 h for P. aeruginosa and E. coli. No viable colonies were recovered from five (20.8%) isolates after 3 h and from nine (37.5%) isolates after 5 h of incu- bation on Cu99%.

Conclusions: Copper has significant antimicrobial activity against multidrug-resistant nosocomial Gram- negative pathogens. This supports the hypothesis that replacement of high-contact materials with copper could reduce the high burden of environmental contamination around high-risk patients. However, this strategy should be seen as an adjunctive measure to established cleaning protocols and to good hygiene practices for prevention of hospital-acquired infections.

Διαβάστε περισσότερα dks473

Efstathiou P., Anagnostakou M., Kouskouni E., Petropoulou C., Karageorgou K, Tseroni M., Manolidou Z., Papanikolaou S., Logothetis E., Tzuma H., Agrafa I.

Διαβάστε περισσότερα: Halo phenomenon

Efstathiou P., Kouskouni E., Karageorgou K, Tseroni M., Manolidou Z., Papanikolaou S., Logothetis E., Tzuma H., Petropoulou C., Agrafa I.

Διαβάστε περισσότερα: Antimicrobial copper application and its influence to the epidemiological data in elementary school population