The document discusses various antimicrobial papers and products that can help reduce healthcare-associated infections. It summarizes different antibacterial papers including those coated with silver nanoparticles or zinc oxide nanoparticles. Nanotechnology allows for magnetic, waterproof and fluorescent antibacterial papers. Proper hand hygiene including effective hand drying remains important, and antimicrobial paper towels can further reduce bacterial contamination compared to warm air dryers.

1. ANTIMICROBIAL PAPER
By
Dr Anjum Hashmi
MBBS,CCS(USA),MPH
Infection Control Director
Maternity & Children’s Hospital
Najran KSA

2. RISK OF INFECTIONS
• Patient may acquire infection before admission to an
hospital known as Community acquired infection.
• Patient may get infected inside the hospital known as
Nosocomial infection/Healthcare Associated Infection.
• It includes
infections not present nor incubating at time of
admission,
infections that appear more than 48 hours after
admission,
infections those acquired in the hospital but appear
after discharge,
and also occupational infections among staff.

3. PREVALENCE HEALTHCARE
ASSOCIATED INFECTIONS
• The problem is huge, it is estimated that there
are over 1.4 million cases of HAI at any given
time, although this is likely to be a gross
underestimation, due to the lack of proper
surveillance.
• Although no health-care setting across the globe
can claim to be free of HAI, there is a difference
between developed and developing countries in
terms of the incidence and type of infections.

4. PREVALENCE OF HAIs
• Developed countries
• In developed countries, with sophisticated treatments and
technologies, HAI continues to account for complications in
5-10% of admissions to acute-care hospitals. For example, in
the U.S. alone there are at least 80,000 fatalities each year
(about 200 deaths/day) from HAI. (WHO 2013)
• Developing countries
• In developing countries, the impact of HAI is far greater, with the
risk being two- to twenty-fold higher than those in the
developed world, and prevalence studies report hospital-wide
infection rates usually higher than 15%. (WHO 2013)
• In these countries, over 4000 children die of HAI every day.
• Approximately half of all patients admitted to neonatal intensive
care units acquire an infection, and over half of them die.

5. HAND
HYGIENE/WASHING
• Hand hygiene is the single most important
intervention to prevent transmission of
infection and should be a quality standard in
all health care institutions.
• Each and every HCW has a responsibility to
prevent transmission of infection.
(CDC, 2005)

6. HAND WASHING
• Scientific evidences showed that microbes
causing HAI are most frequently spread
between patients on the hands of health-care
workers.
• Hand hygiene is a simple, low-cost action to
prevent the spread of the microbes that cause
health care-associated infections (HAI).
• Though hand hygiene is not, the only measure
to counter HAI, but its compliance alone can
dramatically enhance patient safety.

7. FEW FACTS
• Bacteria survive on average 20 minutes to 2 hours on hard
surfaces such as desks, doorknobs and tables.
• A surface as small as a pinhead may contain up to
10 million bacteria.
• Bacteria can double their number in 20 minutes.
• We can eliminate 90% of germs through proper hand
washing.
• Wet hands spread 60,400 bacteria, while dry hand can only
spread 200.
• Residual moisture left on improperly dried hands is the key
factor for bacterial contamination and transmission.
• Thus drying of hands is a key factor in reducing the risk of
infection.

8. MRSA ON DAMP CLOTH TOWEL
DAMP TOWELS PROVIDE A SUPER BUG MRSA
BREEDING GROUND FOR
MRSA
Source: www.hero.ac.uk Source: Thomas Pat,
www.theecologist.org

9. HAND DRYING
• Effective drying of the
hands is an essential part
of the hand hygiene
process.
• A study was conducted
by the University of
Westminster, UK in
2009, to compare the
levels of hygiene offered
by
• Paper towels.
• Warm-air hand dryers.
• HEPA filter jet-air hand

10. KEY STUDY FINDINGS
• After washing
• When dried hands with the warm-air dryer, the
total number of bacteria was found to increase on
average on the finger pads by 194% and on the
palms by 254%.
• When dried with the jet-air dryer, the total number
of bacteria was found to increase on average on the
finger pads by 42% and on the palms by 15%.
• When dried hands with a paper towel, the total
number of bacteria was reduced on average on the
finger pads by up to 76% and on the palms by up to
77%.

11. SUMMARY OF DRYER
CHARACTERISTICS
Keith Redway University of Westminster 2009

13. ANTIMICROBIAL TOWEL
• Washing and drying hands, although
proved to helpful in eliminating microbes,
but does not completely eliminates the
microbes on skin.
• Antibacterial Paper Towels can provide a
simple and effective way to further
reduce bacterial contamination and
transmission thus reduce HAIs.

15. HOW IT WORKS
• Cascades has added an active antibacterial
ingredient benzalkonium chloride to its paper towel.
• Incorporate a high-tech antibacterial coating on the
surface of paper in micro-capsules which release a
sterilizing agent, as towel absorbs water from hands,
and the highly soluble antibacterial ingredient is
transferred from the towel to the skin. This simple
action is what quickly kills 99.9% of residual bacteria.
• The paper towel is green to distinguish it from
regular paper hand towels.
• Conform and approved by FDA regulations and policies.
• Based on 3rd party laboratory testing, Processed Chlorine Free)

16. A GREEN PRODUCT—Inside and Out
• It contains 100% recycled fiber.
• Manufactured with 5 times less water than
the North American paper industry average.
(source : AF&PA 2009)
• Third party certification: Processed Chlorine
Free thus environmental friendly.

18. OTHER
ANTIMICROBIAL PAPER
&
PAPER PRODUCTS
TO REDUCE
HEALTHCARE
ASSOCIATED INFECTIONS

19. ANTIBACTERIAL PAPERS & BOARDS
• Garnett has developed an antibacterial paper which helps
to fight the MRSA super bug in hospitals.
• According to a research finding from University College of
London hospital’s NHS trust, patients’ notes and medical
records are helping to spread the bug.
• The special antibacterial products have been incorporated
into the raw materials used to make medical record cards
and patient files, which help to stop the spread of bacterial
infections such as MRSA.
• This is the first step towards developing a range of products
for the healthcare industry that will help counter the effects
of disease transmission through paper products.
• Paper Technology, 47, 1 February 2006, p. 46.

21. ANTIBACTERIAL OFFICE PAPER
• Domtar, has begun producing paper containing a silver
compound to guard against bacteria, odors and the
growth of fungus, mould and mildew.
• Independent laboratory tests on this product
demonstrated a 99% reduction of MRSA (Methicillin-
resistant Staphylococcus aureus) and K. pneumoniae.
• This paper maintains its antimicrobial features
throughout its shelf life and even after printing and
varnishing.
• It is ideal for the healthcare, laboratory, hospitality,
education and government sectors.
• Tappi Online, ‘New antibacterial paper cuts germ spread in offices’ (18 January 2007).
• Scranton moans, Domtar Launches Antimicrobial Office Paper, www. rssfabrick.nl (25 January
2007).

23. ANTIBACTERIAL WALLPAPER
• A variety of wallpapers with antibacterial
properties are available.
• Along with the other features, the
antibacterial action is more than 97% in
these products.
• The wallpapers can be used in hospitals,
doctor offices, hostels, living rooms,
bedrooms, commercial areas, study rooms,
etc.
• Michael Berger, ‘Antibacterial wallpaper through nanotechnology’, Honolulu, United
States, www.newswiretoday.com; www.nanowerk.com.

25. NANOTECHNOLOGY BEHIND MEDICAL
CHART PAPER, WALLPAPER OTHER PAPERS
• In antibacterial paper non-toxic compounds are
used, which composed of calcium phosphate,
aluminum sulphate hydroxide and silica as carrier.
• Silver nanoparticles coating is done on paper
which release antibacterial silver ions , which are
harmless to the human.
• Zinc oxide nanoparticles coating can also done
onto paper, giving it an antibacterial surface
suitable for use as wallpaper in hospitals.
• Toshihiro Kasuga, Masayuki Nogami, Yoshihiro Abe, ‘Titanium phosphate glassceramics with silver ion
exchangeability’, J. American Ceram. Soc. 82, 3, 1999, p.765.
• Ghule Kalyani, Ghule Anil Vithal, Chen Bo-Jung and Ling Yong-Chien, ‘Preparation and characterization of ZnO
nanoparticles coated paper and its antibacterial activity study’, Green Chem.,8, 2006, pp. 1034–41.

26. NANOTECHNOLOGY IN MAGNETIC,
WATERPROOF ANTIBACTERIAL PAPER
• Antibacterial paper is potentially
important for the food packaging and Waterproof paper
medical applications.
• Fluorescent and magnetic antibacterial
paper can be used for bank notes
/currency to prevent spread of
infection through paper currency.
Fluorescent paper
• To over come the concerns associated
with earlier antibacterial materials,
this paper is nontoxic, environmentally
Paper fibers
friendly, and low in cost. enveloped by the
polymer

27. HOW IT WORKS
• A paper made of an antibacterial
nanomaterial composed of graphene
oxide. The reduced graphene oxide
attack the cell membrane of E. coli
and other bacteria.
• As nanotechnology being applied to
other paper products like books,
magazines, newspapers, paper
money and wallpaper.
• Imagine a paper that resists bacteria A paper made of an
antibacterial
and could cut down on the spreading nanomaterial is shown
of germs from a doctor’s office waiting to attack the cell
membrane of E. coli
room during cold and flu season. cells.