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. 2017 Mar 31;14(4):366.
doi: 10.3390/ijerph14040366.

Proactive Approach for Safe Use of Antimicrobial Coatings in Healthcare Settings: Opinion of the COST Action Network AMiCI

Merja Ahonen  1 , Anne Kahru  2   3 , Angela Ivask  4 , Kaja Kasemets  5 , Siiri Kõljalg  6 , Paride Mantecca  7 , Ivana Vinković Vrček  8 , Minna M Keinänen-Toivola  9 , Francy Crijns  10
Affiliations

Proactive Approach for Safe Use of Antimicrobial Coatings in Healthcare Settings: Opinion of the COST Action Network AMiCI

Merja Ahonen et al. Int J Environ Res Public Health. .

Abstract

Infections and infectious diseases are considered a major challenge to human health in healthcare units worldwide. This opinion paper was initiated by EU COST Action network AMiCI (AntiMicrobial Coating Innovations) and focuses on scientific information essential for weighing the risks and benefits of antimicrobial surfaces in healthcare settings. Particular attention is drawn on nanomaterial-based antimicrobial surfaces in frequently-touched areas in healthcare settings and the potential of these nano-enabled coatings to induce (eco)toxicological hazard and antimicrobial resistance. Possibilities to minimize those risks e.g., at the level of safe-by-design are demonstrated.

Keywords: antimicrobial resistance; copper; ecotoxicity; healthcare associated infections; nanomaterials; risk-benefit analysis; safety; silver.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The share of papers in ISI Web of Science (number and %) for different materials with antimicrobial properties within the pool of papers (3455 in sum) described by truncated search term ’antimicrobial coating’. The materials are presented as data labels. The number of papers in the category ‘other’ was calculated by subtracting papers for silver, copper, titanium, zinc, gold and chitosan from the total nr of papers for antimicrobial coatings (3455). The search was performed on 14 March 2017.
Figure 2
Figure 2
Different types of AMCs: (a) antibacterial agent release-based coatings; (b) contact killing based surfaces; and (c) anti-adhesion surface with specifically designed surface topography. NMs are mostly applied in release-based or contact killing surfaces.
Figure 3
Figure 3
The main proposed mechanisms of AMR against antimicrobial compounds; a simplified scheme.
Figure 4
Figure 4
Conceptual model for the development of antimicrobial resistance (AMR) in response to antibiotics, antimicrobial compounds, antimicrobial coatings (AMC) and cleaning agents, and transfer of AMR between different microbial populations: human, animal and environmental.
Figure 5
Figure 5
SbD approach in safe production and use of AMCs.
See this image and copyright information in PMC

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