Infection prevention and control in ultrasound – best practice recommendations from the European Society of Radiology Ultrasound Working Group
The new guidelines emphasise that there is published evidence that highlights contamination risks of ultrasound transducers, even with the use of transducer covers, and after low level disinfection (LLD). They strongly recommend high level disinfection (HLD) for all interventional ultrasound procedures and endocavitary ultrasound.1
This is supported by a recent NHS Scotland first population-level study that demonstrated a greater risk of positive microbiological reports and antibiotic prescriptions within 30 days for adults who had undergone endocavitary ultrasound procedures when HLD was not used as standard of care. The study states that ‘failure to comply with guidance recommending high-level disinfection of semi‐invasive ultrasound probes (SIUPs) [i.e. endocavitary ultrasound probes] will continue to result in an unacceptable risk of harm to patients’.2
Ultrasound (US) practitioners cannot always know which patients carry transmissible pathogens or who may be susceptible to acquiring infections; hence, high standards of infection prevention and control will ensure that all patients are kept safe.
The guidelines stated that ‘In Germany, Merz et al., like others, favours automated systems for high level disinfection, in particular devices using hydrogen peroxide (Trophon® EPR), now approved by the US Food and Drug Administration [29, 30]. Another important aspect of automated systems is the standardised and reproducible decontamination process thus avoiding operator-associated errors or variations. Ultraviolet (UV) light is less effective in eradicating microbes in comparison to hydrogen peroxide …A publication by Rutala last year emphasises the need for HLD of all semi-critical and critical devices, already detailed in the original American guidance from 2008 [32, 33].’1
1. Nyhsen CM, Humphreys H, Koerner RJ, Grenier N, Brady A, Sidhu P, et al. Infection prevention and control in ultrasound – best practice recommendations from the European Society of Radiology Ultrasound Working Group. Insights Imaging. 2017:doi: 10.1007/s13244-017-0580-3.
2. Health Protection Scotland, NHS National Services Scotland. NHSScotland Risk Based Recommendations for the Decontamination of Semi-Invasive Ultrasound Probes: Risk of infection following semi-invasive ultrasound procedures in Scotland, 2010 to 2016. Version 1.0. October 2017. Accessible at: http://www.hps.scot.nhs.uk/pubs/detail.aspx?id=3366.