ABSTRACT
BACKGROUND: The introduction of antimicrobial surfaces into healthcare environments is believed to impact positively on the rate of healthcare-associated infections by significantly decreasing pathogen presence on surfaces. AIM: To report on a novel efficacy test that uses a dry bacterial inoculum to measure the microbicidal efficacy of antimicrobial surfaces. METHODS: An aerosolized dry inoculum of Staphylococcus aureus or Acinetobacter baumannii was deposited on copper alloy surfaces or a hospital-grade stainless-steel surface. Surviving bacteria were enumerated following incubation of the inoculated surfaces at an environmentally relevant temperature and relative humidity. Damage caused to bacteria by the aerosolization process and by the different surfaces was investigated. FINDINGS: Dry inoculum testing showed a <2-log10 reduction in S. aureus or A. baumannii on the copper alloy surfaces tested after 24 h at 20°C and 40% relative humidity. Potential mechanisms of action included membrane damage, DNA damage and arrested cellular respiration. The aerosolization process caused some damage to bacterial cells. Once this effect was taken into account, the antimicrobial activity of copper surfaces was evident. CONCLUSIONS: Our test provided a realistic deposition of a bacterial inoculum to a surface and, as such, a realistic protocol to assess the efficacy of dry antimicrobial environmental surfaces in vitro.
Subject(s)
Aerosols/pharmacology , Alloys , Bacteria/drug effects , Coated Materials, Biocompatible/standards , Copper/pharmacology , Microbial Viability , Acinetobacter baumannii/drug effects , Anti-Bacterial Agents/pharmacology , Anti-Infective Agents/pharmacology , Cross Infection/microbiology , Cross Infection/prevention & control , Freeze Drying , Humidity , Staphylococcus aureus/drug effects , Surface Properties , TemperatureABSTRACT
BACKGROUND: Antimicrobial surfaces aim to reduce microbial bioburden and improve hygiene. The current antimicrobial surface efficacy test (ISO22196) is an initial screening test but its conditions, high temperature (37°C) and relative humidity (RH) (100%) bear little relationship to in-use conditions. AIM: To develop an antimicrobial surface efficacy test providing a realistic second-tier test, simulating in-use conditions. METHODS: Surface relative humidity, temperature and soiling were measured over one year at a UK hospital, enabling realistic parameters to be set for our surface efficacy test. A nebulizer, connected to a cascade impactor, aerosolized and uniformly deposited a Staphylococcus aureus suspension over test copper alloys and control stainless steel surfaces. Bacteria were enumerated following nebulization, and after a range of contact times, under [20°C, 50% RH] and [20°C, 40% RH] parameters reflecting in-use conditions; [37°C, 100% RH] was employed to reflect conditions used in ISO22196. FINDINGS: All copper alloys produced a >4 log10 reduction after 24h under all conditions tested. Copper alloys were more effective at [37°C, 100% RH] showing a >4 log10 reduction after 30 min than at in-use conditions [20°C, 50% RH and 20°C, 40% RH], for which 60 min was required to achieve the same level of kill, for most but not all alloys. CONCLUSION: The use of the nebulizer to deposit bacterial inocula on surfaces showed little variability in results. Our method was more discriminatory than the ISO22196 enabling distinction between the bactericidal surface activity, which allows for a more rigorous selection of antimicrobial surfaces for potential use in healthcare settings.
