Disinfection of Transvaginal Ultrasound Probes by Ultraviolet C - A clinical Evaluation of Automated and Manual Reprocessing Methods.

PURPOSE: Since pathogens can be transmitted to patients via transvaginal ultrasound probes, it is of particular importance that cleaning and disinfection are performed adequately. This study was designed to do a qualitative comparison of a low-level disinfection technique with disinfectant-impregnated wipes and an automated disinfection technique using ultraviolet C radiation in a clinical setting. MATERIALS AND METHODS: The transvaginal ultrasound probes used in two groups of 160 patients were compared in a prospective controlled study regarding the effectiveness of manual low-level disinfection (Mikrozid sensitive wipes) and automated disinfection using ultraviolet C radiation (Antigermix AS1). Microbiological samples were taken from the whole surface of the probe before and after the disinfection process. RESULTS: Before disinfection, 98.75 % (316/320) of the samples showed bacterial contamination. After automated and manual disinfection, the contamination rates were 34.2 % (54/158, automated) and 40.5 % (64/158, disinfectant wipes) (p > 0.05). Pathogens with the potential to cause healthcare-associated infections, such as Enterococcus faecalis and Klebsiella pneumoniae, were removed completely by both techniques. Manual disinfection showed a lower contamination rate after disinfection of bacteria that usually belong to the vaginal, pharyngeal and skin flora (disinfectant wipes 10.6 %, 11/104, automated 32.5 %, 38/117) (p < 0.001). CONCLUSION: For the clinical routine, automated disinfection with ultraviolet C is a promising technique for transvaginal ultrasound probes because of the simple handling and time efficiency. In our study, this method was completely effective against nosocomial pathogens. However, the study didn't show any significant difference in terms of effectiveness compared to low-level wipe disinfection.

Adrenal gland size in growth restricted fetuses.

Objective To compare the adrenal gland size of fetal growth restricted (FGR) and normal control fetuses. Study design In this prospective study the adrenal gland size of 63 FGR fetuses and 343 normal controls was measured between 20 and 41 weeks of gestation. The total width and the medulla width were measured in a new standardized transversal plane. The cortex width and a calculated ratio of the total and medulla width (adrenal gland ratio) were compared between both groups. Results The mean cortex width and the adrenal gland ratio in FGR fetuses were higher in comparison to the controls (P<0.001; P=0.036, respectively). The cortex width correlated positively with the gestational age (control group: P<0.001; FGR group: P=0.089) whilst the adrenal gland ratio showed no association with the gestational age (control group: P=0.153; FGR group: P=0.314). Conclusion The adrenal gland cortex width and the adrenal gland ratio were increased in FGR fetuses compared to normal fetuses.