Antimicrobial strategies for polymeric hygienic surfaces in healthcare

Within healthcare facilitates, environmental contamination is often identified as a major contributor in the transfer of pathogenic hospital acquired infection (HAI). These infections although mainly from a small collection of bacteria, have given rise to one of the most severe and devastating complications associated with hospital stays. Further to this, data appears to indicate that increased length of stay significantly increases the likelihood of acquiring a HAI. For decades manufactures have used biocides to try and reduce the negative impacts of microbial colonisation on specific products. Historically, strategies have focused on incorporating biocidal preservative compounds to impede biofilm formation, with the aim to reduce diminished aesthetic or structural integrity (biodeterioration). However, more recently focus has shifted in trying to provide either a contact-killing surface or a surface that can significantly reduce microbial colonisation to a level below the threshold for which there is significant pathogen survival, with the aim to reduce transfer of infection. In this review, the focus is on the inclusion of antimicrobials into the almost ubiquitous polymer based surfaces, as a means of reducing contamination within the healthcare environment. This includes already established techniques, such as incorporating inorganic and organic biocides into the polymer matrix and surface coatings, as well as more modern techniques such as light activation and nanoparticles. Further to this, the importance of cleaning and personal hygiene is considered, as well as the potential impact of future policy and legislation strategy.