Executive SummaryA recent Centers for Disease Control and Prevention report estimated that annually 1.7 million patients acquire an infection while in a hospital (known as healthcare-associated infections, or HAIs), and the annual medical costs of healthcare associated with HAIs in U.S. hospitals are estimated to be between $5 billion and $11 billion. In other words, the patients contracted the infection while in the hospital, and the infection was not a result of their medical condition when admitted to the hospital. It is estimated that about 90,000 individuals die every year from HAIs. The list of HAIs is extensive; some are relatively easy to treat and some, like methicillin-resistant Staphylococcus aureus (MRSA), are life-threatening to both patients and staff. At least one third of HAIs are considered preventable and can be directly related to a standard of practice in infection control cleaning techniques. Although important in reducing surface contamination, manual cleaning methods have limited efficacy in reducing the bioburden on the surfaces beyond "high touch" areas, and they are completely ineffective in disinfecting airborne pathogens disseminated via aerosols in healthcare environments. Therefore new, more effective methods are needed to enhance the decontamination of various hospital facilities where diseases can rapidly and easily spread.Alternative disinfection technologies such as gaseous decontaminations are being marketed to the healthcare sector. Gaseous decontamination offers a complementary technology to manual cleaning that increases the probability of an effective reduction in pathogens by providing a comparatively uniform distribution of disinfectant in an entire confined environment. Three commercially available gaseous decontamination technologies have been extensively examined and reported as effective in reducing HAIs: gaseous hydrogen peroxide, chlorine dioxide, and ozone. While there is a role to play for these new technologies in the decontamination of healthcare settings, the requirement for both a thorough preclean of surfaces and safety measures to ensure no gases and vapors penetrate beyond the space being decontaminated calls into question the safety and cost-effectiveness of these methods in healthcare facilities.The goal of this study was to validate the previously observed high biological kill performance of the PAEROSOL decontamination technology against common HAIs in a non-human subject trial within a hospital setting of Madigan Army Medical Center (MAMC) on Joint Base Lewis-McChord in Tacoma, Washington. PAEROSOL-a semi-dry micro-aerosol atomized from a 0.5-0.25% aqueous solution of table salt that has been electrochemically activated-was previously shown to be non-toxic, environmentally safe, and requiring no precautions for its application. As compared to gaseous hydrogen peroxide, chlorine dioxide, and ozone, PAEROSOL application requires neither thorough pre-cleaning of the surfaces, nor special safety measures. In addition to validating the disinfecting efficacy...