Does Copper treating of commonly touched surfaces reduce healthcare acquired infections? A Systematic Review and meta-analysis

Background Healthcare acquired infections (HAIs) cause substantial morbidity and mortality. Copper appears to have strong viricidal properties under laboratory conditions. Aim We conducted a systematic review to examine the potential effect of copper treating of commonly touched surfaces in healthcare facilities. Methods We included controlled trials comparing the effect of copper-treated surfaces (furniture or bed linens) in hospital rooms versus standard rooms on hospital acquired infections (HAIs). Two reviewers independently screened retrieved articles, extracted data, and assessed the risk of bias of included studies. The primary outcome was the occurrence of healthcare acquired infections. Findings We screened 638 records; 7 studies comprising 12362 patients were included. All of included studies were judged to be at high risk in ≥2 of the 7 domains of bias. All 7 included studies reported the effect of copper-treated surfaces HAIs. Overall, we found low quality evidence of a potential clinical importance that copper-treated hard surfaces and/or bed linens and clothes reduced healthcare acquired infections by 27% (RR 0.73; 95% CI 0.57 to 0.94). Conclusion Given the clinical and economic costs of healthcare acquired infections, the potentially protective effect of copper-treated surfaces appears important. The current evidence is insufficient to make a strong positive recommendation. However, it would appear worthwhile and urgent to conduct larger-scale publicly funded clinical trials of the impact of copper coating. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement No specific funding for this research. All authors declare support from the Australian Government National Health and Medical Research Council (NHMRC). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This is a systematic review - ethics approval not applicable All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes Extracted data are available on request to the corresponding author.