New study finds aerosolized hydrogen peroxide


Arlington, Virginia, March 17, 2022 – New Data published today suggest that adding aerosol hydrogen peroxide (aHP) to hospital infection prevention protocols can effectively reduce Clostridioides difficile hospital-acquired infections (CDI), one of the most common hospital-acquired infections (HAIs), in patients in large acute care settings. The results, which offer the first long-term evaluation of an aHP disinfection system for reducing CDI in the clinical setting, appear in the American Journal of Infection Control (AJIC), the journal of the Association of Professionals in Infection Control and Epidemiology (APIC).

“Our study showed that persistence in using an aerosol hydrogen peroxide system had a significant impact on reducing It’s hard hospital-wide infections,” said Christopher L. Truitt, Ph.D., Wayland Baptist University and senior author of the paper.

People infected with It’s hard may be asymptomatic or have symptoms ranging from mild diarrhea to severe and life-threatening inflammation of the colon. According to the Centers for Disease Control and Prevention and the Joint Commission, It’s hard is responsible for 223,000 IASS resulting in more than 12,000 deaths and $6.3 billion in costs in the United States each year.[1],[2] C difference. spores can be transmitted through environmental surfaces in hospital rooms, including bed rails, equipment controls, and doorknobs, and are resistant to hand sanitizers and most disinfectants. Improved protocols for hand hygiene and environmental cleaning, as well as better prescribing of antibiotics, are needed to prevent C difference. spread and infection, but even with consistent implementation of these measures, the microbe is difficult to eradicate from hospital surfaces.

aHP disinfection systems offer a touchless, whole-room approach to enhancing standard environmental cleaning protocols. When placed in a room, the systems generate a dry aerosol mist that contains a specified percentage of hydrogen peroxide. Fog coats all exposed surfaces to kill everything C difference. spores that remain after physical cleaning. To date, there are no long-term data evaluating the use of these systems.

Dr. Truitt and colleagues retrospectively analyzed CDI rates in a large acute care facility in Philadelphia, Pennsylvania, over a 10-year period to assess the effectiveness of an aHP disinfection system in reducing the ICDs. Researchers compared the incidence of healthcare-associated CDI (HA-CDI) in the facility before and after the system was implemented in addition to standard procedures for cleaning CDI patient rooms after discharge or transfer. patients with CDI.

The results suggest that consistent use of an aHP disinfection system contributed to a significant and sustained reduction in HA-CDI levels. Over a period of 27 months before the implementation of the system, the establishment registered 120 HA-CDIs. After implementation, 72 cases were observed over a 33-month interval. This reflects a significant 41% decrease in the facility’s HA-CDI rate – from 4.6 per 10,000 patient days to 2.7 per 10,000 patient days (p

Over an additional five-year period in which the AHP system was used consistently with an environmental cleaning program and other measures, including antibiotic management, researchers observed a reduction of 74 % of hospital-associated CDI.* Between January 2015 and December 2019, CDI rates steadily decreased from 5.4 per 10,000 patient days to 1.4 per 10,000 patient days.

“CDI is difficult to prevent because it is so difficult to eliminate from the environment. The study conducted by Dr. Truitt and his colleagues provides valuable information on the benefits of supplementing prevention efforts with aHP to help reduce the rates of this often-fatal disease significantly,” said Linda Dickey, RN, MPH, CIC, FAPIC and APIC 2022 President.

*Reflects a January 2015 change in the classification and reporting of CDIs from “healthcare acquired” to “hospital onset” according to the National Healthcare Safety Network.

About APIC

Founded in 1972, the Association of Professionals in Infection Control and Epidemiology (APIC) is the leading association of infection preventionists and epidemiologists. With more than 15,000 members, APIC advances the science and practice of infection prevention and control. APIC fulfills its mission through research, advocacy and patient safety; education, accreditation and certification; and fostering the development of tomorrow’s infection prevention and control workforce. Together with our members and partners, we work for a safer world through infection prevention. Join us and learn more about

About AJIC

As the official peer-reviewed journal of APIC, The American Journal of Infection Control (AJIC) is the leading resource on infection control, epidemiology, infectious disease, quality management, occupational health and disease prevention. published by ElsevierAJIC also publishes APIC and CDC infection control guidelines. AJIC is included in Index Medicus and CINAHL. To visit AJIC at


“Evaluation of an aerosol hydrogen peroxide disinfection system for the reduction of Clostridioides difficile Hospital Infection Rates Over a 10-Year Period,” by Christopher Truitt, Ph.D.; Debra Runyan, MT (ASCP), CIC; John Stern, MD; Caroline Tobin; Wesley Goldwater, MBA; and Rodney Madsen, MBA, MPH, was published online in AJIC March 17, 2022. The article can be viewed online at:


Christopher L. Truitt, Ph.D. (corresponding author: [email protected])

Wayland Baptist University and Infection Controls Incorporated, dba GermBlast, Lubbock, TX, USA

Debra A. Runyan, MT (ASCP), CIC

Pennsylvania Hospital, Penn Medicine, Philadelphia, PA, USA

John J. Stern, MD

Pennsylvania Hospital, Penn Medicine, Philadelphia, PA, USA

Caroline Tobin

Pennsylvania Hospital, Penn Medicine, Philadelphia, PA, USA

Wesley Goldwater, MBA

Infection Controls Incorporated, dba GermBlast, Lubbock, TX, USA

Rodney Madsen, MBA, MPH

Infection Controls Incorporated, dba GermBlast, Lubbock, TX, USA

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[1] Centers for Control and Prevention of Disasters. Clostridioides difficile Infection. Published 2019. Accessed November 19, 2020.

[2] The Joint Commission Center for Health Care Transformation. (2016). Clostridium difficile infection reduction project. Oakbrook Terrace: The Joint Commission.


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