Hydrogen peroxide has a multitude of uses and the vapor form was first identified as a sterilant in late 1970s. Following a number of developments, vaporized hydrogen peroxide (VHP) became widely adopted in early 90s as a substitute for ethylene oxide (EO) in device and instrument processing and reprocessing in healthcare facilities. Often VHP was hailed as the replacement technology for EO. Because of key limitations such as scale, penetration, and compatibility with packaging materials, adoption to terminal sterilization of single-use devices has not commenced to any significant level. However, recent developments in sterilization chamber design and process development provide new opportunity for consideration. For future products, such as those that require “end of production line sterilization,” such limitations may be reconsidered and overcome. This article describes those challenges and how they have been addressed, with practical examples. The development of global consensus standards and leveraging the well-established knowledge of VHP sterilization with regard to microorganism inactivation and material compatibility will help facilitate wider consideration of VHP technology as a true alternative to EO in certain product applications.

Background COVID-19 has brought significant challenges to society globally, particularly in the area of healthcare provision. A pressing need exists in protecting those tasked with delivering healthcare solutions during the COVID-19 crisis by providing solutions for preserving adequate supplies of effective personal protective equipment (PPE). Aim To evaluate and validate available methods for the decontamination of N95 filtering facepiece respirators (FFRs) while maintaining functionality during re-use. Methods Multiple low temperature steam and vaporized hydrogen peroxide (VHP) technologies were assessed for inactivation of Mycobacterium sp. and Feline calicivirus (employed as representatives of the contamination challenge). Findings Virus (≥ 3log 10 ) and Mycobacterium sp. (≥ 6log 10 ) inactivation on varying types of N95 FFRs using an array of heat (65-71 o C), humidity (>50% RH) and VHP without affecting the performance of the PPE. Conclusion Methods have been validated and were authorized by the United States Food and Drug Administration (US FDA) under a temporary Emergency Use Authorization (EUA). Based on findings, opportunities exist for development and deployment of decontamination methods made from simple, general-purpose materials and equipment should a future need arise.

ionization-time-of-flight mass spectrometry was used to identify the specimen, resulting in a score of 1.77 for L. felleii. No reaction during the serological aggregation test (Denka Seiken, Tokyo) was observed against L. pneumophila serogroup (SG) 1-SG6, L. bozemanii, L. dumoffii, Legionella gormanii, or L. micdadei. This study is the first report to describe the Legionella contamination of water taps in a brand-new building, before the start of standard usage. Water taps, showers, sinks, and water systems in healthcare facilities have been recognized to be the causes of healthcare-associated legionellosis. 3-5 Previous studies have not considered the possibility that even brand-new hospital water systems may be at risk for Legionella spp colonization during the building process, which can persist and spread once the hospital is operational. Although Legionella spp contamination in water systems has been associated with water scale, stagnant water, and sediment, brand-new buildings, even prior to active use, may possess contamination risk factors, such as stagnant dead spaces. 3 This study indicates that we must pay attention to the risks of healthcare-associated waterborne infections, even in brand-new buildings and before patients move in.