Impact of a Novel Antimicrobial Surface Coating on Healthcare-Associated Infections and Environmental Bioburden at Two Urban Hospitals.

Abstract

BACKGROUND Approximately 1 in 25 people admitted to a hospital in the United States will suffer a healthcare-associated infection (HAI). Environmental contamination of hospital surfaces contributes to HAI transmission. We investigated the impact of an antimicrobial surface coating on HAIs and environmental bioburden at two urban hospitals. METHODS A transparent antimicrobial surface coating was applied to patient rooms and common areas in three units at each hospital. Longitudinal regression models were used to compare changes in hospital-onset multidrug-resistant organism bloodstream infection (MDRO-BSI) and Clostridium difficile infection (CDI) rates in the 12 months before and after application of the surface coating. Incidence rate ratios (IRRs) were compared for units receiving the surface coating application and for contemporaneous control units. Environmental samples were collected pre- and post-application to identify bacterial colony forming units (CFU) and percent of sites positive for select clinically relevant pathogens. RESULTS Across both hospitals, there was a 36% decline in pooled HAIs (MDRO-BSI + CDI) in units receiving surface coating application (IRR=0.64, 95% CI=0.44-0.91), and no decline in control units (IRR=1.20, 95% CI=0.92-1.55). Following the surface application, total bacterial CFU at Hospitals A and B declined by 64% and 75%, respectively; the percentage of environmental samples positive for clinically relevant pathogens also declined significantly for both hospitals. CONCLUSIONS Statistically significant reductions in HAIs and environmental bioburden occurred in units receiving the antimicrobial surface coating, suggesting the potential for improved patient outcomes and persistent reduction in environmental contamination. Future studies should assess optimal implementation methods and long-term impact.