Effect of Copper Impregnated Textiles on Healthcare Associated Infections and Antibiotic Use
Condition: Hospital Acquired Infection
MeSH terms: Infections; Communicable Diseases; Cross Infection
Study type: Observational

Summary: 
      This is a prospective Infection Control study comparing rates of antibiotic usage and
      infections in the General Intensive Care Unit (GICU) in beds with copper impregnated linens
      versus regular linens.
    

Detailed description: 
      One ward of the ICU had copper impregnated linen while the other had regular linen. This
      included sheets, pillowcases, towels and patient gowns. After the first 23 week period was
      completed, there was a 3 week washout period. After this, the wards were switched with the
      first using regular linen and the second using copper impregnated linen.

      The investigators followed participants and documented any infections >48 hours after
      admission to the ICU. The number and days of antibiotics used for the infections were also
      documented. Using assigned study numbers, the investigators obtained demographic data: age,
      sex, co-morbid conditions, and admitting diagnosis. All participants were followed daily in
      the GICU and daily for 48 hours after transfer to the regular floor. Date of discharge will
      be obtained retrospectively. Infection control (IC) routinely obtains Methicillin Resistant
      Staphylococcus Aureus (MRSA) nasal swabs on all patients on admission to the GICU, once
      weekly while in GICU and then again on discharge from the GICU. They monitor the GICU
      patients for healthcare associated infections (HAI) that meet the National Healthcare Safety
      Network (NHSN) 146 definitions. The NHSN is a widely used HAI tracking system, and the
      infections documented included Ventilator associated pneumonia (VAP), Catheter related blood
      stream infections (CLABSI), catheter associate urinary tract infections (CAUTI) and
      Clostridium difficile associated diarrhea (CDAD). They also obtain information on decubitus
      ulcers (bed sores) that develop during hospital stay. Infection control also routinely
      monitors the isolation of multi-drug resistant bacteria, namely Vancomycin Resistant
      Enterococci (VRE), Extended Spectrum beta Lactamase producing organisms (ESBL) and
      Carbapenemase producing enterobacteriaceae (CRE) as well as Multi drug resistant (MDR )
      Acinetobacter baumanii from cultures. This above information will be obtained from the IC
      nurses on a weekly basis by the investigators.

      As most of the infections in the ICU do not meet strict NHSN criteria, the investigators
      defined an infection as: the physician diagnosing an infection, and then initiating
      antibiotics for the same.

      Copper linen were implemented the same as regular linen. There was no difference in the
      nursing or physician staff on either side. No interventions were made other than existing
      hospital wide IC interventions
    

Intervention name(s): Copper impregnated linen
Intervention type(s): Other
Intervention description(s): Copper impregnated linen was used in place of regular linen on one ward (out of two) for each period of the study. Each study period lasted for 23 weeks. After the washout period (3 weeks) the wards were switched.
Intervention MeSH terms: Copper
Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        All patients >18 years and <90 years who were admitted to the GICU during the study period
      
Keywords: infection control; Prevention of hospital acquired infection