Department of Dermatology, University Hospital, Regensburg, Germany.
Department of Microbiology, University of Regensburg, Regensburg, Germany.
Crit Rev Microbiol. 2022 Sep;48(5):531-564. doi: 10.1080/1040841X.2021.1991271. Epub 2021 Oct 26.
Recent reports provide evidence that contaminated healthcare environments represent major sources for the acquisition and transmission of pathogens. Antimicrobial coatings (AMC) may permanently and autonomously reduce the contamination of such environmental surfaces complementing standard hygiene procedures. This review provides an overview of the current status of AMC and the demands to enable a rational application of AMC in health care settings. Firstly, a suitable laboratory test norm is required that adequately quantifies the efficacy of AMC. In particular, the frequently used wet testing (e.g. ISO 22196) must be replaced by testing under realistic, dry surface conditions. Secondly, field studies should be mandatory to provide evidence for antimicrobial efficacy under real-life conditions. The antimicrobial efficacy should be correlated to the rate of nosocomial transmission at least. Thirdly, the respective AMC technology should not add additional bacterial resistance development induced by the biocidal agents and co- or cross-resistance with antibiotic substances. Lastly, the biocidal substances used in AMC should be safe for humans and the environment. These measures should help to achieve a broader acceptance for AMC in healthcare settings and beyond. Technologies like the photodynamic approach already fulfil most of these AMC requirements.
最近的报告提供了证据，表明受污染的医疗保健环境是病原体获得和传播的主要来源。抗菌涂层 (AMC) 可以永久性地和自主地减少这些环境表面的污染，补充标准的卫生程序。本综述概述了 AMC 的现状和在医疗保健环境中合理应用 AMC 的要求。首先，需要合适的实验室测试标准，充分量化 AMC 的功效。特别是，经常使用的湿法测试（例如 ISO 22196）必须被实际干燥表面条件下的测试所取代。其次，必须进行现场研究，以提供实际条件下抗菌功效的证据。抗菌功效至少应与医院感染的传播率相关。第三，各自的 AMC 技术不应增加由杀菌剂引起的额外细菌耐药性发展，也不应与抗生素物质产生协同或交叉耐药性。最后，在 AMC 中使用的杀菌物质对人类和环境应该是安全的。这些措施应有助于在医疗保健环境中更广泛地接受 AMC。像光动力方法这样的技术已经满足了 AMC 的大多数要求。
