Reason for posting: Gels are routinely used in a variety of physical examination and diagnostic medical procedures including ultrasonography and endoscopy. Health Canada, however, has recently warned that several common practices involving the gels may lead to infection.1 These practices include warming the gels in uncapped containers for extended periods of time, not cleaning refillable squeeze bottles, and using nonsterile gels marked for external use only during invasive procedures (such as biopsies) or on mucous membranes. Although no cases of infection linked to these practices are reported in the Health Canada letter, several cases exist in the medical literature of nosocomial infections traced back to contaminated ultrasound gels.2,3,4
What to do: Health Canada has issued recommendations for minimizing the health risks of using gels (see Box 1). In combination with the use of disposable barriers (such as a surgical glove, condom, household cling film or sterile “Opsite” films)4 placed on nonsterile ultrasound probes, these recommendations appear to represent common sense infection control precautions that are easy to implement in both hospital and community settings.
Box 1.
Eric Wooltorton CMAJ
References
- 1.Health Canada. Notice to hospitals: important safety information on ultrasound and medical gels. 2004 October 20. Available: www.hc-sc.gc.ca/hpfb-dgpsa/tpd-dpt/ultrasoundgel_e.html (accessed 2004 Oct 27).
- 2.Hutchinson J, Runge W, Mulvey M, Norris G, Yetman M, Valkova N, et al. Burkholderia cepacia infections associated with intrinsically contaminated ultrasound gel: the role of microbial degradation of parabens. Infect Control Hosp Epidemiol 2004;25(4):291-6. [DOI] [PubMed]
- 3.Weist K, Wendt C, Petersen LR, Versmold H, Ruden H. An outbreak of pyodermas among neonates caused by ultrasound gel contaminated with methicillin-susceptible Staphylococcus aureus. Infec Control Hosp Epidemiol 2000;21(12):761-4. [DOI] [PubMed]
- 4.Abdullah BJ, Mohd Yusof MY, Khoo BH. Physical methods of reducing the transmission of nosocomial infections via ultrasound and probe. Clin Radiol 1998;53(3):212-4. [DOI] [PubMed]