Transvaginal ultrasound probes are human papillomavirus‐free following low‐level disinfection: cross‐sectional multicenter survey

ABSTRACT Objectives To assess the frequency of detection of high‐risk human papillomavirus (hrHPV) on transvaginal ultrasound (TVS) probes and keyboards and evaluate operator compliance with national recommendations for prevention of cross‐infection during TVS. Methods This was a multicenter observa...

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Bibliographic Details
Published in:Ultrasound in obstetrics & gynecology 2019-11, Vol.54 (5), p.688-695
Main Authors: Lucet, J.‐C., Heard, I., Roueli, A., Lafourcade, A., Mandelbrot, L., Estellat, C., Dommergues, M.
Format: Article
Language:English
Subjects:
Cross Infection - prevention & control
Cross Infection - virology
Cross-Sectional Studies
cross‐infection
cross‐sectional study
Deoxyribonucleic acid
diagnostic imaging
Disinfectants
Disinfection
Disinfection - methods
Disinfection - statistics & numerical data
DNA
DNA probes
Equipment Contamination - prevention & control
Female
France
Gloves
Guideline Adherence - standards
Guidelines
Hand Hygiene - standards
Human papillomavirus
Humans
Hygiene
Keyboards
Medical diagnosis
Operators
Papillomaviridae - isolation & purification
papillomavirus infection
Papillomavirus Infections - prevention & control
Personal hygiene
Polls & surveys
prevention and control
Probes
transmission
transvaginal ultrasound
Ultrasonic imaging
ultrasonography
Ultrasonography - instrumentation
Ultrasound
Vagina
viral DNA
virology
Vulva
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Summary:ABSTRACT Objectives To assess the frequency of detection of high‐risk human papillomavirus (hrHPV) on transvaginal ultrasound (TVS) probes and keyboards and evaluate operator compliance with national recommendations for prevention of cross‐infection during TVS. Methods This was a multicenter observational survey involving 46 public and private centers, in the Paris region of France, in which at least five consecutive TVS examinations were performed per day. We audited 676 TVS procedures. We recorded preventive hygiene actions undertaken by the operator at three stages: (1) during TVS; (2) during probe disinfection; and (3) during preparation of the probe for the next TVS. After probe disinfection, we collected one sample from the bare probe and one from the ultrasound keyboard; following probe preparation for the next examination, an additional sample was obtained from the covered probe. The samples were tested for presence of hrHPV DNA using the Cobas® 4800 System. Results We did not detect hrHPV DNA in samples collected from uncovered or covered probes (0%; 95% CI, 0.00–0.55%). Keyboard samples were positive for hrHPV in two cases (0.3%; 95% CI, 0.04–1.07%). During TVS, the operator avoided touching the keyboard with a hand that had touched the patient's vulva in 86% of cases and held the probe with a gloved hand in 68%. Before probe disinfection, the operator wore new gloves, or performed hand disinfection in 8% of cases. The probe disinfection technique used was adequate in 87% of cases, not performed at all in 12% and insufficient in 1%. Before preparing the probe for the next scan, the operators disinfected their hands or used new gloves in 81% of cases. The probe cover and the coupling gel used complied with recommendations in 98% and 46% of cases, respectively. Of the seven preventive hygiene actions recommended in national guidelines, all were performed in 2%, three to six in 95% and two in 3% of observations. In four (9%) centers, disinfection was not performed in over half the observations. Conclusions No evidence of hrHPV DNA was found on TVS probes and probe covers following low‐level disinfection, despite suboptimal compliance with hygiene guidelines. Routine TVS practice could be made easier and safer with a global approach to probe disinfection and hand hygiene. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
ISSN:0960-7692
1469-0705
DOI:10.1002/uog.20268