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Comparison of the Microbiological Efficacy of Hydrogen Peroxide Vapor and Ultraviolet Light Processes for Room Decontamination

  • Nancy L. Havill (a1), Brent A. Moore (a2) and John M. Boyce (a1) (a2)



To compare the microbiological efficacy of hydrogen peroxide vapor (HPV) and ultraviolet radiation (UVC) for room decontamination.


Prospective observational study.


500-bed teaching hospital.


HPV and UVC processes were performed in 15 patient rooms. Five high-touch sites were sampled before and after the processes and aerobic colony counts (ACCs) were determined. Carrier disks with ~106Clostridium difficile (CD) spores and biological indicators (BIs) with 104 and 106Geobacillus stearothermophilus spores were placed in 5 sites before decontamination. After decontamination, CD log reductions were determined and BIs were recorded as growth or no growth.


93% of ACC samples that had growth before HPV did not have growth after HPV, whereas 52% of sites that had growth before UVC did not have growth after UVC (P < .0001). The mean CD log reduction was >6 for HPV and ~2 for UVC. After HPV 100% of the 104 BIs did not grow, and 22% did not grow after UVC, with a range of 7%–53% for the 5 sites. For the 106 BIs, 99% did not grow after HPV and 0% did not grow after UVC. Sites out of direct line of sight were significantly more likely to show growth after UVC than after HPV. Mean cycle time was 153 (range, 140–177) min for HPV and 73 (range, 39–100) min for UVC (P < .0001).


Both HPV and UVC reduce bacterial contamination, including spores, in patient rooms, but HPV is significantly more effective. UVC is significantly less effective for sites that are out of direct line of sight.


Corresponding author

Hospital of Saint Raphael, 1450 Chapel Street, New Haven, CT 06511 (


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1.Otter, JA, Yezli, S, French, GL. The role played by contaminated surfaces in the transmission of nosocomial pathogens. Infect Control Hosp Epidemiol 2011;32:687699.
2.Datta, R, Platt, R, Yokoe, DS, Huang, SS. Environmental cleaning intervention and risk of acquiring multidrug-resistant organisms from prior room occupants. Arch Intern Med 2011;171:491494.
3.Nseir, S, Blazejewski, C, Lubret, R, Wallet, F, Courcol, R, Durocher, A. Risk of acquiring multidrug-resistant gram-negative bacilli from prior room occupants in the ICU. Clin Microbiol Infect 2011;17:12011208.
4.Drees, M, Snydman, D, Schmid, C, et al. Prior environmental contamination increases the risk of acquisition of vancomycin-resistant enterococci. Clin Infect Dis 2008;46:678685.
5.Shaughnessy, MK, Micielli, RL, DePestel, DD, et al. Evaluation of hospital room assignment and acquisition of Clostridium difficile infection. Infect Control Hosp Epidemiol 2011;32:201206.
6.Huang, SS, Datta, R, Platt, R. Risk of acquiring antibiotic-resistant bacteria from prior room occupants. Arch Intern Med 2006;166: 19451951.
7.Boyce, JM, Havill, NL, Lipka, A, Havill, H, Rizvani, R. Variations in hospital daily cleaning practices. Infect Control Hosp Epidemiol 2010;31:99101.
8.Carling, PC, Parry, MM, Rupp, ME, Po, JL, Dick, B, Von Beheren, S. Improving cleaning of the environment surrounding patients in 36 acute care hospitals. Infect Control Hosp Epidemiol 2008; 29:10351041.
9.Rutala, WA, Weber, DJ. Are room decontamination units needed to prevent transmission of environmental pathogens? Infect Control Hosp Epidemiol 2011;32:743747.
10.Boyce, JM. New approaches to decontamination of rooms after patients are discharged. Infect Control Hosp Epidemiol 2009;30: 515517.
11.Otter, JA, Cummins, M, Ahmad, F, van Tonder, C, Drabu, YJ. Assessing the biological efficacy and rate of recontamination following hydrogen peroxide vapour decontamination. J Hosp Infect 2007;67:182188.
12.Otter, JA, French, GL. Survival of nosocomial bacteria and spores on surfaces and inactivation by hydrogen peroxide vapor. J Clin Microbiol 2009;47:205207.
13.Jeanes, A, Rao, G, Osman, M, Merrick, P. Eradication of persistent environmental MRSA. J Hosp Infect 2005;61:8586.
14.Otter, JA, Yezli, S, Schouten, MA, van Zanten, AR, Houmes-Zielman, G, Nohlmans-Paulssen, MK. Hydrogen peroxide vapor decontamination of an intensive care unit to remove environmental reservoirs of multidrug-resistant gram-negative rods during an outbreak. Am J Infect Control 2010;38:754756.
15.Manian, FA, Griesenauer, S, Senkel, D. Impact of an intensive terminal cleaning and disinfection (C/D) protocol involving selected hospital rooms on endemic nosocomial infection (N1) rates of common pathogens at a tertiary care medical center. In: 5th Decennial Meeting of the Society for Healthcare Epidemiology of America (SHEA). Atlanta, GA, 2010. Abstract LB6.
16.Passaretti, CL, Otter, JA, Lipsett, P, et al. Adherence to hydrogen peroxide vapor (HPV) decontamination reduces VRE acquisition in high-risk units. In: 48th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) and the Infectious Diseases Society of America (IDSA). Washington, DC, 2008. Abstract K4124b.
17.Boyce, JM, Havill, NL, Otter, JA, et al. Impact of hydrogen peroxide vapor room decontamination on Clostridium difficile en vironmental contamination and transmission in a healthcare setting. Infect Control Hosp Epidemiol 2008;29:723729.
18.Portala, WA, Gergen, MF, Weber, DJ. Room decontamination with UV radiation. Infect Control Hosp Epidemiol 2010;31:10251029.
19.Nerandzic, MM, Cadnum, JL, Pultz, MJ, Donskey, CJ. Evaluation of an automated ultraviolet radiation device for decontamination of Clostridium difficile and other healthcare-associated pathogens in hospital rooms. BMC Infect Dis 2010;10:197.
20.Boyce, JM, Havill, NL, Moore, BA. Terminal decontamination of patient rooms using an automated mobile UV light unit. Infect Control Hosp Epidemiol 2011;32:737742.
21.French, GL, Otter, JA, Shannon, KP, Adams, NM, Watling, D, Parks, MJ. Tackling contamination of the hospital environment by methicillin-resistant Staphylococcus aureus (MRSA): a comparison between conventional terminal cleaning and hydrogen peroxide vapour decontamination. J Hosp Infect 2004;57:3137.
22.McDonnell, G, Russell, AD. Antiseptics and disinfectants: activity, action, and resistance. Clin Microbiol Rev 1999;12:147179.
23.Hall, L, Otter, JA, Chewins, J, Wengenack, NL. Use of hydrogen peroxide vapor for deactivation of Mycobacterium tuberculosis in a biological safety cabinet and a room. Journal of Clinical Microbiology 2007;45:810815.
24.Hayden, MK, Bonten, MJ, Blom, DW, Lyle, EA, van de Vijver, DA, Weinstein, RA. Reduction in acquisition of vancomycin-resistant Enterococcus after enforcement of routine environmental cleaning measures. Clin Infect Dis 2006;42:15521560.
25.Holmdahl, T, Lanbeck, P, Wullt, M, Walder, MH. A head-to-head comparison of hydrogen peroxide vapor and aerosol room decontamination systems. Infect Control Hosp Epidemiol 2011;32: 831836.
26.Dumigan, DG, Boyce, JM, Havill, NL, Golebiewski, M, Balougun, O, Rizvani, R. Who is caring for your environment of care? developing standardized cleaning procedures and effective monitoring techniques. Am J Infect Control 2010:38(5):387389.
27.Boyce, JM, Havill, NL, Dumigan, DG, Golebiewski, M, Balogun, O, Rizvani, R. Monitoring the effectiveness of hospital cleaning practices by use of an adenosine triphosphate bioluminescence assay. Infect Control Hosp Epidemiol 2009;30:678684.
28.Lawley, TD, Clare, S, Deakin, LJ, et al. Use of purified Clostridium difficile spores to facilitate evaluation of health care disinfection regimens. Appl Environ Microbiol 2010;76:68956900.

Comparison of the Microbiological Efficacy of Hydrogen Peroxide Vapor and Ultraviolet Light Processes for Room Decontamination

  • Nancy L. Havill (a1), Brent A. Moore (a2) and John M. Boyce (a1) (a2)


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