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.
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
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