ANTIMICROBIAL PAPER ANTIMICROBIAL PAPER By

Dr Anjum HashmiDr Anjum HashmiMBBS,CCS(USA),MPHMBBS,CCS(USA),MPH

Infection Control DirectorInfection Control DirectorMaternity & Children’s HospitalMaternity & Children’s Hospital

Najran KSANajran KSA

RISK OF INFECTIONSRISK OF INFECTIONS• Patient may acquire infection before admission to

an hospital known as Community acquired infection.

• Patient may get infected inside the hospital known as Nosocomial infection/Healthcare Associated Infection.

• It includes infections not present nor incubating at time of

admission, infections that appear more than 48 hours after

admission, infections those acquired in the hospital but

appear after discharge, and also occupational infections among staff.

PREVALENCE HEALTHCARE PREVALENCE HEALTHCARE ASSOCIATED INFECTIONSASSOCIATED INFECTIONS

• The problem is huge, it is estimated that there are over 1.4 million cases of HAI at any given time, although this is likely to be a gross underestimation, due to the lack of proper surveillance.

• Although no health-care setting across the globe can claim to be free of HAI, there is a difference between developed and developing countries in terms of the incidence and type of infections.

PREVALENCE OF HAIsPREVALENCE OF HAIs• Developed countriesDeveloped countries• In developed countries, with sophisticated treatments and

technologies, HAI continues to account for complications in 5-10% of admissions to acute-care hospitals. For example, in the U.S. alone there are at least 80,000 fatalities each year (about 200 deaths/day) from HAI. (WHO 2013)

• Developing countriesDeveloping countries• In developing countries, the impact of HAI is far greater, with the

risk being two- to twenty-fold higher than those in the developed world, and prevalence studies report hospital-wide infection rates usually higher than 15%. (WHO 2013)

• In these countries, over 4000 children die of HAI every day.• Approximately half of all patients admitted to neonatal intensive

care units acquire an infection, and over half of them die.

HAND HAND HYGIENE/WASHINGHYGIENE/WASHING

• Hand hygiene is the single most important intervention to prevent transmission of infection and should be a quality standard in all health care institutions.

• Each and every HCW has a responsibility to prevent transmission of infection.

(CDC, 2005)

HAND WASHINGHAND WASHING• Scientific evidences showed that microbes

causing HAI are most frequently spread between patients on the hands of health-care workers.

• Hand hygiene is a simple, low-cost action to prevent the spread of the microbes that cause health care-associated infections (HAI).

• Though hand hygiene is not, the only measure to counter HAI, but its compliance alone can dramatically enhance patient safety.

FEW FACTSFEW FACTS• Bacteria survive on average 20 minutes to 2 hours on hard

surfaces such as desks, doorknobs and tables.• A surface as small as a pinhead may contain up to

10 million bacteria.• Bacteria can double their number in 20 minutes.• We can eliminate 90% of germs through proper hand

washing.• Wet hands spread 60,400 bacteria, while dry hand can only

spread 200.• Residual moisture left on improperly dried hands is the key

factor for bacterial contamination and transmission. • Thus drying of hands is a key factor in reducing the risk of

infection.

MRSA ON DAMP CLOTH TOWELMRSA ON DAMP CLOTH TOWELSUPER BUG MRSASUPER BUG MRSA

DAMP TOWELS PROVIDE ADAMP TOWELS PROVIDE ABREEDING GROUND FOR MRSABREEDING GROUND FOR MRSA

Source: Thomas Pat, www.theecologist.org

Source: www.hero.ac.uk

HAND DRYINGHAND DRYING• Effective drying of the

hands is an essential part of the hand hygiene process.

• A study was conducted by the University of Westminster, UK in 2009, to compare the levels of hygiene offered by

• Paper towels.• Warm-air hand dryers. • HEPA filter jet-air hand

dryers.

KEY STUDY FINDINGSKEY STUDY FINDINGS• After washing

• When dried hands with the warm-air dryer, the total number of bacteria was found to increase on average on the finger pads by 194% and on the palms by 254%.

• When dried with the jet-air dryer, the total number of bacteria was found to increase on average on the finger pads by 42% and on the palms by 15%.

• When dried hands with a paper towel, the total number of bacteria was reduced on average on the finger pads by up to 76% and on the palms by up to 77%.

SUMMARY OF DRYER SUMMARY OF DRYER CHARACTERISTICSCHARACTERISTICS

Keith Redway University of Westminster 2009

ANTIMICROBIAL TOWELANTIMICROBIAL TOWEL• Washing and drying hands, although

proved to helpful in eliminating microbes, but does not completely eliminates the microbes on skin.

• Antibacterial Paper Towels can provide a simple and effective way to further reduce bacterial contamination and transmission thus reduce HAIs.

HOW IT WORKSHOW IT WORKS• Cascades has added an active antibacterial

ingredient benzalkonium chloride to its paper towel. • Incorporate a high-tech antibacterial coating on the

surface of paper in micro-capsules which release a sterilizing agent, as towel absorbs water from hands, and the highly soluble antibacterial ingredient is transferred from the towel to the skin. This simple action is what quickly kills 99.9% of residual bacteria.

• The paper towel is green to distinguish it from regular paper hand towels.

• Conform and approved by FDA regulations and policies.• Based on 3rd party laboratory testing, Processed Chlorine Free)

A GREEN PRODUCT—Inside and OutA GREEN PRODUCT—Inside and Out• It contains 100% recycled fiber.• Manufactured with 5 times less water than

the North American paper industry average. (source : AF&PA 2009)

• Third party certification: Processed Chlorine Free thus environmental friendly.

OTHEROTHERANTIMICROBIAL PAPER ANTIMICROBIAL PAPER

& & PAPER PRODUCTSPAPER PRODUCTS

TO REDUCE TO REDUCE HEALTHCARE HEALTHCARE

ASSOCIATED INFECTIONSASSOCIATED INFECTIONS

ANTIBACTERIAL PAPERS & BOARDSANTIBACTERIAL PAPERS & BOARDS• Garnett has developed an antibacterial paper which helps

to fight the MRSA super bug in hospitals. • According to a research finding from University College of

London hospital’s NHS trust, patients’ notes and medical records are helping to spread the bug.

• The special antibacterial products have been incorporated into the raw materials used to make medical record cards and patient files, which help to stop the spread of bacterial infections such as MRSA.

• This is the first step towards developing a range of products for the healthcare industry that will help counter the effects of disease transmission through paper products.

• Paper Technology, 47, 1 February 2006, p. 46.

ANTIBACTERIAL OFFICE PAPERANTIBACTERIAL OFFICE PAPER• Domtar, has begun producing paper containing a silver

compound to guard against bacteria, odors and the growth of fungus, mould and mildew.

• Independent laboratory tests on this product demonstrated a 99% reduction of MRSA (Methicillin-resistant Staphylococcus aureus) and K. pneumoniae.

• This paper maintains its antimicrobial features throughout its shelf life and even after printing and varnishing.

• It is ideal for the healthcare, laboratory, hospitality, education and government sectors.

• Tappi Online, ‘New antibacterial paper cuts germ spread in offices’ (18 January 2007).• Scranton moans, Domtar Launches Antimicrobial Office Paper, www. rssfabrick.nl (25 January

2007).

ANTIBACTERIAL WALLPAPERANTIBACTERIAL WALLPAPER• A variety of wallpapers with antibacterial

properties are available. • Along with the other features, the

antibacterial action is more than 97% in these products.

• The wallpapers can be used in hospitals, doctor offices, hostels, living rooms, bedrooms, commercial areas, study rooms, etc.

• Michael Berger, ‘Antibacterial wallpaper through nanotechnology’, Honolulu, United States, www.newswiretoday.com; www.nanowerk.com.

NANOTECHNOLOGY BEHIND MEDICAL NANOTECHNOLOGY BEHIND MEDICAL CHART PAPER, WALLPAPER OTHER PAPERSCHART PAPER, WALLPAPER OTHER PAPERS• In antibacterial paper non-toxic compounds are

used, which composed of calcium phosphate, aluminum sulphate hydroxide and silica as carrier.

• Silver nanoparticles coating is done on paper which release antibacterial silver ions , which are harmless to the human.

• Zinc oxide nanoparticles coating can also done onto paper, giving it an antibacterial surface suitable for use as wallpaper in hospitals.

• Toshihiro Kasuga, Masayuki Nogami, Yoshihiro Abe, ‘Titanium phosphate glassceramics with silver ion exchangeability’, J. American Ceram. Soc. 82, 3, 1999, p.765.

• Ghule Kalyani, Ghule Anil Vithal, Chen Bo-Jung and Ling Yong-Chien, ‘Preparation and characterization of ZnO nanoparticles coated paper and its antibacterial activity study’, Green Chem.,8, 2006, pp. 1034–41.

NANOTECHNOLOGY IN MAGNETIC, NANOTECHNOLOGY IN MAGNETIC, WATERPROOF ANTIBACTERIAL PAPERWATERPROOF ANTIBACTERIAL PAPER• Antibacterial paper is potentially

important for the food packaging and medical applications.

• Fluorescent and magnetic antibacterial paper can be used for bank notes /currency to prevent spread of infection through paper currency.

• To over come the concerns associated with earlier antibacterial materials, this paper is nontoxic, environmentally friendly, and low in cost.

Waterproof paper

Paper fibers enveloped by the polymer

Fluorescent paper

HOW IT WORKSHOW IT WORKS• A paper made of an antibacterial

nanomaterial composed of graphene oxide. The reduced graphene oxide attack the cell membrane of E. coli

and other bacteria.• As nanotechnology being applied to

other paper products like books, magazines, newspapers, paper money and wallpaper.

• Imagine a paper that resists bacteria and could cut down on the spreading of germs from a doctor’s office waiting room during cold and flu season.

A paper made of an antibacterial nanomaterial is shown to attack the cell membrane of E. coli cells.