163. Copper Surfaces (CuS) Significantly Lower Rate of Hospital Acquired Infections (HAIs) in the Medical Intensive Care Unit (MICU)
Session: Oral Abstract Session: Infectious Diseases Practice Challenges
Friday, October 21, 2011: 11:15 AM
Room: 151AB
Background: HAIs result in significant patient (pt) morbidity and mortality. Environmental surfaces are known to harbor microorganisms; however the contribution of surface contamination to HAIs has not been well defined.  Previously we reported that CuS reduced the median environmental bioburden by 97% compared to non-copper surfaces in MICU pt rooms. We now report the effect of CuS on HAIs among MICU pts.

Methods: Pts admitted to the MICU in 3 hospitals from 7/12/10 - 5/13/11 were randomly placed into rooms with either standard (plastic, wood, stainless or chrome) surfaces or rooms with CuS (bedrails, IV pole, overbed table, chair, computer monitor bezel, and call button or computer mouse).  Pts were characterized and followed prospectively for development of HAI or for new MRSA or VRE colonization. HAIs were defined by NHSN criteria.

Results: 564 pts were admitted over the study period (233 to hospital A, 182 to hospital B, and 149 to hospital C) of whom 269 (47.7%) were admitted to rooms with CuS. There was no significant difference in age, sex, race, APACHE II score, presence of infection on admission, or MICU LOS between those admitted to rooms with CuS and those to rooms without CuS. The overall HAI rate was 12.23 per 1000 pt days and was significantly lower in copper vs standard rooms [8.95 vs 15.16 per 1000 pt days, OR 0.55 (95%CI 0.41-0.73), p=0.00003]. In addition, the overall MRSA or VRE acquisition rate was 7.55 per 1000 pt days and was significantly lower in copper vs standard rooms [6.12 vs 8.8 per 1000 patient days, OR 0.67 (95%CI 0.47-0.96), p=0.03].  In the subpopulation of pts admitted to rooms where all 6 objects with CuS remained in the room for the entire MICU stay, there was an even greater effect on reduction of HAIs vs those never exposed to CuS [6.88 vs 15.72, OR 0.40 (95%CI 0.29-0.54), p<0.0001].

Conclusion: CuS have been shown to reduce environmental bioburden when placed into MICU pt care rooms. In this study we demonstrate that pts admitted to MICU rooms with CuS are significantly less likely to develop HAIs or to acquire MRSA or VRE compared to those admitted to rooms without CuS. This suggests that environmental bioburden contributes substantially to risk of HAI in the MICU and that by reducing bioburden (through placement of CuS) this risk can be significantly lowered. 

Subject Category: N. Hospital-acquired and surgical infections, infection control, and health outcomes including general public health and health services research

Cassandra Salgado, MD, MS1, Kent A. Sepkowitz, MD, FIDSA2, Joseph John, MD3, Joseph Cantey, MD1, Urania Rappo, MD, PharmD4, Hadi Baig3, Susan Singh, MPH2, Hubert Attaway1, Harold Michels, PhD5 and Michael Schmidt, PhD1, (1)Medical University of South Carolina, Charleston, SC, (2)Memorial Sloan Kettering Cancer Center, New York, NY, (3)Ralph H. Johnson VA Medical Center, Charleston, SC, (4)Memorial Sloan-Kettering Cancer Center, New York, NY, (5)Copper Development Association, New York, NY


C. Salgado, Department of Defense: Investigator, Research grant

K. A. Sepkowitz, Department of Defense: Investigator, Research grant

J. John, Department of Defense: Investigator, Research grant

J. Cantey, Department of Defense: Investigator, Research grant

U. Rappo, None

H. Baig, None

S. Singh, None

H. Attaway, None

H. Michels, Copper Development Association: Employee, Salary
Department of Defense: Investigator, Research grant

M. Schmidt, Department of Defense: Investigator, Research grant

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.