title: A head-to-head comparison of hydrogen peroxide vapor and aerosol room decontamination systems.
abstract: OBJECTIVE
  New technologies have emerged in recent years for the disinfection of hospital rooms and equipment that may not be disinfected adequately using conventional methods. There are several hydrogen peroxide-based area decontamination technologies on the market, but no head-to-head studies have been performed.
  
  
  METHODS
  We conducted a head-to-head in vitro comparison of a hydrogen peroxide vapor (HPV) system (Bioquell) and an aerosolized hydrogen peroxide (aHP) system (Sterinis).
  
  
  METHODS
  The tests were conducted in a purpose-built 136-m(3) test room.
  
  
  METHODS
  One HPV generator and 2 aHP machines were used, following recommendations of the manufacturers. Three repeated tests were performed for each system. The microbiological efficacy of the 2 systems was tested using 6-log Tyvek-pouched Geobacillus stearothermophilus biological indicators (BIs). The indicators were placed at 20 locations in the first test and 14 locations in the subsequent 2 tests for each system.
  
  
  RESULTS
  All BIs were inactivated for the 3 HPV tests, compared with only 10% in the first aHP test and 79% in the other 2 aHP tests. The peak hydrogen peroxide concentration was 338 ppm for HPV and 160 ppm for aHP. The total cycle time (including aeration) was 3 and 3.5 hours for the 3 HPV tests and the 3 aHP tests, respectively. Monitoring around the perimeter of the enclosure with a handheld sensor during tests of both systems did not identify leakage.
  
  
  CONCLUSIONS
  One HPV generator was more effective than 2 aHP machines for the inactivation of G. stearothermophilus BIs, and cycle times were faster for the HPV system.
authors.affiliation: Infectious Diseases Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.
authors.forename: T
authors.initials: T
authors.lastname: Holmdahl
authors.forename: P
authors.initials: P
authors.lastname: Lanbeck
authors.forename: M
authors.initials: M
authors.lastname: Wullt
authors.forename: M H
authors.initials: MH
authors.lastname: Walder
mesh_terms: D003428:Cross Infection / Q000382:microbiology / Q000517:prevention & control; D003666:Decontamination / Q000379:methods*; D004202:Disinfectants / Q000008:administration & dosage / Q000494:pharmacology; D001411:Geobacillus stearothermophilus / Q000187:drug effects*; D006801:Humans; D006861:Hydrogen Peroxide / Q000008:administration & dosage* / Q000494:pharmacology; D017053:Infection Control / Q000379:methods*; D010362:Patients' Rooms; D013171:Spores, Bacterial / Q000187:drug effects; D013997:Time Factors; D014835:Volatilization
chemical_list: D004202:Disinfectants; D006861:Hydrogen Peroxide