Research Articles by Dr. Curtis J. Donskey, MD:  [ 2016 SHEA Research Poster ]     [ 2016 AJIC Article ]



Is this another “hydrogen peroxide” disinfection system?

No. The Altapure technology uses PAA, a highly respected organic chemistry that is non toxic, ends “green” leaving no residue, and is safe for electronics. Important differences are explained below.

Is Altapure ® and it's AP-4 ™ product just another “fogging” device?

No. Altapure has pushed the envelope of aerosol generation technology, and its technology and performance level is completely new to the market. Altapure offers a paradigm change with respect to large area high-level disinfection.

Will the Altapure technology achieve a consistent 100% kill of Clostridium difficile (C. diff), MRSA, and other pathogens?

Yes. The Altapure technology will consistently deliver a 100% kill, including spores like Clostridium difficile (C. diff), when the treatment protocol is followed.

For more information, please see this page:  Test Results & Efficacy

What is the AP-4 ™ System?

The AP-4 ™ system is an advanced ultrasonic product capable of delivering a dense cloud of sub-micron droplets for the high-level disinfection of large spaces such as those found in a typical hospital.

The deployed sub-micron aerosol delivers gas-like performance and large, “3-D area coverage ™ ”, that can fill and treat multiple connected areas, complex geometries, long horizontal and vertical runs, and high-level disinfect or decontaminate the various surfaces within these spaces, including any equipment or objects therein.

How long does it take to treat a standard hospital room?

Less than fifty (50) minutes.

A standard 3,000 cubic foot hospital room can be completely disinfected and repopulated in less than 45 minutes and achieve a “no growth” result for spores, bacteria, and viruses. This includes the time for setup and breakdown of the system, which takes a total of 10 minutes. Our high level disinfection process consists of 4 stages:

* Deploy - in the deploy stage the AP-4 ™ fills all areas of the room with the sub-micron aerosolized Altacare solution.

* Dwell - the Altacare PAA solution is suspended in the air as a sub-micron sized aerosol, bombarding and destroying the pathogens through oxidation.

* Dehumidification - will remove the Altacare aerosol from the room through our Air Reprocessor system housed in the AP-4 ™.

* Deodorization - the Air Reprocessor scrubs the air with an Activated Charcoal and HEPA filtration system to remove any remaining odor from the Altacare PAA solution.

For more information, please see this page:  Process Steps

Does Altapure ® always achieve a 100% complete kill? Is there any organism you can’t kill?

Altapure's clinically proven process will deliver a predictable and consistent log 6+ reduction (99.9999% kill) when used in accordance with our instructions. More importantly, we achieve a “no growth” result for Viruses * Bacteria * Spores, in the treated space, including under tables, around corners, and in attached spaces like patient bathrooms.

When competitors publish their data, you must be careful to determine exactly what bacteria or virus the log reduction data is for, and where the biological challenges were located in the room, especially outside line of sight from the treatment device. More importantly, it is important to determine what spores (hardest to kill) were used in the testing. Were the spores located in challenging locations in the rooms and connected spaces?

It is important to note that third party laboratories, medical researchers, and hospitals, have proved that the Altapure technology can achieve “'No Growth” on all tested surfaces in the treated space, for bacterial spores like Clostridium difficile (C. diff / CDF / C-diff) and even hearty "gold standard" test organisms like G. Stearothermophilus spores (the same organism used daily in every hospital as a biological control test for all steam sterilizers).

For more information, please see this page:  Test Results & Efficacy

How long do we have to wait after the treatment cycle to enter the room?

No waiting / Immediate Access. Once the treatment cycle has finished, the treated room is safe to enter and is available for immediate occupation. Altacare ® PAA cold sterilant is non-toxic and safe, allowing for immediate repopulation of the room.

For more information, please see this page:  Aerosol Liquid & Process Safety

After a hospital room has been treated by Altapure ® can it can be re-contaminated?

If contaminated equipment, personnel, or devices, are brought into a room that has been treated by Altapure, it is possible to introduce and pass this new contamination to surfaces in that room, or even to any patient(s) in that room and infect them. This is why strict control protocols needs to be put into place and followed.

It is important to remember that peer reviewed clinical research has shown, according to Rutala et al. (2010), that patients hospitalized in rooms previously occupied by individuals infected or colonized with Methicillin-resistant Staphylococcus aureus (MRSA), [58] Vancomycin-resistant Enterococcus (VRE), [59] or Clostridium difficile (C. diff / CDF / C-diff) [60] are at significant risk of acquiring these organisms from contaminated environmental surfaces. [62] For example, Shaughnesy et al. (2011) stated that room assignment has been shown to be important in the acquisition of hospital-acquired infections, with a 40% increased risk of acquiring Methicillin-resistant Staphylococcus aureus (MRSA) and Vancomycin-resistant enterococcus (VRE) infection when the previous room occupant was positive. [27] [29] This is why it is important to clean each patient room before reoccupying it with a new patient.

Altapure's technology and process provides the certainty and confidence, that the patient is entering an extremely clean hospital room or operating space, that was treated with a methodology that offers a “Total Kill” and “No Growth Standard” for:  Viruses, Bacteria, and Spores.

For more information, please see this page:  Test Results & Efficacy

You state that your product is tested and meets standard: IEC60601-1 for medical equipment, why is this important?

It is actually important for all high level disinfection equipment in the industry to meet this standard, since IEC60601-1 has stringent requirements for “conducted emissions” and it is essential that equipment meets this standard, given its close proximity to patients and other equipment in the area that may be used for patient care. If large area disinfection equipment does not meet this standard, it could possibly disrupt other hospital equipment connected to the same electrical system, and cause that equipment to malfunction. This electrical standard is very important.

Can the AP-4 ™ product be operated remotely?

Yes. The AP-4 ™ is remotely operated using a small, hand held controller that is touch screen activated. It communicates via wireless means with one or more AP-4 ™ machines and any ancillary devices. The remote control device is approved for use in all medial, and scientific environments. It meets all FCC regulations and our transceiver is approved for use in Europe and Japan.

Is your process corrosive to the equipment in the room?

No. We have done extensive testing on computers, electronics, televisions, and other equipment commonly found in hospital rooms and ICU units, with no corrosion issues.  Methodist Hospital in Indianapolis, IN performed 1,300 deploys in the Critical Care areas with no reported equipment problems.  A Level 1 Trauma Center in the Northeast, that averaged 5,000 deploys per year using Altapure's HJ-30i system, has also reported no evidence of corrosion damage.

For more information, please see this page:  Aerosol Liquid & Process Safety

What is Altacare ®, and is it EPA approved?

Altacare ® cold sterilant is a reagent grade peroxyacetic acid (PAA) solution. This chemistry has been utilized in hospitals and clinics for over 20 years. Altacare is EPA approved.

Altacare concentrate is mixed inside the AP-4 ™ machine, with reverse osmosis deionized (RODI) water, prior to and during each operation cycle. This mixed liquid is then converted into an aerosol that consists of the following percentage of ingredients:

Peroxyacetic Acid = 0.18%
Hydrogen Peroxide = 0.88%
Distilled Water: 98.58% (Total Inert Ingredients: 98.94%)

Total = 100.0%

For more information, please see this page:  Aerosol Liquid & Process Safety


How many rooms can one (1) liter of Altacare ® clean?

About 15 rooms.


Is there any danger to employees or patients if they are accidentally exposed to the aerosol?

No.  However, it’s not a pleasant experience.

For more information, please see this page:  Aerosol Liquid & Process Safety

Is there a 1 year warranty included in the price?


Can the AP-4 ™ system high-level disinfect the Ebola virus?

While Altapure has not yet had the opportunity to conduct testing against the Ebola virus, it has achieved “total kill” / “no growth” against the Poliovirus (VR-1562), per the AOAC International's test methods ( Please see this page:  Test Results & Efficacy ).

In addition, since there are no products on the market (2014) with specific label claims against the Ebola virus, the CDC recommends using a U.S. Environmental Protection Agency (EPA) registered hospital disinfectant with a label claim for a non-enveloped virus (ie: Norovirus, Rotavirus, Adenovirus, Poliovirus) to disinfect environmental surfaces in rooms of patients with suspected or confirmed Ebola virus infection.

The CDC also states that EPA-registered hospital disinfectants with label claims against non-enveloped viruses (ie: Poliovirus) are broadly antiviral and capable of inactivating both enveloped and non-enveloped viruses. However, as a precaution, selection of a disinfectant product with a higher potency than what is normally required for an enveloped virus, is being recommended at this time.

It is important to remember that all large area, high-level disinfection systems, should be used as an adjunct to regular cleaning / disinfection procedures for hard room surfaces. All federal labeling and directions for use must be followed.

Please visit the following CDC link for more information:

Altapure meets the recommended level of performance, and it is believed that Altapure's technology can achieve a more consistent, faster, and better result, than any other large area, high level disinfection option currently available to the world today.

Why did we choose Altacare?

After testing various chemical products, Altapure chose to work with the PAA / Peroxyacetic Acid chemistry contained in Altacare for the following reasons:

a) EPA approved for fogging.
b) Delivers a rapid kill for viruses, bacteria, and spores.
c) Decomposes and dries into safe and environmentally friendly components of: water vapor, oxygen, and acetic acid (vinegar) vapor.
d) Leaves no residue once dry.
e) Can obtain full spore kill with only 0.88 % H2O2 & 0.18 % PAA.
f) Pharmaceutical quality raw ingredients.
g) For over 20 years, Altacare ® PAA chemistry has been used in hospitals and clinics.

For more information, please see this page: Altacare Cold Sterilant

* Click here to learn more about Altapure and the AP-4 ™.


* Please click here for citations and references.