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The University of Southampton
Biological Sciences

Demonstrating and harnessing the antimicrobial properties of copper

Research at Southampton’s School of Biological Sciences has proved the antimicrobial properties of copper alloys by demonstrating their ability to kill a range of harmful pathogens including MRSA and SARS-CoV2.

These findings have led to major clinical trials and influence in public health bodies, leading to the installation of antimicrobial copper touch surfaces globally in hospitals, supermarkets and public transport.

Context

Recognised for its antibacterial, antiviral and antifungal properties, copper has a rich history of being exploited for health purposes. Its first recorded medical use can be found in Egyptian books written between 2600 and 2200 BC, which describe the use of copper in sterilising chest wounds and drinking water. It was used to treat skin infections in ancient Greece, cure ailments in ancient China and India, and remains an important component of traditional medicine today.

Research challenge

Research since the early 2000s led by Professor Bill Keevil, in collaboration with the New York-based Copper Development Association (CDA), has described the processes through which copper and its alloys exhibit their antimicrobial properties.

Initial research showed that copper alloys kill the bacteria E.Coli and Listeria, thus highlighting the potential of copper surfaces as an alternative to stainless steel to reduce cross-contamination during food preparation.

Further research by Keevil demonstrated copper’s ability to kill superbugs such as MRSA, vancomycin-resistant enterococci (VRE) and Clostridium difficile. Most notably, two strains of VRE were killed in less than one hour on alloys containing 90 per cent copper.

In 2012, Keevil and colleagues demonstrated the mechanisms that occur when pathogens land on copper surfaces due to touch, coughs or sneezes. These studies showed that copper ions rapidly inhibit cell respiration, attack the bacterial cell membrane and destroy the DNA and RNA inside. This disproved previous claims that copper does not affect genetic integrity.

Translation of research findings into clinical trials

The original research formed the basis of two influential clinical trials led by the CDA and advised by Keevil over 2010-2013.

The first trial was undertaken in the UK. It measured the effectiveness of copper plating on killing bacteria, reporting a 90 per cent reduction in bacterial loading on copper-plated surfaces.

These findings led to a second major trial across three hospitals in the USA. It involved copper plating the surfaces of six frequently touched objects in intensive care units (ICUs), recording a 58 per cent reduction in infection rates. A study by the University of York found that a 20-bed ICU could save almost £2 million over five years using this approach.

Installation of antimicrobial copper surfaces in healthcare settings and public spaces

Following the trials, at least 60 hospitals in 20 countries in Europe, South America, Africa and Asia installed antimicrobial copper surfaces, predominantly in high-risk clinical settings such as ICUs and neonatal wards.

Antimicrobial copper was also installed in transport settings, including copper-plated drinking fountains in the world’s busiest airport, Atlanta, and copper handrails on the Polish bus network.

Antimicrobial copper for commercial products and COVID-19

A company specialising in copper-impregnated fabric, Copper Clothing Ltd, was set up in 2012 after the founder discovered Keevil’s research online. The company subsequently commissioned Keevil to evaluate the antimicrobial properties of products including bed sheets, pyjamas, socks and more recently a facemask, with hundreds of thousands of units sold.

Additionally, copper electroplating firm Copper Cover has relied on Keevil’s validation of its products to bring them to market, including a test for SARS-CoV2. The COVID-19 pandemic saw the company coat more than 10,000 commonly touched surfaces in locations such as care homes, hospitals and schools.

Further trials were commissioned by supermarket chain Morrisons, with surfaces such as door push plates and trolley handles under consideration for copper plating.

Informing regulatory standards globally

Keevil’s findings paved the way for the successful development of standards by the US Environmental Protection Agency that regulate the commercialisation of products with an antimicrobial touch surface claim. This has resulted in the certification of more than 450 copper-containing antimicrobial products on the market.

Keevil’s research has also led to the incorporation of antimicrobial copper into French and Polish standards for healthcare facilities, and test methods standardised by the British Standards Institute.

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Key Publications

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