Objectives

Intracavity ultrasound transducer handles are not routinely immersed in liquid high-level disinfectants. We show that residual bacteria, including pathogens, persist on more than 80% of handles that are not disinfected, whereas use of an automated device reduces contamination to background levels. Clinical staff should consider the need for handle disinfection.Infect Control Hosp Epidemiol 2015;36(5): [581][582][583][584] Ultrasound transducers that contact broken skin or mucous membranes are considered semicritical devices and should undergo high-level disinfection (HLD) between patients. 1 Studies have shown residual contamination on ultrasound transducers when HLD is not performed 2,3 and cases of hepatitis B and C infection have been reported where transmission was thought to have been caused by improper reprocessing of ultrasound transducers. 4,5 HLD methods that involve soaking ultrasound transducers in liquid chemicals, such as glutaraldehyde or ortho-phthalaldehyde, do not typically disinfect the handle. Some major manufacturers specifically advise against submersion of the handle owing to the transducer not being fully sealed. There are no clear recommendations on whether transducer handles should be disinfected, nor is there any consensus on the risk that contaminated transducer handles might pose to patients.Although full immersion of transducers in liquid is not generally possible, approaches that allow the HLD of the entire transducer are now available. This study surveyed the residual contamination on transducer handles when not disinfected (routine soaking method) and also assessed the efficacy of an automated disinfection device capable of disinfecting both heads and handles of ultrasound transducers. methodsThis study was a prospective, bi-centric, cross-sectional study, performed at an ultrasound clinic and public hospital. No patients were excluded and no patient data were collected so the study did not require ethics approval. Following routine ultrasound procedures, all transducers were cleaned with detergent and water and were dried with paper towels. Handle samples were then collected from 2 study groups after the handles were subjected to different disinfection methods. Groups were sampled sequentially in randomized order.The first group of transducers (hereafter referred to as "glutaraldehyde disinfection of head only" [GDHO]) underwent reprocessing according to the existing protocol at the clinic where the head of the transducer was soaked in a 2.4% solution of glutaraldehyde for 20 minutes at room temperature. Transducer handles were not disinfected (per normal practice).The second group of transducers (hereafter referred to as "automated disinfection of head and handle" [ADHH]) were subjected to HLD with an automated disinfection system that disinfects the entire transducer including the handle (trophon EPR; Nanosonics). The device was operated according to the manufacturer's instructions for use.Matched control samples (shams) were collected to quantify contamination occurring during...

Automated, hydrogen peroxide-based disinfection devices offer an alternative to manual ultrasound probe disinfection technologies. Such devices reduce the risks of operator error and can improve patient and operator safety by preventing exposure to toxic chemicals. The adoption of next-generation disinfection devices may help to decrease infection risk and improve patient safety.

Infection control and prevention is critical to delivering safe and high‐quality care to patients undergoing sonographic procedures. In Australia comprehensive standards for reprocessing of ultrasound probes are based on the AS/NZS, TGA and ASUM recommendations. These standards align with the US Centers for Disease Control and Prevention recommendations. However compliance to these guidelines is not ideal and there exists an unmet need for refinement of the guidelines relating to specific factors in clinical sonography.Significant microbiological evidence exists reflecting the increased risk of infection transmission specifically through inadequately reprocessed ultrasound probes. Studies have reported > 80% of transvaginal ultrasound probe handles are contaminated with disease causing pathogens since handle disinfection is omitted from standard reprocessing protocols. Significantly, it was recently discovered that widely‐used high level disinfectants referred to in guidelines are unable to kill HPV while it is becoming increasingly apparent that attention must be paid to the clinical sonography environment as a potential source of nosocomial pathogens.Ultrasound probe reprocessing guidelines and standards are comprehensive however the challenge is in general awareness and effective implementation into practice. As future research in this area is performed, guidelines will need to be amenable to revision to provide patients with the best standard of care.

Short oral presentation abstracts reconstruction in coronal section before insertion of Mirena, 14 had expulsion at different time points after insertion. The 2 nd subgroup consisted of 17 women with already occurred expulsion. Results: Upon retrospective analysis of uterine cavity configuration, area and size it was established that IUS expulsion happened in no case with regular triangular shape of uterine cavity, area of uterine cavity 5,6-7,6 cm2 and distance between tubal angles less than 4,5 cm.In 11 patients of the second subgroup with occurred expulsion, different degrees of uterine cavity deformity were noted. The highest rate of expulsions (58,1%) was seen in patients of both subgroups who had distance between tubal angles above 4,5 cm (5,21 ± 0,54 cm) and cavity area more than 9.0 cm 2 (12,78 ± 2,01 cm 2 ) which is significantly different from same characteristics of control group (p < 0,05). There was no difference in mean length of uterine cavity between the groups of carriers and patients with occurred expulsions. Conclusions: The analysis of data allows establishing the advantages of three-dimensional echography in predicting expulsion of IUS Mirena. Patients who are prescribed treatment with Mirena should undergo three-dimensional reconstruction of uterine cavity in coronal section before insertion of Mirena. The probability of expulsion is high in cases of deformities of uterine cavity which can hamper correct placement of IUS, and in cases when the width of cavity between tubal angles is more than 4,5 cm. OP16.07 Comparison of 3D/4D transvaginal ultrasound to 3D saline infused sonohysterography for evaluation of endometrial polypsObjectives: The purpose of this study was to evaluate the accuracy of 3D/4D transvaginal ultrasound (3D/4D TVUS) and SIS for the evaluation of endometrial polyps for women with abnormal uterine bleeding or postmenopausal bleeding. Methods: Between 2009 and 2011, 159 women with abnormal uterine bleeding or postmenopausal bleeding were evaluated with 3D/4D TVUS, SIS, and hysteroscopy. Pathology was obtained from either a dilation and curettage or hysterectomy. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for TVUS and SIS for diagnosing endometrial polyps were determined. Results: After endometrial polyps were confirmed with histology, the sensitivity and specificity of 3D/4D TVUS for the diagnosis of polyps were 91.3% and 90.9% respectively. The sensitivity and specificity of SIS were 97.3% and 96% respectively. The PPV and NPV for 3D/4D TVUS were 96% and 80%, while the PPV and NPV for SIS were 96.5% and 93%. Conclusions: In this study, we compared the accuracy of TVUS to SIS to diagnose endometrial polyps. Previous studies have analyzed the ability non 3D/4D TVUS to correctly diagnose endometrial polyps. With the advancement 3D/4D technology to ultrasound, the ability to accurately diagnose polyps may eliminate the need for further testing with SIS if the diagnosis is endometrial polyps. OP16.08 Three-dimensional (3D) in v...