Building Antimicrobial Resistance Into the Fabric of Hospitals, Literally

Ed Eckenhoff has had an exciting career. He's a lifelong hospital administrator, having served as vice president of the Rehabilitation Institute of Chicago. He's president emeritus of the National Rehabilitation Hospital in Washington, D.C., which he founded in 1986. But most recently he's taken an interest in PurThread technologies. He's a stakeholder in the company, an enterprise out of Cary, N.C., that produces antimicrobial cloth.

Mr. Eckenhoff's interest in PurThread comes partly from his lifetime of experience in hospitals, not only as a hospital leader, but also as a patient. Fifty years ago, Mr. Eckenhoff was in a car accident in which he was thrown out of the vehicle. His spinal cord was injured, and he was rendered paraplegic.

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While Mr. Eckenhoff has beaten the odds, many victims of spinal cord injury are not so lucky. The average lifespan of someone like Mr. Eckenhoff is 37 years post-injury. "Many of us die from infections," he says. "When spinal cord-injured people take as many antibiotics as they do, antibiotics no longer work."

This antibiotic conundrum isn't unique to those with spinal cord injuries. Most patients with illness and disability are more susceptible to infection than able-bodied people, so encouraging hospitals to invest in warding off infections without the use of antibiotics seems like a no-brainer to Mr. Eckenhoff. "I think this is a winner," he says of PurThread. "We kill bugs without the use of antibiotics. Using silver— an element that kills bugs — just made inordinate sense," he says.

According to Lisa T. Grimes, president and CEO of the company, PurThread wards its textiles against microbes with silver. The company uses a proprietary process in which the germ-killing element is embedded into the individual fibers of the cloth before it is spun into yarn or worked into fabric. After that, the yarn can be made into pretty much anything: scrubs, lab jackets, sheets and blankets among them.

Scott Ballenger, PurThread's senior vice president of business development, notes the end result is indistinguishably similar from products without antimicrobial qualities. The feel is the same, the care is the same and no workflow processes have to change for the silver to work its evidence-based magic. Additionally, switching out items made from standard fabric for those created from its antimicrobial counterpart cuts down on microbial presence without relying on a behavior change, the primary downfall of many a quality improvement effort.

Indeed, recent research supports the idea that soft surfaces are often neglected in the hospital disinfection process. For whatever reason — added hassle or difficulty, or uncertainty over product care — soft surfaces are cleaned rather infrequently. Most prominently, a study on privacy curtains came to the attention of the healthcare community in late 2013, when researchers determined the curtains were laundered between three and four times per year. Another set of recommendations released in early 2014 warns of the infection-spreading dangers of the iconic white coat.

Infrequent cleaning of soft surfaces means simple touches effectively move pathogens from dirty surfaces to clean ones, compounding the infection control problem. "We likely touch nearly 4,000 things each day," says Mr. Ballenger.

"The real question," says Mr. Eckenhoff "is not if you've washed your hands, but what have you touched after you washed your hands?"

Patient-centricity aside, another facet of Mr. Eckenhoff's interest in PurThread is economic. His inner hospital administrator approves of the technology based on the fact that the cost of hospital-acquired infections in this day and age is staggering. "It's in the billions of dollars. If we can lower infection rates, if we can lower the number of beds we have to place in isolation due to infection, then hospitals are going to do better. As an administrator this makes such sense," he says. "Roughly a third of hospitals don't break even. They have to begin to understand they have to chip away at the problem."

Ms. Grimes says the reason PurThread and soft-surface technology in general should make sense in healthcare is because it requires little investment for a lot of return. Clinical trials and trials at the Iowa City-based University of Iowa have confirmed infection control improvements after the implementation of antimicrobial fabrics.

Despite the inadequacies of soft-surface disinfection in hospital settings, Mr. Eckenhoff's years of experience as both a hospital leader and as a patient have led him to sympathize with hospitals' plight. "Things have become very complex," he says. "The piecemeal nature of infection control makes it a tough place in which to bring about a strategy. [The question of] who has to make HAI-reducing decisions becomes confusing."

So to Mr. Eckenhoff, a passive solution makes a lot of sense. And, he says, he's not the only one. "Our shareholders see the logic as well. Our job now is to move the industry to understand the same things we do," he says.

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