Abstract

ObjectivesThe objective of these recommendations is to highlight the importance of infection prevention and control in ultrasound (US), including diagnostic and interventional settings.MethodsReview of available publications and discussion within a multidisciplinary group consistent of radiologists and microbiologists, in consultation with European patient and industry representatives.RecommendationsGood basic hygiene standards are essential. All US equipment must be approved prior to first use, including hand held devices. Any equipment in direct patient contact must be cleaned and disinfected prior to first use and after every examination. Regular deep cleaning of the entire US machine and environment should be undertaken. Faulty transducers should not be used. As outlined in presented flowcharts, low level disinfection is sufficient for standard US on intact skin. For all other minor and major interventional procedures as well as all endo-cavity US, high level disinfection is mandatory. Dedicated transducer covers must be used when transducers are in contact with mucous membranes or body fluids and sterile gel should be used inside and outside covers.ConclusionsGood standards of basic hygiene and thorough decontamination of all US equipment as well as appropriate use of US gel and transducer covers are essential to keep patients safe.Main messages• Transducers must be cleaned/disinfected before first use and after every examination.• Low level disinfection is sufficient for standard US on intact skin.• High level disinfection is mandatory for endo-cavity US and all interventions.• Dedicated transducer covers must be used for endo-cavity US and all interventions.• Sterile gel should be used for all endo-cavity US and all interventions.

Highlights

  • Low level disinfection is sufficient for standard US on intact skin

  • High level disinfection is mandatory for endo-cavity US and all interventions

  • A recent publication has shown that bacterial contamination of ultrasound (US) transducers is significantly higher than contamination of public toilet seats and bus poles [1]

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Summary

Introduction

A recent publication has shown that bacterial contamination of ultrasound (US) transducers is significantly higher than contamination of public toilet seats and bus poles [1]. Even in proven cases of infection transmission, the exact route may remain unclear and insufficiently decontaminated needle guides as well as post-procedures follow-up US examinations without high level decontamination merit consideration [4, 5]. This highlights the need for thorough standardised decontamination protocols. National guidance and legislation regulating decontamination procedures vary throughout Europe. European guidance on interventional US procedures has already been published stressing amongst other issues the importance of good hygiene [6]. Detailed European guidance on transducer decontamination, choice of US gel and transducer covers is lacking. There remains a wide range of practice amongst European US practitioners, as shown in a survey of the European Society of Radiology (ESR) US Working Group (WG) [7]

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