The antimicrobial activity of copper surfaces against a variety of contemporary carbapenemase-producing Gram-negative bacteria representative of the most problematic nosocomial pathogens worldwide was evaluated. Twenty-four clinical isolates, comprising four of Escherichia coli, two of Enterobacter spp., eight of Klebsiella pneumoniae and five each of Pseudomonas aeruginosa and Acinetobacter baumannii producing either VIM-1 and/or KPC-2 or VIM-2 or OXA-type carbapenemases, were studied. The antimicrobial activity of 99% copper (Cu99%) and a 63% alloy (Cu63%) was evaluated in comparison with that of stainless steel (SS) and polyvinylchloride (PVC) by incubating ∼10(6) cfu/cm(2) of the tested strains on each surface at room temperature. Copper demonstrated antimicrobial activity against all studied isolates. This effect was observed earlier and was more pronounced for Cu99% than for Cu63%. Cu99% showed a bactericidal effect after <2 h for A. baumannii, 3 h for Enterobacter spp., 5 h for K. pneumoniae and 6 h for P. aeruginosa and E. coli. No viable colonies were recovered from five (20.8%) isolates after 3 h and from nine (37.5%) isolates after 5 h of incubation on Cu99%. Copper has significant antimicrobial activity against multidrug-resistant nosocomial Gram-negative pathogens. This supports the hypothesis that replacement of high-contact materials with copper could reduce the high burden of environmental contamination around high-risk patients. However, this strategy should be seen as an adjunctive measure to established cleaning protocols and to good hygiene practices for prevention of hospital-acquired infections.