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Infections Associated with Use of Ultrasound Transmission Gel: Proposed Guidelines to Minimize Risk

  • Susan C. Oleszkowicz (a1), Paul Chittick (a1) (a2), Victoria Russo (a1), Paula Keller (a1), Matthew Sims (a1) (a2) and Jeffrey Band (a1) (a2)...


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Department of Epidemiology, Beaumont Health System, 3601 West 13 Mile Road, Royal Oak, MI 48073 (


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1. Olshtain-Pops, K, Block, C, Temper, V, et al. An outbreak of Achromobacter xylosoxidans associated with ultrasound gel used during transrectal ultrasound guided prostate biopsy. J Urol 2011;185:144147.
2. Keizur, J, Lavin, B, Leidich, R. Iatrogenic urinary tract infection with Pseudomonas cepacia after transrectal ultrasound guided needle biopsy of the prostate. J Urol 1993;149:523526.
3. Hutchinson, J, Runge, W, Mulvey, M, et al. Burkholderia cepacia infections associated with intrinsically contaminated ultrasound gel: the role of microbial degradation of parabens. Infect Control Hosp Epidemiol 2004;25:291296.
4. Weist, K, Wendt, C, Petersen, L, Versmold, H, Ruden, H. An outbreak of pyodermas among neonates caused by ultrasound gel contaminated with methicillin-susceptible Staphylococcus aureus . Infect Control Hosp Epidemiol 2000;21:761764.
5. Gaillot, O, Maruejouls, C, Abachin, E, et al. Nosocomial outbreak of Klebsiella pneumoniae producing SHV-5 extended-spectrum β-lactamase, originating from a contaminated ultrasonography coupling gel. J Clin Microbiol 1998;36:13571360.
6. Jacobson, M, Wray, R, Kovach, D, Henry, D, Speert, D, Matlow, A. Sustained endemicity of Burkholderia cepacia complex in a pediatric institution, associated with contaminated ultrasound gel. Infect Control Hosp Epidemiol 2006;27:362366
7. Chittick, P, Russo, V, Sims, M, et al. Outbreak of Pseudomonas aeruginosa respiratory tract infections in cardiovascular surgery associated with contaminated ultrasound gel used for trans-esophageal echocardiography—Michigan, December 2011–January 2012. MMWR Morb Mortal Wkly Rep 2012;61:262264.
8. Product line. Pharmaceutical Innovations website. Accessed April 12, 2012.
9. Muradali, D, Gold, WL, Phillips, A, Wilson, S. Can ultrasound probes and coupling gel be a source of nosocomial infection in patients undergoing sonography? an in vivo and in vitro study. Am J Roentgenol 1995;164:15211524.
10. Ohara, T, Itoh, Y, Itoh, K. Ultrasound instruments as possible vectors of staphylococcal infection. J Hosp Infect 1998;40:7377.
11. Favero, MS, Bond, WW. Chemical disinfection of medical and surgical materials. In: Block, SS, ed. Disinfection, Sterilization, and Preservation. 4th ed. Philadelphia: Lea & Febiger, 1991:618619.
12. Health Canada. Notice to Hospitals: Important Safety Information on Ultrasound and Medical Gels. October 20, 2004. Accessed March 16, 2012.
13. Rutala, WA, Weber, DJ; Healthcare Infection Control Practices Advisory Committee. Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008. Accessed April 24, 2012.
14. Ashline, V, Stevens, A, Carter, MJ. Nosocomial peritonitis related to contaminated dialysate warming water. Am J Infect Control 1981;9:5052.
15. Muyldermans, G, de Smet, F, Pierard, D, et al. Neonatal infections with Pseudomonas aeruginosa associated with a water-bath used to thaw fresh frozen plasma. J Hosp Infect 1998;39:309314.
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Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
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