Effect of copper-impregnated composite bed linens and patient gowns on healthcare-associated infection rates in six hospitals

Background: Hospital linens and patient gowns are frequently touched and contaminated, and may contribute to endogenous, indirect-contact, and aerosol transmission of nosocomial-related pathogens. Recently Sentara Healthcare adopted biocidal copper oxide-impregnated linens across its hospitals. Aim: To assess whether the replacement of the linens resulted in the reduction of healthcare-associated infection (HCAI). Methods: Rates of HCAI caused by Clostridium difficile and multidrug-resistant organisms (MDROs) were compared in six Sentara Healthcare hospitals with similar patient demographics (total of 1019 beds) in three parallel periods (90, 180 and 240 days) before and after (periods A1, A2 and A3, and periods B1, B2, and B3, respectively), replacing all the regular non-biocidal linens with the copper oxide-impregnated biocidal linens. Findings: During periods B1, B2, and B3, compared with periods A1, A2 and A3, there were 61.2% (P < 0.05), 41.1% (P < 0.05) and 42.9% (P < 0.01) reductions in HCAI per 10,000 patient-days in hospital caused by C. difficile, respectively; 48.3% (P > 0.05), 36.4% (P > 0.05), and 19.2% (P > 0.05) reductions in HCAI per 1000 patient-days caused by MDROs; and 59.8% (P < 0.01), 39.9% (P < 0.05), and 37.2% (P < 0.05) in the reduction of HCAI per 1000 patient-days caused by C. difficile and MDROs combined. Conclusion: The use of biocidal copper oxide-impregnated linens in the six analysed Sentara Healthcare hospitals resulted in significant reduction in both HCAI caused by C. difficile, and the combined metric of C. difficile or MDRO infection. Similar reductions in HCAI caused by MDROs were observed, although these reductions did not reach statistical significance, probably due to very low HCAI rates caused by these pathogens in the study facilities. (C) 2018 Published by Elsevier Ltd on behalf of The Healthcare Infection Society.