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New Guidelines: Take Care With Ultrasound Gel

November 13, 2012
Written by: , Filed in: Cardiac Imaging, Obstetric Ultrasound, Pediatric Radiology
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Radiologists aren’t normally threats to spread infectious diseases. But it can happen.

Epidemiologists at Beaumont Health System in Royal Oak, Michigan, received a mixed blessing in December 2011 when they got a chance to closely observe an infectious disease cluster. Unfortunately, it was at their own hospital. The culprit turned out to be ultrasound transmission gel.

The cluster of infections from the common Pseudomonas aeruginosa bacterium occurred in a cardiovascular surgery intensive care unit. Researchers traced the outbreak to bottles of ultrasound gel that had been contaminated during the manufacturing process. The gel was used for intraoperative transesophageal echocardiography. It eventually became subject to a national recall.

That experience led to a commentary in the December issue of Infection Control and Hospital Epidemiology in which the Beaumont epidemiologists propose a set of guidelines for using the gels. Said lead author Susan Oleszkovicz:

After our investigation of the Pseudomonas outbreak last year linked the source of the outbreak to contaminated ultrasound gel, we were surprised to find that very little guidance is available on appropriate uses for different ultrasound gel products.

Gels usually contain bacterial inhibitors such as parabens or methyl benzoate. But, the commentary points out, “One study demonstrated that an ultrasound gel had no intrinsic antimicrobial properties and could function as a medium for bacterial growth.”

The article suggests that manufacturers and professional societies work toward developing recommendations for appropriate and safe use of the gels. Meanwhile, the authors have some suggestions:

  • Use only sterile, single-dose gel in any procedures that are invasive or involve nonintact skin or fresh surgical wounds.
  • Use only sterile, single-dose gel with newborns or critically ill children.
  • Use of multidose, nonsterile gel on intact skin is OK, but containers should be sealed when not in use and replaced when empty rather than refilled.

In other words, use common sense. Unfortunately, all human beings need that simple reminder sometimes.

Related seminar: Maternal Fetal Imaging

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