96% reduction in bacteria in a hospital environment

The control of healthcare-associated infections (HCAIs) remains a challenge for healthcare providers. This involves employing a combination of infection prevention and control strategies, including hand hygiene, cleaning, training and the adoption of new technologies, to tackle the problem.

As a result, a wide range of infection control products and technologies are
available on the market, including antimicrobial technology. BioCote Ltd works
with equipment manufacturers, engineering silver ion technology into a variety
of healthcare related products, helping them to resist the growth of bacteria
and mould on their surface. Silver is an ideal antimicrobial agent because it
has a high efficacy against a wide range of medically-important microorganisms
and is regarded as nontoxic.

For the NHS and other healthcare providers to employ new technologies and products
they need to show a demonstrable ability to contribute positively to infection
control. The use of any product that claims it has antimicrobial efficacy should
be supported by a robust evidence-base.


Spreading bacteria in a hospital environment




A pilot study, conducted at the Heart of England NHS Foundation Trust, investigated
to what extent BioCote® antimicrobial products can reduce microbial contamination
in a healthcare environment. In independent laboratory tests, BioCote® antimicrobial
protected materials regularly demonstrate reductions in counts of E. coli and
S. aureus greater than 99%, compared with untreated samples. The aim of this
study was to determine to what degree this high level of antimicrobial efficacy
could be achieved in a real-life hospital environment.



Two outpatient units provided the environments for this 18 month pilot study.
Unit A was refurbished with BioCote® treated products including blinds, tiles,
door handles, sack holders and light switches and also a number of untreated
products. A similar, refurbished outpatient ward containing untreated items
(Unit B), served as a control. Both outpatient units were similar in terms of
volume of people, layout and floor-surface area and were subjected to standard
cleaning practice. Both were allowed to function for 12 months before swabbing
commenced. Swabs were collected over a five month period from BioCote® treated
and untreated products in both outpatient units. Swabs were processed for total
counts of viable bacteria and results expressed as average counts of colony-forming
units (CFUs).



• Table 1 shows that CFU counts from BioCote® treated products in unit A were
between 62% and 98% lower than from comparable, untreated products in Unit B.

• The products used in the trial were manufactured from a variety of materials
e.g plastics and fabrics. CFU counts from these different materials were also
compared and are shown at the bottom of Table 1.

• CFU counts from BioCote® treated materials were between 70% (fabrics) to 99%
(laminates) lower than untreated equivalents.

• CFU counts from BioCote® treated products in Unit A were compared with CFU
counts from untreated products in both Unit A and Unit B.

• CFU counts on untreated products in Unit A were also compared to untreated
products in Unit B.



Table 1

Unit A - BioCote® treated vs Unit B - Untreated % reduction of CFU counts, on
products & materials


Bacteria in hospital, spread on products



Figure 1: Inter-site comparison of average (mean) CFU counts
from BioCote® treated and untreated products in Units A and B.



Bacteria in hospital, percentages of reduction





Results suggest that BioCote® antimicrobial products will demonstrate the
same high level of antimicrobial efficacy in a real-life environment as seen
in laboratory tests, e.g. an average bacterial reduction of 95.8%. In addition
to the effect of standard cleaning, BioCote® antimicrobial products showed sustained
reductions in bacterial counts, compared to untreated products. Because BioCote®
technology does not wear out or wipe off surfaces, it can provide a continuous
decontamination effect. Treated products can complement cleaning practices,
helping to continually reduce levels of bacteria on surfaces and in the wider
healthcare environment.

Bacterial contamination on untreated products in Unit A was on average 43.5%
lower compared with untreated products in Unit B. This suggests that a reduction
in bacteria on BioCote® antimicrobial surfaces results in lower numbers of bacteria
on other surfaces because there are fewer bacteria being transferred. Using
a number of antimicrobial objects in a healthcare environment may therefore
help the decontamination of the wider environment.