How Many Healthcare-Associated Infections Must Occur Before We Yell “Enough”?

The medical industry needs to raise its standards for hospital associated infections.

July 27, 2022

6 Min Read
Image Courtesy of BioInteractions

Arjun Luthra, Commercial Director at BioInteractions


In the past century, modern medicine has broken countless barriers towards a safer, more effective healthcare protocol. One of the most important discoveries came in 1928 at St. Mary's Hospital, London, when Alexander Fleming discovered penicillin. Penicillin, an antibiotic, was found to weaken the cells’ walls and cause bacteria to die, allowing a person to recover from a bacterial infection. This scientific breakthrough led to the widespread use of antibiotics, which in turn resulted in a large (positive) impact on clinical outcomes, improvements in public health, and a significant reduction in death and disabilities derived from infections.

Unfortunately, antibiotics are not the be-all and end-all solution to hospital-borne infections. As revealed by the European Centre for Disease Prevention and Control, more than 4 million people acquire a Healthcare-Associated Infection (HCAI) each year, resulting in 37,000 deaths. Combatting HCAIs is a significant problem for the healthcare sector globally. HCAIs are the sixth leading cause of death in western countries. However, treating all these infections with antibiotics is leading the general population to develop antibiotic resistance, in turn lowering the effectiveness of the treatments and the public trust in medicine.

Researchers have been able to pinpoint the cause of most of these infections: bacteria-infested surfaces inside of hospitals. There is an identified need to protect surfaces from germs and microbes. This is not only true for healthcare devices and surfaces, but also for materials like equipment, walls, textiles—the list is almost endless. Everything is susceptible to microbes, which find their way to humans through their hand hygiene. It is not always possible to clean, disinfect or use strong chemicals on surfaces to prevent the growth of germs during regular intervals.

Thankfully, scientists have now found a solution to this problem: antimicrobial coatings.

A novel antimicrobial coating is an application of a chemical agent on a surface that can stop the growth of disease-causing micro-organisms. Apart from increasing the surface’s durability, appearance and corrosion resistance for example, these coatings also protect from harmful disease-causing microbes. When medical equipment is coated with an antimicrobial solution, it can prevent up to 99.999% of a wide range of germs, significantly reducing the risk of infection for the patients. Antimicrobial coatings stick to the surface they are applied on and remain effective for a period, defining them as one of the best options to fight bacteria in this environment.

How do we elevate the status of antimicrobial coatings?

Currently, there are many companies in this industry that have turned their resources to the development of a highly effective antimicrobial coating, a new coating technology for medical devices which represents a paradigm shift in infection prevention and protection against a broad range of pathogens. But unfortunately, most of these products are still far from perfect.

The truth is, the medical industry needs to raise its standards, and this will only come through technology innovations. Not every antimicrobial coating on the market will solve the issues the industry is facing, and in this instance, we should not settle for less than perfect. There are already many products being used that offer an antimicrobial coating with a certain level of protection, but they are often silver-based and may also be leaching, in turn leading them to lose their effectiveness over time.

The perfect antimicrobial coating needs to prevent growth as well as confront active infections by incorporating both active and passive components to create a non-leaching, effective, safe, and durable solution for even the most sensitive medical devices and implants. There is a solution that has already been tested that is fully compliant with current medical device regulations, has been independently tested to international standards (ISO, EN, PAS) and proven to provide monoclonal protection which kills a broad spectrum of gram-positive and gram-negative bacteria as well as enveloped and non-enveloped viruses, including E.Coli, MRSA, Influenza, Norovirus and SARS-Cov-2. It has also been proven to be suitable for skin protection which allows the user to spread protection rather than germs, as well as protect most other surfaces including woven and non-woven fabrics and non-porous surfaces such as metals (nitinol) and polymers (polycarbonate and polyurethanes). Using this solution will not only save time needed for medical treatment, therefore raising productivity, but it will also result in a significant reduction of HCAIs, and therefore many lives saved.

Why isn’t their use more widespread?

One of the main factors stunting the widespread use of antimicrobial coatings are the current regulations in place. Under today’s European Union (EU) regulations, medical devices are considered medicines and are therefore tested by the European Medicines Agency (EMA) following the same tests and approval processes that drugs do. Regulators want to make sure that any positive effects an antimicrobial coating has are systematic, able to be replicated across the board, in different settings and for different patients.

In the US, the use of antimicrobial coatings is more widespread than in the EU. The FDA allows the use of silver-based coatings, regardless of them leaching and reducing their effectivity overtime. In the EU, however, this is seen as a risk to the patient and regulated against.

Thorough testing and aiming for perfection in all medical-adjacent products are especially important not only for patient care, but also to bring about a continued cycle of technology innovation. This current method of testing helps hospitals, patients, and doctors to be certain that antimicrobial coatings are effective against HCAIs. However, this process can be very elongated, at times up to years, for brands ultimately to earn accreditation, which slows down progress. Regulations need to be thorough and effective, but they also need to move forward to assist with innovation.

What will happen in the future?

The prospect of a biocompatible technology which can enhance the function of medical devices through eliminating existing microbes and actively confronting existing infections within the patient represents a paradigm shift in prevention and treatment of surgical infections. The future will bring further developments in material sterilization, bacterial reduction, and bacterial elimination. Antimicrobial coatings will cement themselves as the golden standard of excellence in healthcare, used in all things that go inside the patient and around open wounds. Additionally, they will help prolong the active lifecycle of medical devices, which has a significant economic, health and social care impact.

As time goes on, the focus will switch from infection reaction to infection prevention. Once science understands how to prevent infections, we will also be able to prevent pandemics, lockdowns, and raise the public’s confidence in antibiotics.

The future brings an opportunity to raise medical standards. The innovation already exists. All we need to do now is choose to develop it.

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