A head-to-head comparison of hydrogen peroxide vapor and aerosol room decontamination systems

Infect Control Hosp Epidemiol. 2011 Sep;32(9):831-6. doi: 10.1086/661104.


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.

Design: 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).

Setting: 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.

Conclusion: 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.

Publication types

  • Comparative Study

MeSH terms

  • Cross Infection / microbiology
  • Cross Infection / prevention & control
  • Decontamination / methods*
  • Disinfectants / administration & dosage
  • Disinfectants / pharmacology
  • Geobacillus stearothermophilus / drug effects*
  • Humans
  • Hydrogen Peroxide / administration & dosage*
  • Hydrogen Peroxide / pharmacology
  • Infection Control / methods*
  • Patients' Rooms
  • Spores, Bacterial / drug effects
  • Time Factors
  • Volatilization


  • Disinfectants
  • Hydrogen Peroxide