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Background <p>Environmental surfaces contribute significantly to healthcare-associated infection (HAI) transmission. This study evaluated HyTAMO, a titanium dioxide-silver composite coating, in chronic respiratory care wards where patients require prolonged mechanical ventilation.</p> Methods <p>Two 36-bed ventilator-dependent chronic care wards on different floors were compared from October 2024 to March 2025. Ward 2&#xa0;F (experimental) received HyTAMO coating on high-touch surfaces; Ward 3&#xa0;F (control) maintained standard cleaning. Environmental sampling (ATP, total viable counts and 16&#xa0;S rRNA sequencing) was performed at baseline and weeks 0, 1, 2, 4, and 8. HAI rates were monitored for 5 months using CDC definitions.</p> Results <p>Baseline characteristics were generally comparable, except for patient age (80.0 vs. 75.6 years, favoring control group infection risk). Environmental bacterial counts showed no statistically significant Group × Time interaction (F(5,20) = 3.012, <i>p</i> = 0.076). However, HAI density in the experimental ward showed a progressive decline from 4.7 to 0.9 per 1000 patient-days over the 5-month post-intervention period, whereas the control ward exhibited an initial decrease followed by a rebound to pre-intervention levels (3.67→0.83→5.87‰). Poisson regression revealed a significant Group × Time interaction (<i>p</i> = 0.038), indicating divergent HAI trajectories between wards.</p> Conclusions <p>HyTAMO coating was associated with significantly divergent HAI trends compared with the control ward over a 5-month period, with the experimental ward showing progressive decline in HAI density despite non-significant differences in environmental bacterial counts. The disconnect between environmental and clinical outcomes warrants mechanistic investigation. The ultra-long patient stay duration (mean 3.2 years) provided ideal conditions for assessing long-term coating durability.</p> Trial registration <p>Not applicable. The Institutional Review Board of Changhua Christian Hospital formally determined that this study does not constitute human subjects research (IRB Exemption Statement, May 17, 2024) accordingly, trial registration was not required.</p>

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Long-term effectiveness of titanium dioxide-silver composite coating in reducing healthcare-associated infections in chronic respiratory care wards: a controlled trial

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月16日

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  • Yu-Kai Yang,
  • Wen-Ching Sun,
  • Chang-Hua Chen,
  • Szu-Han Chen,
  • Wan-Ying Chou,
  • Sen-Yung Liu

摘要

Background

Environmental surfaces contribute significantly to healthcare-associated infection (HAI) transmission. This study evaluated HyTAMO, a titanium dioxide-silver composite coating, in chronic respiratory care wards where patients require prolonged mechanical ventilation.

Methods

Two 36-bed ventilator-dependent chronic care wards on different floors were compared from October 2024 to March 2025. Ward 2 F (experimental) received HyTAMO coating on high-touch surfaces; Ward 3 F (control) maintained standard cleaning. Environmental sampling (ATP, total viable counts and 16 S rRNA sequencing) was performed at baseline and weeks 0, 1, 2, 4, and 8. HAI rates were monitored for 5 months using CDC definitions.

Results

Baseline characteristics were generally comparable, except for patient age (80.0 vs. 75.6 years, favoring control group infection risk). Environmental bacterial counts showed no statistically significant Group × Time interaction (F(5,20) = 3.012, p = 0.076). However, HAI density in the experimental ward showed a progressive decline from 4.7 to 0.9 per 1000 patient-days over the 5-month post-intervention period, whereas the control ward exhibited an initial decrease followed by a rebound to pre-intervention levels (3.67→0.83→5.87‰). Poisson regression revealed a significant Group × Time interaction (p = 0.038), indicating divergent HAI trajectories between wards.

Conclusions

HyTAMO coating was associated with significantly divergent HAI trends compared with the control ward over a 5-month period, with the experimental ward showing progressive decline in HAI density despite non-significant differences in environmental bacterial counts. The disconnect between environmental and clinical outcomes warrants mechanistic investigation. The ultra-long patient stay duration (mean 3.2 years) provided ideal conditions for assessing long-term coating durability.

Trial registration

Not applicable. The Institutional Review Board of Changhua Christian Hospital formally determined that this study does not constitute human subjects research (IRB Exemption Statement, May 17, 2024) accordingly, trial registration was not required.