1961. A Randomized Controlled Trial of the Effect of Accelerated Copper Textiles on Healthcare-Associated Infections and Multidrug-Resistant Organisms: The “Investigating Microbial Pathogen Activity of Copper Textiles” (IMPACT) Study
Session: Poster Abstract Session: Clinical Trials
Saturday, October 6, 2018
Room: S Poster Hall
Background: Healthcare-associated infections (HAIs) and multidrug-resistant organisms (MDROs) remain critically important problems. Although copper has well-described antimicrobial properties, the impact of copper-impregnated linens on HAIs and MDROs in healthcare settings remains undefined.

Methods: This study was conducted in a 24-bed medical ICU and a 24-bed surgical ICU from 1/12/16 to 7/31/16. Six beds in each ICU were randomized to CottonX™ accelerated copper linens (flat sheet, fitted sheet, pillow cover, gown) (Argaman Technologies Ltd.) and 18 beds to regular linens. Patients were enrolled if they were in the ICU for ≥3 days and were followed prospectively for development of an HAI (including C. difficile infection) and/or MDRO from ICU day 3 through 2 days after ICU discharge. MDROs were defined as a new clinical culture (i.e., no culture with the same organism in the prior year) with methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, or ceftriaxone-resistant or carbapenem-resistant Enterobacteriaceae. A patient could be included more than once for distinct ICU stays (“episodes”).

Results: Among 1,021 subjects, the median age was 61 and 448 (44%) were female. Of 1,205 total episodes, 678 (56%) were in the MICU, 527 (44%) were in the SICU, and 351 (29%) were randomized to copper rooms. There were no significant differences between study groups with regard to demographics, comorbidities, indwelling devices, or antibiotic use. The overall rate (per 1,000 patient days) of the composite outcome (HAI or MDRO) was 11.66 and 15.44 in copper and non-copper episodes, respectively, [incidence rate ratio (IRR) = 0.76 (95% CI, 0.46, 1.19); p=0.22]. Rates of HAIs were 10.26 and 10.41 for copper and non-copper episodes, respectively ([IRR (95% CI) = 0.99 (0.57, 1.64); p=0.97]. Rates of MDROs were 3.73 and 6.51 for copper and non-copper episodes, respectively [IRR (95%CI) = 0.57 (0.23, 1.26); p=0.15]. Results were consistent when stratified by type of ICU.

Conclusion: While not statistically significant, there was a nearly 50% lower rate of MDRO infection and colonization with use of CottonX™ accelerated copper linens, possibly in part due to decreases in environmental contamination. Future work should further explore the role of copper linens in reducing MDROs.

Ebbing Lautenbach, MD, MPH, MSCE, FIDSA, FSHEA1, David Pegues, MD, FIDSA, FSHEA2, Barry Fuchs, MD3, Niels Martin, MD4, Irving Nachamkin, DrPH, MPH4, Warren Bilker, PhD5, Pam Tolomeo, MPH6, Leigh Cressman, MA7, Jacqueline Omorgobe, BS4, Kristen Johnson, BS4, Jennifer Han, MD, MSCE8 and CDC Prevention Epicenters Program, (1)Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, (2)Healthcare Epidemiology, Infection Prevention and Control, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, (3)Division of Pulmonary Medicine and Critical Care, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, (4)University of Pennsylvania, Philadelphia, PA, (5)Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, (6)Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, (7)Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, (8)Division of Infectious Diseases, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA

Disclosures:

E. Lautenbach, None

D. Pegues, DaVita / Total Renal Care: Consultant , Consulting fee .

B. Fuchs, None

N. Martin, None

I. Nachamkin, None

W. Bilker, None

P. Tolomeo, None

L. Cressman, None

J. Omorgobe, None

K. Johnson, None

J. Han, None

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