Transvaginal ultrasound probes are HPV-free following low-level disinfection: a cross-sectional multicentre survey of 676 observations.

Abstract

OBJECTIVE\nTo assess the safety of transvaginal ultrasound (TVUS), based on probe and environment screening for high risk human papillomavirus (hrHPV) together with a detailed description of everyday practice.\n\n\nMETHODS\nMulticentre observational survey. We audited 676 TVUS procedures in 46 centres in the Paris region. We recorded preventive hygiene actions at three steps: (1) during previous TVUS, (2) during probe disinfection, and (3) during the preparation of the probe for next TVUS. Immediately before this TVUS, we sampled the keyboard, the bare probe, and the covered probe for hrHPV DNA detection (Cobas® 4800 Roche Molecular Systems, Alameda, CA, United States).\n\n\nRESULTS\nWe failed to detect hrHPV DNA on uncovered or covered probes (0%, 95% CI, 0%-0.55%). Keyboards were positive in 2 cases (0.3%, 95% CI, 0.04%-1.07%). During the previous TVUS the operator avoided touching the keyboard with a hand that had touched the patient s vulva in 85 % of cases, and held the probe with a gloved hand in 68%. For disinfection, the operator wore fresh gloves or repeated hand disinfection in 8% of cases. Disinfection technique was adequate in 87% of cases, not performed in 12 %, and insufficient in 1 %. When preparing the probe for the next scan, hands were cleaned or new gloves used in 81 % of cases, the probe cover and the gel matched guidelines in 98% and 46 % respectively. Of the 7 preventive actions expected, all were performed in 2%, three to six in 95 %, and two in 3% of observations. In 4 centres (9%), disinfection was lacking in over half of the observations.\n\n\nCONCLUSIONS\nNo evidence of hrHPV DNA was found on probes and probe covers following LLD, despite suboptimal compliance with guidelines. Everyday practice could be made easier and safer with a global approach to probe disinfection and hand hygiene. This article is protected by copyright. All rights reserved.