1145. Sparring with Spores: Ultrasounds as a vector for pathogen transmission in the intensive care unit
Session: Poster Abstract Session: Healthcare Epidemiology: Environmental and Occupational Health
Friday, October 5, 2018
Room: S Poster Hall
  • Sparring with spores.pdf (522.5 kB)
  • 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.

    Amrita John, MBBS1, Aanchal Kapoor, MD1, Thriveen Sankar Chittoor Mana, MS2, Annette Jencson, BSMT(ASCP)SM, CIC3, Jennifer Cadnum, B.S.4, Abhishek Deshpande, MD, PhD5 and Curtis J. Donskey, MD6, (1)Critical Care Medicine, Cleveland Clinic Foundation, Cleveland, OH, (2)Case Western Reserve University, Cleveland, OH, (3)Research Service, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, (4)Research Service, Cleveland VA Medical Center, Cleveland, OH, (5)Department of Infectious Diseases, Cleveland Clinic, Cleveland, OH, (6)Infectious Diseases, Case Western Reserve University, Cleveland, OH


    A. John, None

    A. Kapoor, None

    T. Sankar Chittoor Mana, None

    A. Jencson, None

    J. Cadnum, None

    A. Deshpande, 3M: Investigator , Research grant . Clorox: Investigator , Research grant . STERIS: Investigator , Research grant .

    C. J. Donskey, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.