1145. Sparring With Spores: Ultrasounds as a Vector for Pathogen Transmission in the Intensive Care Unit. (26th November 2018)

• Record Type: Journal Article
• Authors: John, Amrita; Kapoor, Aanchal; Mana, Thriveen Sankar Chittoor; Jencson, Annette; Cadnum, Jennifer; Deshpande, Abhishek; Donskey, Curtis J
• Is Part Of: Open forum infectious diseases. Volume 5(2018)Supplement 1
• Page Start: S344
• Page End: S344
• Publication Date: 2018-11-26
• Subjects: Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofy210.978
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: Background: Portable equipment that is shared among patients can be a potential source of pathogen dissemination. In busy healthcare settings, cleaning of shared medical equipment may be suboptimal. In addition, equipment such as ultrasound probe heads present a challenge because sporicidal cleaning solutions such as bleach cannot be used. Methods: We conducted a culture survey of ultrasounds in 15 intensive care units (ICUs) at a large tertiary care referral center, including medical, surgical, neurology, cardiology, and cardiovascular ICUs. Multiple high-touch surfaces on different types of ultrasound equipment used in the ICUs were swabbed to assess for the presence of Clostridium difficile and antibiotic-resistant Gram-negative bacilli. To assess cleaning, a fluorescent marker visible only under UV light was placed on high-touch surfaces on each of the cultured ultrasounds and a black light was used determine if the marker was removed after 24 hours and again after 1 week. Results: Of 15 ultrasounds cultured, 7% were contaminated with C. difficile spores and 7% were contaminated with Gram-negative bacilli. Based on fluorescent marker removal, only 20% of the ultrasounds were cleaned within 24 hours and only 31% were cleaned within 1 week. Ultrasounds with touchscreens were cleaned more frequently than those with no touchscreen. For equipment with a combination of touchscreen features and knobs, the touchscreens were cleaned more often than the knobs which often had residual marker even after 7 days. Conclusion: Ultrasound equipment can be a vector for transmission of C. difficile and other pathogens in critical care settings. In our facility, cleaning of ultrasound equipment was suboptimal, particularly for ultrasounds that did not have a touchscreen interface. Since ultrasounds are being employed in critical care settings with increasing frequency, there is a need for improved methods for cleaning and disinfection. Disclosures: A. Deshpande, 3M: Investigator, Research grant. Clorox: Investigator, Research grant. STERIS: Investigator, Research grant.