Schmidt, Michael G, Von Dessauer, Bettina, Benavente, Carmen, et al. 2015.

Copper surfaces are

associated with significantly lower concentrations of bacteria on selected surfaces within a
pediatric intensive care unit. American Journal of Infection Control. 2015 Nov.
http://dx.doi.org/10.1016/j.ajic.2015.09.008
Adrian Sarli
1-19-2016
Reading Report 1
Summary
A pediatric hospital installed antimicrobial copper surfaced objects in half of the rooms in two of
their acute care wards for 12 months. The hospital installed copper bed rails, bed rail levers,
intravenous poles, faucet handles and workstation surfaces. The particular alloy used was one
specifically recognized by the US Environmental Protection Agency as anti-microbial. The
microbial levels on commonly-touched surfaces were measured twice a month during the
experimental period. The microbial levels were compared to a control patient room with normal,
non-copper objects. It was suggested that a microbe level of 500 colony-forming units (CFU) per
100 cm2 could put patients at increased risk for a hospital acquired infection, so this was set as
the hospitals goal. The mean level for each tested control-group object in the study was above
this danger level. However, the copper objects in the experimental group measured during the
study had mean levels significantly below the danger level and 40% lower than the control
objects. In addition, many of the samples had microbial levels that were undetectable by the
sampling techniques used. These findings demonstrated that copper can be similarly effective in
a pediatric setting as previous studies demonstrated in adult intensive care unit settings. The
study suggests that hospitals may find it beneficial to consider installing more copper-surfaced
items in all their roomspediatric as well as adult.

Evaluation

This study does a good job of demonstrating that copper surfaces may reduce the levels
of bacteria present in hospital rooms. However, the study has some inherent challenges. The
study was not blinded. The fact that the hospital staff could easily tell which rooms were in the
experimental control groups had the potential to affect their behaviorperhaps the staff took
greater precautions in the experimental rooms (more thorough hand washing, for example). It
would be non-trivial to blind an experiment of this type however, as its pretty obvious to the
staff which room contains copper objects. It may be possible, though, to find some sort of paint
or powder-coat that mimics the look and feel of a copper coating that could be used on the
control group.
Based on this study we would have good grounds for hypothesizing that copper-covered
objects would reduce the incidence of hospital acquired infections, but it would be good to do a
follow-up study to demonstrate this. Fewer bacteria in a room doesnt necessarily mean a lower
infection rate. There may be unknown factors that would lead the copper-covered objects to
contain a higher percentage of especially dangerous bacteria for example. Or perhaps hospitalacquired infections dont rely on room objects for their spreadperhaps they are more often
spread directly by a staff member with unwashed hands touching a patient. A study that pointed
to clinical results directly attributable to copper objects might encourage more hospitals to begin
rethinking their room design.
Another flaw in this study is the deviance from the protocol due to the hospital being at
over 100% capacity during peak season. While this estimated 12% deviation from the protocol
should have caused the copper to appear less effective than it really was, it is nevertheless an

anomaly, and if possible, it would be good to see a replication of this work with closer adherence
to the protocol.