Materials Innovations for Infection Prevention
Monday9 November 2009
IOM3, London
09.00 Registration09.30 Introduction: Sue Dunkerton, HealthTech and Medicines KTN
09.45 Session 1
09.30 Keynote 1: The Threat Explained. Professor Clive Beggs. Professor of Medical Technology at the University of Bradford / The magnitude and seriousness of healthcare associated infection (HCAI) has enticed many commercial organisations to develop technical solutions to the problem. While some of these interventions may be successful, many prove ineffective because their developers have a poor understanding of the epidemiology associated with HCAI. In order to develop successful technical interventions it is essential to first understand the routes by which infection is spread within hospitals. While the epidemiology associated with HCAI is complex, there is an unfortunate tendency to oversimplify the issue and to adopt a ‘one size fits all’ approach to infection control. The reality is however, that not all infections possess the same characteristics. Consequently, infection control strategies must be adopted that take into account the differences between the various types of infection.
10.10 Infection Prevention:The Journey to Market. Chris Dyke, Medilink West Midlands / The advancement of combination devices such as drug eluding stents delivered by minimally-invasive treatments and the potential for customisation via Rapid Manufacture has led to an increased demand for new and innovative materials and products.
But with the urgency for products to tackle infection problems is there a likelihood of causing other problems? Therefore before these materials, and the products that they form or coat, can reach their target market they have a few hoops to jump through.
An outline for the route innovative products can take to market; questions and views you may wish to ask, to make the journey easier will be explored.
10.30 Biofilm Models for the Testing of Antimicrobial-Releasing Materials. Dr Jonathan Pratten, UCL Eastman Dental Institute / Biofilms are surface-associated microorganisms. There are many laboratory models to grow biofilms which can also be used to assess the susceptibility of these microorganisms to antimicrobials released from materials. The complexities of these models vary considerably and indeed, the susceptibility of biofilms grown in these different models are also not standardised. However, it is clear that such methods are necessary for the testing of novel materials which release antibiotics and/or antimicrobial agents. These persistent bacterial communities are far more resistant than their planktonic counterparts and for many years it has been obvious that standardised tests such as disc diffusion and MIC are no longer appropriate on their own. There has been a growing realization that biofilms are found in almost every area of healthcare and are a major contributing factor to the difficulty of treating infections. Therefore, there is an obvious need for appropriate testing of novel anti-biofilm compounds and materials.
10.50 Antimicrobial Copper - Recent Developments. Mark Tur, Copper Development Agency / In extensive “Proof of Principle” trials conducted since 1994, copper has been shown to be dramatically effective against a range of microbes, viruses & fungal spores. Recent work has concentrated on both extending the list of pathogens to include those of current concern like Swine Flu and Tuberculosis, as well as understanding the practical aspects of implementation.
Since my last presentation at this venue two years ago, the first phase of UK clinical trials at SellyOakHospital have been reported with very positive results. The second, more extensive phase, is nearing completion. Clinical trials are also underway in Germany, South Africa and the USA.
Driven by the clinical trials, the need to identify touch surface hot spots and then match them to manufacturing capabilities has been a major focus of the CDA in the last two years. In most cases this has been straightforward but novel processing technologies are in development which will allow even easier deployment of copper alloys in a variety of scenarios. However there may still be a gap between designers and industry that needs to be bridged.
Further research is underway which will highlight the versatility of these copper containing materials as an antimicrobial.
11.10 Refreshments
11.40 Session 2
11.40 Antimicrobial Fabrics – An Overview. Brian McCarthy, Technical Textiles, Materials KTN / The initial and traditional use of antimicrobials in textiles was to prevent the biodeterioration of textile substrates- fibres, yarns and fabrics - in storage and during transport. Problems have been associated with both natural and synthetic substrates. In recent years, the focus has moved to hygenic finishes intended to prevent odour generation on fabrics associated with microbial proliferation and the application of active antimicrobial agents to limit or minimise microbe transfer from fabrics. This presentation will review the current range of agents currently available in the light of the EU Biocide Directive, the range of potential applications - from bedding. sportswear, presonnel protective equipment and medical textiles - and the various microbiological test methods available to evaluate efficacy. For example, silver has been incorporated into wound dressings, stethoscope diaphrams, catheters, plimbing fixtures and now surgical gowns and curtains. It is now estimated that medical use of silver is 200,000 troy ounces (6,220 kilograms) globally - a quadrupling of usage since 2005.
12.00 Keynote 2: The Healthcare Acquired Infection (HCAI) Technology Programme. Paul Cryer, Programme Manager, Department of Health, HCAI Technology Innovation Programme / The HCAI Technology Innovation Programme was launched by the Secretary of State for Health in January 2008 in the Clean Safe Care publication. It has been designed to accelerate the invention, development and adoption of new and novel technologies that will help combat HCAIs. Key aspects of the programme include;
National engagement with front line NHS infection prevention practitioners to determine what technologies are required;
Strategies to provide commercial organisations opportunities to minimise redundant cost, time and effort and opportunities to influence outcomes through early creative conversations about need and process;
Clearly focused but very flexible project management that is able to absorb and manage the very diverse range of interests, ambitions and time horizons through active partnering with stakeholders;
Constructing a collective of public sector organisations through creative partnerships where each can contribute their best talent and provide a seamless relationship to external stakeholders through a single A-Z pathway;
Develop deep involvement with those who show an interest in manufacturing the technologies in proactively and jointly creating procurement frameworks through which intellectual property can pass effectively;
Actively showcase the technologies at specialist hospitals to pull demand from the NHS along with providing swift access to supply chain catalogues to speed availability.
12.45 Chemical Vapour Deposition of Silver and Copper Containing Coatings. Howard Foster, Parasitology and Disease Research Centre, School of Environment and Life Sciences, University of Salford / Novel antimicrobial surfaces are being developed and tested in a unique cooperation between Materials Scientists, Microbiologists and Health Protection specialists. Silver and copper are well known antimicrobial agents but are soft, easily scratched metals which may allow microorganisms to survive on the surface. A novel CVD (Chemical Vapour Deposition) method produces coatings comprising both the metal and silica, which gives a hard glass-like structure but which retains antimicrobial activity. The coatings are being tested for activity against hospital related pathogens. There are no standard methods for such studies and methods to evaluate the performance in the hospital setting have been developed which allow both laboratory testing against known organisms and in situ testing of activity of the coatings against clinical pathogens in a hospital setting. The ability to coat different surfaces will provide self-disinfecting coatings which have the promise to help to limit transmission of infections in the hospital setting. The coatings will also have potential application in the food industry and in aviation, particularly in kitchen areas, cabin interiors, lavatories and galley equipment.
13.05 Inorganic Nanomaterials for Antimicrobial Protection. Selvaraj Subbiah, Intrinsiq Materials / Due to the recent outbreak of H1NI flu (swine flu), and a constant threat from Bird flu, governments around the world are funding pandemic preparedness. Our multi component antimicrobial technology provides truly broad-spectrum protection in a chemically stable, and physically durable material, incorporating separate microbe-deactivating technologies that work synergistically. The technology has demonstrated very good antimicrobial activity against a range of organisms, and results so far from toxicity testing are favourable. The technology is highly tunable and we can custom engineer a solution that meets the unique needs of various product applications. Target applications include facemasks, medical disposables, air and water filtration, and hygienic surfaces
13.25 Lunch
14.15 Session 3
14.15 Ultra Thin,Prophylactic Liquid Glass (SiO2) Coatings for Use in Healthcare and AssociatedEnvironments. Neil McClelland, Project Manager, Nanopool GmbH / SiO2 ultra thin layering technology allows the end user to apply a layer of pure quartz glass on to almost any surface.
When in place this highly durable , nano scale coating, offers a range of benefits including super-phobicity, and biostatic characteristics. The coating can also be used for in-vivo application.
In addition to heath-care applications the coatings can be used in almost any environment and on almost any surface.
14.35 Lenticular Posters as a Visual Stimulus for Infection Control. Robbie Rohan P4YT / P4YT Limited is a niche advertising agency who work in collaboration with Jeffrey Robb of the Hologram Company, which was established in 1994 and employs specialist technicians with over 100 years of joint experience.
The principle medium the Agency uses to carry strategic communication messages is the lenticular, which is a digital photographic product within the hologram genre with 3D, page flip and morphing characteristics.
Earlier this year Penny For Your Thoughts Ltd was commissioned by the D0H to develop a communication strategy at UCLH NHS Foundation Trust to create a high awareness of Health Care Acquired Infections (HCAI). The principle medium to carry the strategically developed message is the lenticular A3 poster - which with the movement of the head flips from one page to another. The effect and interest is dramatic and the posters are employed next to every hospital bed to act as the voice of the patient to ensure that anyone who comes in contact uses the gel dispenser at the end of the bed.
Within an environment of multiple messages within hospitals, all competing for attention, the lenticular stands out alone!
Given a compelling product message, the lenticular ensures that the audience “Stops, Thinks and Recalls!”- a very persuasive marketing tool.
14.45 Nanosensors for Superbugs and Superdrugs. Dr Rachel McKendry, London Centre for Nanotechnology, UniversityCollegeLondon / The widespread and often indiscriminate use of antibiotics has fuelled the alarming growth of antibiotic resistant superbugs, including methicillin resistant Staphylococcus aureus (MRSA) and vancomycin resistant Enterococci (VRE). To remain one step ahead of the superbugs it is vital to develop new antibiotics and yet the drug pipeline is severely limited. We recently reported the nanomechanical detection of vancomycin-cell wall peptide interactions on cantilever arrays and discriminated between vancomycin-sensitive and vancomycin-resistant phenotypes.1 In this talk I will present our new work which exploits this technology to search for new superdrugs active against VRE. We have investigated a series of vancomycin derivatives and detect a dramatic enhancement in surface binding affinities compared to homogeneous solution measurements. We identify a glycopeptide which binds 11,000 more strongly to resistant VRE phenotype analogues. Our findings reveal a fundamental new nanomechanical framework to understand the surface mechanism of glycopeptides binding to model bacterial cell wall peptides, which not only has important implications on the design of nansensors with significantly improved drug detection sensitivity but will also impact on our understanding of antibiotics on real bacteria.
15.05 Open Air Factor- A Cascade Reaction of Hydroxyl Radicals. Alan Mole Tri-Air Developments Ltd. / The history of the Open Air Factor, its tropospheric activity in the creation of hydroxyl radicals and its current role in the prevention of HCAIs will be discussed.
Hydroxyl radicals are omnipresent in outdoor air, yet virtually absent indoors. We examine the method and effect of their production on the occupied indoor environment.
15.25 The Use of UV Light in Infection Control. John Burrows, Pathogen Solutions Ltd / The germicidal properties of UV Light have been known about since 1877, when Downes and Blunt published their paper at the Royal Society of Medicine, “Researches on the Effect of Light upon Bacteria and Other Organisms”. UV light was widely exploited in the 1930’s particularly in the USA, where it was used against TB, in hostels for the homeless. The discovery of antibiotics saw a loss of interest in its use, but recent events have seen renewed enthusiasm for such technologies, with the airborne route for infection now being seen as having real significance.
As a consequence of the SARS outbreak of 2003, my company Pathogen Solutions Ltd., became involved in finding ways to deploy UV. We developed a method that would make it safe and easy to use. More importantly however, we have been able overcome the inherent problem of poor propagation at the wavelength required for germicidal action.
The short presentation will cover the development of a successful UV product and its deployment as a component in a successful infection control strategy.
15.45 Refreshments
16.05 Session 4
16.05 NHS Smart Ideas: Temporary Isolation Unit. Mike Phillips, Renfrew Group / The NHS Smart Ideas Programme has taken a radical approach to the identification of possible new and novel technologies through an exciting new procurement route with industry.
By encouraging collaboration between infection control experts, frontline users and industry and design specialists (Renfrew Group) it has helped to stimulate and speed up the development of innovative solutions to NHS problems.
The best option for Isolation is to provide more permanent Side Rooms. Whilst this is yet to be achieved, a temporary solution is proposed where a degree of portable isolation is taken to the patient. The importance of encouraging good infection control procedure is given high priority, particularly hand washing, with soap and water in the case of C.Diff, in combating cross infection by contact.
The systems combine to effect behavioural change; to improve hand washing procedure and frequency and to promote effective barrier nursing techniques. Thereby reducing cross infection by reducing unnecessary contacts, and limiting the spread by air.
Dignity and comfort of the patient always being a high priority, a degree of Isolation is brought through the temporary side room and Air management systems. Careful design of the elements make for as comfortable an environment as possible. All stake holders must find the experience of using the system acceptable, but particularly the patient. If the patient doesn't like it, it will not be widely used.
Ease of cleaning and ergonomics are balanced with practical, manufacturable designs.
Conflicting demands have created demanding requirements and the talk will focus on the on the resultant designs and materials selection.
16.25 Design Bugs Out Part 1: Hospital Equipment. Grace Davey, Helen Hamlyn Centre / The Department of Heath and NHS Purchasing and Supply Agency worked in collaboration with Design Council, to deliver the Design Bugs Out program. The aim was to bring designers together with clinical specialists, patients and front line staff to find ways that design could make a difference in the fight against Health Care Associated Infections.
Through a national competition the Design Council appointed some of the UK’s top designers and manufacturers to work on 5 of the briefs focusing on furniture in the bed space. A specialist healthcare team at the Royal College of Art, Helen Hamlyn Centre was awarded six design challenges centred around everyday equipment
This short presentation will cover the six everyday items of hospital equipment designed at the Helen Hamlyn Centre, and how these designs were conceptualised.
16.40 Design Bugs Out Part 2: Design Principles of Hospital Furniture. Geoff Hollington, Design Consultant, Hollington / Hospital furniture and equipment probably provide an important vector for the spread of infection. The materials that constitute the surfaces of these products have an important part to play in reducing infection-spread — they can be super-cleanable or they can have active antimicrobial properties — but an equally significant contribution will come from the three-dimensional design of the parts and assembly: the shapes of the surfaces and the way they interrelate. Ideally materials specifications and design tactics should be close-coupled. A design should be as easy as possible to clean and users should be encouraged to touch only a minimum of cleanable touch-points. This sounds like common sense but in reality, when human behaviour and resource economics are taken into account, the most effective design strategies may be less obvious.
17.00 Finish
For further details please see the event website or contact Dawn Bonfield on 01438 821740 or.