Prevention of Cross-Infection
in Diagnostic Ultrasound Improves Patient Care
COVID-19: Germitec UV-C Disinfection Systems
During the COVID-19 pandamic, we have been asked by healthcare organisations about the ability to kill the COVID-19 Coronavirus using our various UV-C high level disinfection systems: Hypernova Chronos, Antigermix S1 and Antigermix E1.
At this point in time we have not conducted tests against this specific strain of Coronavirus and therefore cannot specifically state that it will be effective. However, what we do know is that our UV-C medical devices have proven effective against bacteria, mycobacteria, fungi, and viruses (such as HPV, Poliomavirus, Enterovirus Polio, Adenovirus, Orthopoxvirus, Parvovirus, and Herpes virus) and continue to be an extremely effective tool for high level disinfection of ultrasound probes (including TE), and ENT endoscopes.
We have seen that historical studies, for example Darnell et al,1 have looked at the effectiveness of UV-C against SARS-COV, a different strain of Coronavirus and have concluded positively, that UV-C light is effective in killing it.
The current feedback from Laboratories has been the following:
“ We have looked at the various characteristics of organisms such as the polio virus and adenovirus. When compared with Covid-19 there is no unique structure or characteristic (i.e. envelope, nucleocapsid, glycoprotein, etc) associated with Covid-19 that would suggest that it would have any greater resistance to disinfection than other coronaviruses or those organisms tested in the initial validation of the Germitec UV-C machines.”
Moreover, EPA considers that testing against other viruses is sufficient to claim efficacy against Covid-19 positive list:
“How does EPA know that these products work on SARS-CoV-2? While these products have not been tested against SARS-CoV-2, the cause of COVID-19, they are expected to be effective based on: Demonstrated efficacy against a harder-to-kill virus; Qualified for the emerging viral pathogens claim; or Demonstrated efficacy against another human coronavirus similar to SARS-CoV-2. SARS-CoV-2 is a new virus. Such pathogens are often unavailable commercially for laboratory testing.”2
Under the Spaulding classification the ultrasound probe is classified into non-critical probe, semi-critical probe and critical probe, determined by how the probe comes in contact with the patient’s procedure site and the level of cross-infection risk.3-8
Non-critical probe is low level disinfected as the probe contacts intact skin or non-infected skin and the potential cross-infection risk is low.
Semi-critical probe is high level disinfected as the probe may contact non-intact skin (wound or burn) or mucus membrane and the potential risk of cross-infection is considered medium to high.
Critical probe should be sterilised, if not possible can be high level disinfected and placed inside a sterile cover to prevent the contamination of a sterile field. The potential risk of cross-infection is considered high.
Clinical Support - Guidelines, Research Papers and Webinars
WHO – Coronavirus disease (COVID-19) pandemic
COVID-19 Position Statements and Guidelines
- World Federation for Ultrasound in Medicine and Biology Position Statement: How to Perform a Safe Ultrasound Examination and Clean Equipment in the Context of COVID-19
- WFUMB Provides Free Access to the following materials – Manual on prevention and treatment of COVID-19: Faced with an unknown virus, sharing and collaboration are the best remedy
- WFUMB Position Statement: How to perform a safe ultrasound examination and clean equipment in the context of COVID-19.
- Prevention of pathogen transmission during ultrasound use in the Intensive Care Unit: Recommendations from the College of Intensive Care Medicine Ultrasound Special Interest Group (USIG)
- Ultrasound Transducer and Equipment Cleaning and Disinfection. By UK FUSIC Committee on behalf of Intensive Care Society and endorsed by Society for Acute Medicine.
- ASUM Guidelines COVID-19 Infection prevention and control guidance for all ultrasound practitioners.
- ISUOG Safety Committee Position Statement: safe performance of obstetric and gynaecological scans and equipment cleaning in the context of COVID-19 Released 23 March 2020.
- Our Italian Experience Using Lung Ultrasound for Identification, Grading and Serial Follow‐up of Severity of Lung Involvement for Management of Patients with COVID‐19. Published on 1 April 2020 by Echocardiography.
- What’s new in lung ultrasound during the COVID-19 pandemic
- COVID-19 pneumonia: different respiratory treatments for different phenotypes?
- Efforts to Attenuate the Spread of Infection (EASI): a prospective, observational multicentre survey of ultrasound equipment in Australian emergency departments and intensive care units.
UV-C Research Papers
- Evaluation of a new disinfection method for ultrasound probes used for regional anesthesia: ultraviolet C light
- UVC radiation as an effective disinfectant method to inactivate human papillomaviruses
- Evaluation of ultraviolet C for disinfection of endocavitary ultrasound transducers persistently contaminated despite probe covers
- Decontamination of Intravaginal Probes Infected by Human Papillomavirus (HPV) Using UV-C Decontamination System
Prevention of Pathogen Transmission during POCUS
Presenter: Dr Cartan Costello –MB BCH BAO, FCICM, FACRRM, FRACGP, BA Com, Grad Dip Crit Care Echo
Specific Recommendations from the USIG focus on Eight (8) recommendations:
- Ultrasound-guided procedures
- Ultrasound machine and probe
- Cost and Practicality
- Use of sterile probe covers
- Ultrasound gel
- Documentation and traceability
- Human Resources
How To Integrate Scientific Evidence into Best Clinical Practice
Presenter: Dr. David J. Weber, MD, MPH, FIDSA, FSHEA, FRSM
Provides an insight into Best Research Evidence, who has a strong background in researching Healthcare-associated Infection and developing Guidelines (2008 CDC Guideline – Disinfection and Sterilization in Healthcare Facilities).
- How to Integrate Scientific Evidence into Best Clinical Practice
- Assessing Scientific Evidence: Disinfectants and Disinfecting devices
- Darnell, M., Subbarao, K., Feinstone, S. and Taylor, D. (2004). Inactivation of the coronavirus that induces severe acute respiratory syndrome, SARS-CoV. Journal of Virological Methods, 121(1), pp.85-91.
- .Nyhsen, C. M., et al. (2017). “Infection prevention and control in ultrasound – best practice recommendations from the European Society of Radiology Ultrasound Working Group.” Insights Imaging 8(6): 523-535.
- French Ministry of Health issues guidance requiring disinfection of endocavitary ultrasound probes https://solidarites-sante.gouv.fr/soins-et-maladies/qualite-dessoins-et-pratiques/securite/article/prevention-des-risques-d-infection-associes-a-l-utilisation-dessondes-d.
- Health Service Executive (HSE) Quality Improvement Division (2017). HSE Guidance for Decontamination of Semi-crical Ultrasound Probes; Semi-invasive and Non-invasive Ultrasound Probes. Document: QPSD-GL-028-1.
- Health Facilities Scotland, NHS National Services Scotland, Health Protection Scotland. Scotland, March 2016. NHS Scotland Guidance for Decontamination of Semi-Critical Ultrasound Probes; Semi-invasive and Non-invasive Ultrasound Probes. Document: HPS/HFS Version 1.0.
- Kollmann, C. and K. Salvesen (2017). “Best Practice recommendations for cleaning and disinfection of ultrasound transducers whilst maintaining transducer integrity.” European Committee for Medical Ultrasound Safety (ECMUS).
- JACQUES S. et al. (2017) GUIDELINES FOR CLEANING TRANSVAGINAL ULTRASOUND TRANSDUCERS BETWEEN PATIENTS World Federation for Ultrasound in Medicine & Biology