Effect of Copper Impregnated Textiles on Healthcare Associated Infections and Antibiotic Use

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

Inclusion Criteria:All patients >18 years and <90 years who were admitted to the GICU
during the study period

Exclusion Criteria:

1. Those that did not meet the age criteria as above.

2. Any patients with Menke's syndrome or Wilson's disease

3. Any patient with an allergy to copper or iodine

4. Any patient who wishes to opt out of participating