Copper-coated textiles: armor against MDR nosocomial pathogens

Virucidal and Bactericidal Properties of Biocompatible Copper Textiles

The COVID-19 pandemic highlights the global threat posed by emerging viruses, emphasizing the critical need for effective strategies to combat pathogen transmission. Moreover, alongside emerging viruses, the increasing threat of antimicrobial resistance further reinforces the need to develop novel methods for infection control. Anti-pathogenic coatings on textiles offer a promising solution; in this study, three electroless copper-plated fabrics are evaluated for their antipathogenic properties following International Standards Organisation (ISO) standards. Prior to electroless plating, materials are activated either by immersion in a Pd catalyst solution (material A) or by ink-jet printing Cu/Ag catalyst along the weft (material B) or warp thread (material C). This study demonstrates that activation method influences the materials antipathogenic performance, with all materials achieving complete bactericidal/fungicidal neutralization within 30 min of incubation. Material B exhibits up to 4-log virucidal effects within 1 h against viruses such as coronavirus (OC43, 229E), Influenza A (H1N1), and Rotavirus A. Furthermore, biocompatibility testing indicates that material B exhibited low in vitro cytotoxicity. Textile B demonstrates strong antibacterial results even after one year of accelerated aging with no significant difference (P = 0.74) in efficiency against MRSA, highlighting promising applications for infection control in clinical settings reducing pathogen transmission, nosocomial infections and the associated economic burden.

Conductive Textiles for Signal Sensing and Technical Applications

Conductive textiles have found notable applications as electrodes and sensors capable of detecting biosignals like the electrocardiogram (ECG), electrogastrogram (EGG), electroencephalogram (EEG), and electromyogram (EMG), etc; other applications include electromagnetic shielding, supercapacitors, and soft robotics. There are several classes of materials that impart conductivity, including polymers, metals, and non-metals. The most significant materials are Polypyrrole (PPy), Polyaniline (PANI), Poly(3,4-ethylenedioxythiophene) (PEDOT), carbon, and metallic nanoparticles. The processes of making conductive textiles include various deposition methods, polymerization, coating, and printing. The parameters, such as conductivity and electromagnetic shielding, are prerequisites that set the benchmark for the performance of conductive textile materials. This review paper focuses on the raw materials that are used for conductive textiles, various approaches that impart conductivity, the fabrication of conductive materials, testing methods of electrical parameters, and key technical applications, challenges, and future potential.

The "Maskne" microbiome - pathophysiology and therapeutics

"Maskne" is a new term coined during the 2020 COVID-19 pandemic. It refers to a subset of acne mechanica, deserving consideration in view of widespread reusable fabric mask-wearing to control the pandemic worldwide. Understanding of underlying pathophysiology directly relates to the novel skin microenvironment and textile-skin friction created by mask-wearing, distinct from nontextile-related acne mechanica previously linked to wearing of headgear. Specifically, the occlusive microenvironment leads to microbiome dysbiosis, which is linked to various dermatological conditions. Additional textile-skin interactions include factors such as breathability, stickiness sensations, moisture saturation, and hygiene maintenance. Increased skin temperatures can trigger sweat/heat-related dermatoses, and ear loops potentially trigger pressure-induced dermatoses. Important therapeutic considerations include increased skin irritation potential of conventional acne treatments under occlusion, exacerbation of chronic dermatoses, that is, perioral dermatitis, rosacea, and eczema, and susceptibility of these same patient groups to heightened discomfort with mask-wearing. Cotton, as the traditional fabric of choice for dermatology patients, has limited benefits in the context of face masks - increased subjective discomfort relates to increased moisture saturation and stickiness, inevitable because of high biofluid load of the nasal and oral orifices. Prolonged textile-skin contact time, directly proportional to the risk of maskne, can be an opportunity for the application of biofunctional textiles.

Copper-Polyurethane Composite Materials: Particle Size Effect on the Physical-Chemical and Antibacterial Properties

In this work, thermoplastic polyurethane (TPU) composites incorporated with 1.0 wt% Cu particles were synthesized by the melt blending method. The effect of the incorporated copper particle size on the antibacterial, thermal, rheological, and mechanical properties of TPU was investigated. The obtained results showed that (i) the addition of copper particles increased the thermal and mechanical properties because they acted as co-stabilizers of polyurethane (PU) (ii) copper nanoparticles decreased the viscosity of composite melts, and (iii) microparticles > 0.5 µm had a tendency to easily increase the maximum torque and formation of agglomerates. SEM micrographics showed that a good mixture between TPU and copper particles was obtained by the extrusion process. Additionally, copper-TPU composite materials effectively inhibited the growth of the Gram-negative Escherichia coli and the Gram-positive Staphylococcus aureus. Considering that the natural concentration of copper in the blood is in the range of 0.7-0.12 mg/L and that the total migration value of copper particles from TPU was 1000 times lower, the results suggested that TPU nanocomposites could be adequately employed for biomedical applications without a risk of contamination.

Efficacy of copper-impregnated hospital linen in reducing healthcare-associated infections: A systematic review and meta-analysis

Background

Healthcare-associated infections (HAI) are a significant burden on the healthcare system. Recent research has suggested the role of copper in reducing HAI. The purpose of this study was to systematically search literature and pool data from studies evaluating the efficacy of copper-impregnated hospital linen in reducing HAI.

Methods

We carried out a systematic electronic search of PubMed, ScienceDirect, BioMed Central, Springer, Embase, and Google Scholar databases for controlled studies evaluating the efficacy of copper-impregnated linen in reducing the incidence of HAI. The last search was carried out on 15^th February 2020.

Results

Six studies were included. There was no restriction on the type of organism causing HAI in three studies while three trials reported HAI from Clostridioides difficile and multi-drug resistant organisms (MDRO). A meta-analysis of six studies indicated the use of copper-impregnated linen did not reduce the risk of HAI [Incidence rate ratio (IRR):0.66, 95% CI:0.28–1.58, p = 0.36, I² = 100%)]. On subgroup analysis, while pooled data from three studies HAI indicated a statistical significant reduction in all-HAI with copper-impregnated linen (IRR:0.76, 95% CI:0.75–0.77, p<0.00001, I² = 0%), no such difference was seen when HAI was defined as infection by Clostridioides difficile and MDROs only (IRR:0.57, 95% CI:0.12–2.75, p = 0.48, I² = 99%). Meta-regression analysis for study duration and number of days of hospitalization did not demonstrate any influence on the overall effect size. On sensitivity analysis, there was no change in the significance of results after the sequential exclusion of every study.

Conclusion

Current evidence on the use of copper-impregnated linen to reduce HAI is conflicting. Our results indicate that copper-impregnated linen may reduce HAI, but there is still no evidence of such an effect regarding infections caused by MDRO or Clostridioides difficile. The overall quality of evidence is not high. Homogenous high-quality studies are required to strengthen the evidence on this subject.

How long can nosocomial pathogens survive on textiles? A systematic review

Aims: Healthcare-associated infections linked to contaminated textiles are rare but underline their potential role as a source for transmission. The aim of the review was to summarize the experimental evidence on the survival and persistence of the different types of nosocomial pathogens on textiles.

Methods: A literature search was performed on MedLine. Original data on the survival of bacteria, mycobacteria, and fungi and persistence of viruses on textiles were evaluated.

Results: The survival of bacteria at room temperature was the longest on polyester (up to 206 days), whereas it was up to 90 days for some species on cotton and mixed fibers. Only low inocula of 100 CFU were found on all types of textiles with a short survival time of ≤3 days. Most bacterial species survived better at elevated air humidity. The infectivity of viruses on textiles is lost much faster at room temperature, typically within 2–4 weeks.

Conclusions: Contaminated textiles or fabrics may be a source of transmission for weeks. The presence of pathogens on the coats of healthcare workers is associated with the presence of pathogens on their hands, demonstrating the relevance of textile contamination in patient care.

Bacteria accumulate copper ions and inhibit oxide formation on copper surface during antibacterial efficiency test

Copper surface after antibacterial test against E. coli was examined in the aspect of corrosion. Results from scanning electron microscope (SEM), grazing incidence X-ray diffractometer (GIXRD) and Raman spectroscopy together confirmed less oxidation on copper surface with the presence of E. coli. The inhibition of the cuprous oxide (Cu₂O) layer instead ensured the continuous exposure of copper surface, letting localised corrosion attacks observable and causing a stronger release of copper ions. These phenomena are attributed to the fact that E. coli act as ions reservoirs since high amount of copper accumulation were found by energy dispersive X-ray spectroscopy (EDS).

The Use of Copper as an Antimicrobial Agent in Health Care, Including Obstetrics and Gynecology

Health care-associated infections (HAIs) are a global problem associated with significant morbidity and mortality. Controlling the spread of antimicrobial-resistant bacteria is a major public health challenge, and antimicrobial resistance has become one of the most important global problems in current times. The antimicrobial effect of copper has been known for centuries, and ongoing research is being conducted on the use of copper-coated hard and soft surfaces for reduction of microbial contamination and, subsequently, reduction of HAIs. This review provides an overview of the historical and current evidence of the antimicrobial and wound-healing properties of copper and explores its possible utility in obstetrics and gynecology.

Harnessing Metal Homeostasis Offers Novel and Promising Targets Against Candida albicans

Fungal infections, particularly of Candida species, which are the commensal organisms of human, are one of the major debilitating diseases in immunocompromised patients. The limited number of antifungal drugs available to treat Candida infections, with the concomitant increasing incidence of multidrug-resistant (MDR) strains, further worsens the therapeutic options. Thus, there is an urgent need for the better understanding of MDR mechanisms, and their reversal, by employing new strategies to increase the efficacy and safety profiles of currently used therapies against the most prevalent human fungal pathogen, Candida albicans. Micronutrient availability during C. albicans infection is regarded as a critical factor that influences the progression and magnitude of the disease. Intracellular pathogens colonize a variety of anatomical locations that are likely to be scarce in micronutrients, as a defense strategy adopted by the host, known as nutritional immunity. Indispensable critical micronutrients are required both by the host and by C. albicans, especially as a cofactor in important metabolic functions. Since these micronutrients are not freely available, C. albicans need to exploit host reservoirs to adapt within the host for survival. The ability of pathogenic organisms, including C. albicans, to sense and adapt to limited micronutrients in the hostile environment is essential for survival and confers the basis of its success as a pathogen. This review describes that micronutrients availability to C. albicans is a key attribute that may be exploited when one considers designing strategies aimed at disrupting MDR in this pathogenic fungi. Here, we discuss recent advances that have been made in our understanding of fungal micronutrient acquisition and explore the probable pathways that may be utilized as targets.

Copper signaling in the brain and beyond

Transition metals have been recognized and studied primarily in the context of their essential roles as structural and metabolic cofactors for biomolecules that compose living systems. More recently, an emerging paradigm of transition-metal signaling, where dynamic changes in transitional metal pools can modulate protein function, cell fate, and organism health and disease, has broadened our view of the potential contributions of these essential nutrients in biology. Using copper as a canonical example of transition-metal signaling, we highlight key experiments where direct measurement and/or visualization of dynamic copper pools, in combination with biochemical, physiological, and behavioral studies, have deciphered sources, targets, and physiological effects of copper signals.