FW: Intracavity ultrasound probes and disinfectant susceptibility to high-risk papillomavirus type 16

[Glenys Harrington]

Dear All,

I recently viewed the Infection Control Today Webinar titled: “Infection
Control in Ultrasound: Mitigating cross contamination risk”. The webinar
provided an excellent overview of the topic and Dr Cathryn Murphy PhD
(Australia) was one of the panelists.
http://www.infectioncontroltoday.com/webinars/2015/11/infection-control-in-u
ltrasound.aspx?cmpid=LI1-6
&sc=LI1-6

In the webinar Dr Craig Meyers, Professor of Microbiology and Immunology at
Penn State College of Medicine discussed the following:

. Human Papillomavirus HPV16

. By way of background HPV types 16 and 18, are responsible for most
HPV-caused cancers such as cervical, anogenital and oropharyngeal cancers

. Human Papillomavirus HPV16 and susceptibility of commonly used
disinfectants

. The possibility of fomite or non-sexual transmission of HPV16

. The efficacy of an automated ultrasound probe disinfector against
high-risk human papillomavirus.

Interestingly both Glutaraldehyde and Cidex OPA (0.55% ortho-phthalaldehyde)
are not virucidal against Human Papillomavirus HPV16 and HPV18. See the
following attachments:

. Myers J et al. Susceptibility of high-risk human papillomavirus
type 16 to clinical disinfectants. J Antimicrob Chemother 2014; 69:
1546-1550.

. Myers C et al. The efficacy of an automated ultrasound probe
disinfector against high-risk human papillomavirus. SHEA Spring 2015:
Science Guiding Prevention, May 14-15 2015, Orlando, Florida, USA

I had a quick look at the Australasian Society for Ultrasound in Medicine
(ASUM) web page:

In their Policies and Statements B2 “Statement on the Disinfection of
Transducers” May 1996 (Reaffirmed September 2015) there are no specific
guidelines/recommendations in relation to high level disinfectant selection
and use in situations where Human Papillomavirus may be a risk.
http://www.asum.com.au/newsite/Files/Documents/Policies/2015.09.03%20B2%20di
sinfection%20final.pdf

Also of interest was a conference presentation (ASUM Annual Meeting 2015)
by Dr Jocelyne Basseal titled “Disinfection of ultrasound transducers;
Results from an ASUM survey” This was an anonymous survey of ASUM members
to assess current practices in relation to transducer disinfection and basic
hygiene for external and intracavity probes.

They received 105 responses from across Australia and NZ.

While the presentation was encouraging in terms of a future strategies to
improve infection prevention and control in the area of sonography I was
surprised at some of the current practices for both external and intracavity
probes including:

. Topping up of ultrasound gel(41%) (i.e. reusing the same container
over and over again without cleaning will results in contamination with
organisms such as pseudomonas (personal ICP experience)

. Using non-sterile gel for intracavity biopsy procedures(5%) (see
TGA and FDA contaminated ultrasound gel recall
http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm299409.htm
https://www.tga.gov.au/alert/l-gel-ultrasound-transmission-gel-recall )

. cleaning “only” for intracavity transducers (2.5%), i.e. no high
level disinfection

. cleaning ultrasound machine keyboard daily (60%), cleaning machine
keyboard week (approx. 30%), i.e. they should be cleaned between each
patient

. no ultrasound induction training on employment (43%)

. no training from the manufacturer (approx. 58%), and so on….

http://www.asum.com.au/newsite/Files/Documents/elearning/ASUM%202015%20Confe
rence%20Session/Concurrent%209B/Concurrent%209B.html

This survey also begs the question what infection prevention and control
training sonographers are receiving in university Medical Sonography
courses?

As Glutaraldehyde and Cidex OPA (0.55% ortho-phthalaldehyde) are commonly
used disinfecting agents in health facilities it may be timely to review
current practices and procedures relating not only to intracavity ultrasound
practices and procedures in relation to high-risk Human Papillomaviruses but
intracavity ultrasound practices in general at your Health Facility.

regards

Glenys

Glenys Harrington

Consultant

Infection Control Consultancy (ICC)

PO Box 5202

Middle Park

Victoria, 3206

Australia

M: +61 404 816 434

infexion@ozemail.com.au

ABN 47533508426

MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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[Jocelyne Basseal]

Dear Glenys and ACIPC group

Thank you for bringing up a very important discussion relating to
ultrasound transducers and for mentioning ASUM and my conference
presentation.

ASUM’s Standard of Practice Board will be reviewing its current guidelines
this year with our Infection Control expert.

On another note, I am keen to work with more Infection Control specialists
(via ACIPC) to improve the current situation and if there is anyone that
would like to be involved or offer any comments for discussion with ASUM,
we would be thrilled to hear from you.

Please also feel free to contact me directly via my work email (details
below).

Thank you again for bringing up this topic Glenys, wishing you all the best
Kind regards
Jocelyne

*Dr Jocelyne Basseal*

*BSc (Hons), PhD*
*Publications and Scientific Editor*

*Work days: Monday, Tuesday and Wednesday (8.30am-4.30pm)*

*Australasian Society for Ultrasound in Medicine (ASUM)*PO Box 943, Crows
Nest NSW 1585, SYDNEY AUSTRALIA.
*j.basseal@asum.com.au *ABN 64 001 679 161. ASUM is
certified ISO 9001:2008 Quality Management System
*www.asumconference.com.au*

On Sun, Jan 10, 2016 at 12:00 AM, Glenys Harrington wrote:

> Dear All,
>
>
>
> I recently viewed the Infection Control Today Webinar titled: **Infection
> Control in Ultrasound: Mitigating cross contamination risk*.** The
> webinar provided an excellent overview of the topic and Dr Cathryn Murphy
> PhD (Australia) was one of the panelists.*
> http://www.infectioncontroltoday.com/webinars/2015/11/infection-control-in-ultrasound.aspx?cmpidLI1-6&scLI1-6
>
>
>
> In the webinar Dr Craig Meyers, Professor of Microbiology and Immunology
> at Penn State College of Medicine discussed the following:
>
>
>
> Human Papillomavirus HPV16
>
>
>
> *By way of background HPV types 16 and 18, are responsible for
> most HPV-caused cancers such as cervical, anogenital and oropharyngeal
> cancers*
>
>
>
> Human Papillomavirus HPV16 and susceptibility of commonly
> used disinfectants
>
>
>
> The possibility of fomite or non-sexual transmission of HPV16
>
>
>
> The efficacy of an automated ultrasound probe disinfector
> against high-risk human papillomavirus.
>
>
>
> Interestingly both Glutaraldehyde and Cidex *OPA* (*0.55*% *ortho-phthalaldehyde)
> *are not virucidal against Human Papillomavirus HPV16 and HPV18. See the
> following attachments:
>
>
>
> *Myers J et al. Susceptibility of high-risk human
> papillomavirus type 16 to clinical disinfectants.** J Antimicrob
> Chemother 2014; 69: 15461550. *
>
>
>
> *Myers C et al. The efficacy of an automated ultrasound probe
> disinfector against high-risk human papillomavirus.** SHEA Spring 2015:
> Science Guiding Prevention, May 14-15 2015, Orlando, Florida, USA*
>
>
>
> I had a quick look at the Australasian Society for Ultrasound in Medicine
> (ASUM) web page:
>
>
>
> In their Policies and Statements B2 *Statement on the Disinfection of
> Transducers *May 1996 (Reaffirmed September 2015) there are no specific
> guidelines/recommendations in relation to high level disinfectant *selection
> and use in situations where Human Papillomavirus may be a risk*.
> http://www.asum.com.au/newsite/Files/Documents/Policies/2015.09.03%20B2%20disinfection%20final.pdf
>
>
>
> Also of interest was a conference presentation (ASUM Annual Meeting 2015)
> by Dr Jocelyne Basseal titled ***Disinfection of ultrasound
> transducers; Results from an ASUM survey* This was an *anonymous*
> survey of ASUM members to assess current practices in relation to
> transducer disinfection and basic hygiene for external and intracavity
> probes.
>
>
>
> They received 105 responses from across Australia and NZ.
>
>
>
> While the presentation was encouraging in terms of a future strategies to
> improve infection prevention and control in the area of sonography I was
> surprised at some of the current practices for both external and
> intracavity probes including:
>
> Topping up of ultrasound gel(41%) (i.e. reusing the same
> container over and over again without cleaning will results in
> contamination with organisms such as pseudomonas (personal ICP experience)
>
> Using non-sterile gel for intracavity biopsy procedures(5%)
> (see TGA and FDA contaminated ultrasound gel recall
> http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm299409.htm
> https://www.tga.gov.au/alert/l-gel-ultrasound-transmission-gel-recall )
>
>
>
> cleaning only for intracavity transducers (2.5%), i.e. no
> high level disinfection
>
>
>
> cleaning ultrasound machine keyboard daily (60%), cleaning
> machine keyboard week (approx. 30%), i.e. they should be cleaned between
> each patient
>
>
>
> no ultrasound induction training on employment (43%)
>
>
>
> no training from the manufacturer (approx. 58%), and so on…
>
>
>
>
> http://www.asum.com.au/newsite/Files/Documents/elearning/ASUM%202015%20Conference%20Session/Concurrent%209B/Concurrent%209B.html
>
>
>
> This survey also begs the question what infection prevention and control
> training sonographers are receiving in university Medical Sonography
> courses?
>
>
>
> As Glutaraldehyde and Cidex *OPA* (*0.55*% *ortho-phthalaldehyde) are
> commonly used disinfecting agents in health facilities it may be timely to
> review current practices and procedures relating** not only to **intracavity
> ultrasound practices and procedures** in relation to high-risk *Human
> Papillomaviruses but *intracavity ultrasound** practices in general **at
> your **Health F**acility.*
>
>
>
> regards
>
>
>
> Glenys
>
>
>
>
>
> Glenys Harrington
>
> Consultant
>
> Infection Control Consultancy (ICC)
>
> PO Box 5202
>
> Middle Park
>
> Victoria, 3206
>
> Australia
>
> M: +61 404 816 434
>
> infexion@ozemail.com.au
>
> ABN 47533508426
>
>
>
>
>
>
>
>
>
>
> MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO
> NOT REPRESENT THE OPINION OF ACIPC.
>
> The use of trade/product/commercial brand names through the list is
> discouraged by ACIPC. If you wish to discuss specific reference to products
> or services by brand or commercial names, please do this outside the list.
>
> Archive of all messages are available at http://aicalist.org.au/archives
> – registration and login required.
>
> Replies to this message will be directed back to the list. To create a new
> message send an email to aicalist@aicalist.org.au
>
> To send a message to the list administrator send an email to
> aicalist-request@aicalist.org.au.
>
> You can unsubscribe from this list be sending ‘signoff aicalist’ (without
> the quotes) to listserv@aicalist.org.au
>

MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

Replies to this message will be directed back to the list. To create a new message send an email to aicalist@aicalist.org.au

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[Cath Murphy]

Dear Glenys

Thank you for highlighting this resource and for further raising the issue of disinfection. As you will appreciate my interest came from observation and familiarity with USA ultrasound (U/S) disinfection practice. In June 2015 I had the good fortune to moderate a panel of experts at APIC 2015 where the issues of HPV transmission and U/S decontamination were explored in great detail. Later as I prepared for a series of presentations to the American U/S community and also Infection Control Today I recognised that there were many anomalies between what is routinely done in the USA compared to Australia. Craig Meyer’s work, and his findings on traditional methods of disinfection such as those we routinely use in Australia, should prompt an urgent review by clinicians and relevant organisations and individuals charged with development of guidelines, policies and/ or protocols in this area.

FYI I also delivered a Webinar to ASUM and I am happy to share copies of my slides from any of those presentations with others if they are interested. In return I would hope only for appropriate attribution. I also have a good bank of research articles should anyone have an interest. Please email outside of this group if interested.

Like you, I am passionate about helping other IPs recognise problems, innovate and improve quality. It seems that there are enough IC&P problems to allow us and others with IC&P longevity to do that for our entire careers and still leave plenty of mysteries for subsequent IPs. I will be emailing Dr Basseal separately to offer assistance in ASUM’s directive development.

Wishing all ACIPC members a successful and healthy 2016.

Sincerely
Cath

Cathryn Murphy RN MPH PhD
Executive Director
Infection Control Plus Pty Ltd
PO Box 106
West Burleigh 4219
Queensland
AUSTRALIA

E: Cath@infectioncontrolplus.com.au

http://www.infectioncontrolplus.com.au

Dear All,

I recently viewed the Infection Control Today Webinar titled: “Infection Control in Ultrasound: Mitigating cross contamination risk”. The webinar provided an excellent overview of the topic and Dr Cathryn Murphy PhD (Australia) was one of the panelists. http://www.infectioncontroltoday.com/webinars/2015/11/infection-control-in-ultrasound.aspx?cmpidLI1-6&scLI1-6

In the webinar Dr Craig Meyers, Professor of Microbiology and Immunology at Penn State College of Medicine discussed the following:

* Human Papillomavirus HPV16

* By way of background HPV types 16 and 18, are responsible for most HPV-caused cancers such as cervical, anogenital and oropharyngeal cancers

* Human Papillomavirus HPV16 and susceptibility of commonly used disinfectants

* The possibility of fomite or non-sexual transmission of HPV16

* The efficacy of an automated ultrasound probe disinfector against high-risk human papillomavirus.

Interestingly both Glutaraldehyde and Cidex OPA (0.55% ortho-phthalaldehyde) are not virucidal against Human Papillomavirus HPV16 and HPV18. See the following attachments:

* Myers J et al. Susceptibility of high-risk human papillomavirus type 16 to clinical disinfectants. J Antimicrob Chemother 2014; 69: 1546-1550.

* Myers C et al. The efficacy of an automated ultrasound probe disinfector against high-risk human papillomavirus. SHEA Spring 2015: Science Guiding Prevention, May 14-15 2015, Orlando, Florida, USA

I had a quick look at the Australasian Society for Ultrasound in Medicine (ASUM) web page:

In their Policies and Statements B2 “Statement on the Disinfection of Transducers” May 1996 (Reaffirmed September 2015) there are no specific guidelines/recommendations in relation to high level disinfectant selection and use in situations where Human Papillomavirus may be a risk. http://www.asum.com.au/newsite/Files/Documents/Policies/2015.09.03%20B2%20disinfection%20final.pdf

Also of interest was a conference presentation (ASUM Annual Meeting 2015) by Dr Jocelyne Basseal titled “Disinfection of ultrasound transducers; Results from an ASUM survey” This was an anonymous survey of ASUM members to assess current practices in relation to transducer disinfection and basic hygiene for external and intracavity probes.

They received 105 responses from across Australia and NZ.

While the presentation was encouraging in terms of a future strategies to improve infection prevention and control in the area of sonography I was surprised at some of the current practices for both external and intracavity probes including:

* Topping up of ultrasound gel(41%) (i.e. reusing the same container over and over again without cleaning will results in contamination with organisms such as pseudomonas (personal ICP experience)

* Using non-sterile gel for intracavity biopsy procedures(5%) (see TGA and FDA contaminated ultrasound gel recall http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm299409.htm https://www.tga.gov.au/alert/l-gel-ultrasound-transmission-gel-recall )

* cleaning “only” for intracavity transducers (2.5%), i.e. no high level disinfection

* cleaning ultrasound machine keyboard daily (60%), cleaning machine keyboard week (approx. 30%), i.e. they should be cleaned between each patient

* no ultrasound induction training on employment (43%)

* no training from the manufacturer (approx. 58%), and so on……

http://www.asum.com.au/newsite/Files/Documents/elearning/ASUM%202015%20Conference%20Session/Concurrent%209B/Concurrent%209B.html

This survey also begs the question what infection prevention and control training sonographers are receiving in university Medical Sonography courses?

As Glutaraldehyde and Cidex OPA (0.55% ortho-phthalaldehyde) are commonly used disinfecting agents in health facilities it may be timely to review current practices and procedures relating not only to intracavity ultrasound practices and procedures in relation to high-risk Human Papillomaviruses but intracavity ultrasound practices in general at your Health Facility.

regards

Glenys

Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
PO Box 5202
Middle Park
Victoria, 3206
Australia
M: +61 404 816 434
infexion@ozemail.com.au
ABN 47533508426

MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

Replies to this message will be directed back to the list. To create a new message send an email to aicalist@aicalist.org.au

To send a message to the list administrator send an email to aicalist-request@aicalist.org.au.

You can unsubscribe from this list be sending ‘signoff aicalist’ (without the quotes) to listserv@aicalist.org.au

MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

Replies to this message will be directed back to the list. To create a new message send an email to aicalist@aicalist.org.au

To send a message to the list administrator send an email to aicalist-request@aicalist.org.au.

You can unsubscribe from this list be sending ‘signoff aicalist’ (without the quotes) to listserv@aicalist.org.au

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