DEGUM Recommendations on Infection Prevention in Ultrasound and Endoscopic Ultrasound

Abstract

Microbial contamination of ultrasound probes for percutaneous or endoscopic use is common. However, infectious diseases caused by transmission of microorganisms by US procedures have rarely been reported. In Germany, legal regulations address hygiene in ultrasound procedures. Based on these regulations and the available literature, an expert panel of the German Society of Ultrasound in Medicine (DEGUM) has formulated sophisticated recommendations on hygienic measures in percutaneous and endoscopic US, including US-guided interventions.

Key words

ultrasound - infection - intervention - disinfection - endoscopic ultrasound

• References

• 1 Dietrich CF, Nürnberg D. (Hrsg) Interventioneller Ultraschall. Lehrbuch und Atlas für die interventionelle Sonografie. Stuttgart: Thieme; 2011
• 2 Hillmann R, Döffert J. Praxis der anästhesiologischen Sonografie. München: Elsevier; 2016
• 3 Kähler C, Gembruch U, Heling KS. et al. Empfehlungen der DEGUM zur Durchführung von Amniozentese und Chorionzottenbiopsie. Ultraschall in Med 2013; 34: 435-440
• 4 Müller T, Blank W. Sonografisch gesteuerte perkutane Punktionen und Therapieverfahren. In: Braun B, Günther R, Schwerk WB. (Ed.) Ultraschalldiagnostik. Lehrbuch und Atlas. Landsberg: ecomed; 2011. bk. 47. Ergänzungslieferung, 1–96
• 5 Marhofer P, Schebesta K, Marhofer D. Hygieneaspekte in der ultraschallgestützten Regionalanästhesie. Anaesthesist 2016; 65: 492-498
• 6 Merz E. Transducer hygiene – an underrated topic?. Ultraschall in Med 2005; 26: 7-8
• 7 Shokoohi H, Armstrong P, Tansek R. Emergency department ultrasound probe infection control: challenges and solutions. Open Access Emerg Med OAEM 2015; 7: 1-9
• 8 Nyhsen CM, Humphreys H, Nicolau C. et al. Infection prevention and ultrasound probe decontamination practices in Europe: a survey of the European Society of Radiology. Insights Imaging 2016; 7: 841-847
• 9 Infektionsschutzgesetz. https://www.gesetze-im-internet.de/bundesrecht/ifsg/gesamt.pdf Letzter Zugriff 27.12.2017
• 10 Medizinproduktegesetz. https://www.gesetze-im-internet.de/mpg/ Letzter Zugriff 27.12.2017
• 11 Richtlinie 93/42/EWG des Rates vom 14. Juni 1993 über Medizinprodukte. http://eur-lex.europa.eu/legal-content/DE/TXT/?uri=celex%3A31993L0042 Letzter Zugriff 27.12.2017
• 12 Verordnung über das Errichten, Betreiben und Anwenden von Medizinprodukten (Medizinprodukte-Betreiberverordnung – MPBetreibV). https://www.gesetze-im-internet.de/mpbetreibv/MPBetreibV.pdf Letzter Zugriff 27.12.2017
• 13 KRINKO. Anforderungen an die Hygiene bei Punktionen und Injektionen. Bundesgesundheitsbl; 2011 54. 1135-1144
• 14 KRINKO/BfArM. Anforderungen an die Hygiene bei der Aufbereitung von Medizinprodukten. Bundesgesundheitsbl; 2012 55. 1244-1310
• 15 KRINKO. Prävention von Infektionen, die von Gefäßkathetern ausgehen: Teil 1 – Nichtgetunnelte zentralvenöse Katheter Empfehlung der Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) beim Robert Koch-Institut. Bundesgesundheitsbl; 2017 60. 171-206
• 16 Amann B, Appel T, Aravopouou F. et al. Aufbereitung von Ultraschallsonden. Zentralsterilisation; 2017 3. 195-197
• 17 Arbeitskreis “Krankenhaus- & Praxishygiene” der AWMF. Intraartikuläre Punktionen und Injektionen: Hygienemaßnahmen. AWMF-Register Nr. 029/006, S1-Leitlinie. Hyg Med 2015; 40: 366-368
• 18 Arbeitskreis “Krankenhaus- & Praxishygiene” der AWMF. Hygienemaßnahmen bei intravasalen Punktionen und intravasaler Medikamentenapplikation. AWMF-Register Nr. 029/015, S1-Leitlinie. Hyg Med 2016; 41: 227-229
• 19 Deutsche Gesellschaft für Krankenhaushygiene e. V. Hinweise für die Aufbereitung ausgewählter semikritischer Medizinprodukte. Hyg Med 2016; 41: 317-318
• 20 Kerwat K, Schulz-Stübner S, Steinfeldt T. et al. Hygieneempfehlungen für die Regionalanästhesie. Anasthesiol Intensivmed Notfallmed Schmerzther 2015; 56: 34-40
• 21 Lorentzen T, Nolsøe CP, Ewertsen C. et al. EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part I. General Aspects (long Version). Ultraschall in Med 2015; 36: E1-E14
• 22 Sanz GE, Theoret J, Liao MM. et al. Bacterial contamination and cleanliness of emergency department ultrasound probes. CJEM 2011; 13: 384-389
• 23 Ridge C. Sonographers and the Fight Against Nosocomial Infections: How Are We Doing?. J Diagn Med Sonogr 2005; 21: 7-11
• 24 Lawrence MW, Blanks J, Ayala R. et al. Hospital-wide survey of bacterial contamination of point-of-care ultrasound probes and coupling gel. J Ultrasound Med 2014; 33: 457-462
• 25 Frazee BW, Fahimi J, Lambert L. et al. Emergency department ultrasonographic probe contamination and experimental model of probe disinfection. Ann Emerg Med 2011; 58: 56-63
• 26 Fowler C, McCracken D. US probes: risk of cross infection and ways to reduce it--comparison of cleaning methods. Radiology 1999; 213: 299-300
• 27 Sykes A, Appleby M, Perry J. et al. An investigation of the microbiological contamination of ultrasound equipment. Br J Infect Control 2006; 7: 16-20
• 28 Schneider D. Untersuchungen zur Kontamination von transdermalen Ultraschallsonden im klinischen Alltag in Verbindung mit einem Review zur Kontamination von Ultraschallsonden und der klinischen Relevanz. Dissertation. Greifswald: 2013 http://d-nb.info/1041903901
• 29 Westerway SC, Basseal JM, Brockway A. et al. Potential Infection Control Risks Associated with Ultrasound Equipment – A Bacterial Perspective. Ultrasound Med Biol 2017; 43: 421-426
• 30 Skowronek P, Wojciechowski A, Leszczyński P. et al. Can diagnostic ultrasound scanners be a potential vector of opportunistic bacterial infection?. Med Ultrason 2016; 18: 326-331
• 31 Sartoretti T, Sartoretti E, Bucher C. et al. Bacterial contamination of ultrasound probes in different radiological institutions before and after specific hygiene training: do we have a general hygienical problem?. Eur Radiol 2017; 27: 4181-4187
• 32 Rutala W, Weber D. Guideline for disinfection and sterilization in healthcare facilities. https://stacks.cdc.gov/view/cdc/11560 Letzter Zugriff 27.12.2017
• 33 Middendorf M. Haftungsrechtliche Aspekte der Krankenhaushygiene nach der Reform des Infektionsschutzgesetzes. Krankenhaushygiene Up2date 2011; 6: 313-321
• 34 KRINKO. Händehygiene in Einrichtungen des Gesundheitswesens. Bundesgesundheitsbl; 2016 59. 1189-1220
• 35 Heudorf U, Hofmann H, Kutzke G. et al. Aufbereitung von Ultraschallsonden im Krankenhaus – ein nicht zu vernachlässigendes Thema. Hyg Med 2007; 32: 183-186
• 36 KBV. Vereinbarung von Qualitätssicherungsmaßnahmen nach § 135 Abs. 2 SGB V zur Ultraschalldiagnostik (Ultraschall-Vereinbarung). http://www.kbv.de/media/sp/Ultraschallvereinbarung.pdf Letzter Zugriff 27.12.2017
• 37 McDonnell G, Burke P. Disinfection: is it time to reconsider Spaulding?. J Hosp Infect 2011; 78: 163-170
• 38 Malavaud S, Joffre F, Auriol J. et al. Hygiene recommendations for interventional radiology. Diagn Interv Imaging 2012; 93: 813-822
• 39 O’doherty AJ, Murphy PG, Curran RA. Risk of Staphylococcus aureus transmission during ultrasound investigation. J Ultrasound Med 1989; 8: 619-620
• 40 Chittick P, Russo V, Sims M. et al. An outbreak of Pseudomonas aeruginosa respiratory tract infections associated with intrinsically contaminated ultrasound transmission gel. Infect Control Hosp Epidemiol 2013; 34: 850-853
• 41 Cheng A, Sheng WH, Huang YC. et al. Prolonged postprocedural outbreak of Mycobacterium massiliense infections associated with ultrasound transmission gel. Clin Microbiol Infect 2016; 22: 382.e1-382.e11
• 42 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: 291-296
• 43 Marigliano A, D’Errico MM, Pellegrini I. et al. Ultrasound echocardiographic gel contamination by Burkholderia cepacia in an Italian hospital. J Hosp Infect 2010; 76: 360-361
• 44 Provenzano DA, Liebert MA, Steen B. et al. Investigation of current infection-control practices for ultrasound coupling gel: a survey, microbiological analysis, and examination of practice patterns. Reg Anesth Pain Med 2013; 38: 415-424
• 45 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: 144-147
• 46 Weist K, Wendt C, Petersen LR. et al. An outbreak of pyodermas among neonates caused by ultrasound gel contaminated with methicillin-susceptible Staphylococcus aureus. Infect Control Hosp Epidemiol 2000; 21: 761-764
• 47 Spratt HG, Levine D, Tillman L. Physical therapy clinic therapeutic ultrasound equipment as a source for bacterial contamination. Physiother Theory Pract 2014; 30: 507-511
• 48 Gaillot O, Maruéjouls C, Abachin E. et al. Nosocomial outbreak of Klebsiella pneumoniae producing SHV-5 extended-spectrum beta-lactamase, originating from a contaminated ultrasonography coupling gel. J Clin Microbiol 1998; 36: 1357-1360
• 49 Schabrun S, Chipchase L, Rickard H. Are therapeutic ultrasound units a potential vector for nosocomial infection?. Physiother Res Int J 2006; 11: 61-71
• 50 Oleszkowicz SC, Chittick P, Russo V. et al. Infections associated with use of ultrasound transmission gel: proposed guidelines to minimize risk. Infect Control Hosp Epidemiol 2012; 33: 1235-1237
• 51 Belavy D. Brief reports: regional anesthesia needles can introduce ultrasound gel into tissues. Anesth Analg 2010; 111: 811-812
• 52 Ejtehadi F, Ejtehadi F, Teb JC. et al. A safe and practical decontamination method to reduce the risk of bacterial colonization of ultrasound transducers. J Clin Ultrasound 2014; 42: 395-398
• 53 Bello TO, Taiwo SS, Oparinde DP. et al. Risk of nosocomial bacteria transmission: evaluation of cleaning methods of probes used for routine ultrasonography. West Afr J Med 2005; 24: 167-170
• 54 Chu K, Obaid H, Babyn P. et al. Bacterial contamination of ultrasound probes at a tertiary referral university medical center. Am J Roentgenol 2014; 203: 928-932
• 55 Chuan A, Tiong C, Maley M. et al. Decontamination of ultrasound equipment used for peripheral ultrasound-guided regional anaesthesia. Anaesth Intensive Care 2013; 41: 529-534
• 56 Kac G, Gueneret M, Rodi A. et al. Evaluation of a new disinfection procedure for ultrasound probes using ultraviolet light. J Hosp Infect 2007; 65: 163-168
• 57 Savasci U, Oren NC, Akpak YK. et al. Comparison of probe disinfection procedures in routine ultrasonography: hot water versus antiseptic wiping. Intern Med Tokyo Jpn 2014; 53: 2201-2204
• 58 Adhikari S, Blaivas M, Morrison D. et al. Comparison of infection rates among ultrasound-guided versus traditionally placed peripheral intravenous lines. J Ultrasound Med 2010; 29: 741-747
• 59 Alakkad H, Naeeni A, Chan VWS. et al. Infection related to ultrasound-guided single-injection peripheral nerve blockade: a decade of experience at toronto Western hospital. Reg Anesth Pain Med 2015; 40: 82-84
• 60 González-Michaca L, Chew-Wong A, Soltero L. et al. Percutaneous kidney biopsy, analysis of 26 years: complication rate and risk factors; comment. Rev Investig Clin Organo Hosp Enfermedades Nutr 2000; 52: 125-131
• 61 Nolsøe C, Nielsen L, Torp-Pedersen S. et al. Major complications and deaths due to interventional ultrasonography: a review of 8000 cases. J Clin Ultrasound JCU 1990; 18: 179-184
• 62 Piccinino F, Sagnelli E, Pasquale G. et al. Complications following percutaneous liver biopsy. A multicentre retrospective study on 68276 biopsies. J Hepatol 1986; 2: 165-173
• 63 Giorgio A, Tarantino L, de Stefano G. et al. Complications after interventional sonography of focal liver lesions: a 22-year single-center experience. J Ultrasound Med 2003; 22: 193-205
• 64 Boyum JH, Atwell TD, Schmit GD. et al. Incidence and Risk Factors for Adverse Events Related to Image-Guided Liver Biopsy. Mayo Clin Proc 2016; 91: 329-335
• 65 Strobel D, Bernatik T, Blank W. et al. Incidence of bleeding in 8172 percutaneous ultrasound-guided intraabdominal diagnostic and therapeutic interventions – results of the prospective multicenter DEGUM interventional ultrasound study (PIUS study). Ultraschall in Med 2015; 36: 122-131
• 66 Caturelli E, Giacobbe A, Facciorusso D. et al. Free-hand technique with ordinary antisepsis in abdominal US-guided fine-needle punctures: three-year experience. Radiology 1996; 199: 721-723
• 67 Micu MC, Vlad VM, Bolboacă SD. et al. Musculoskeletal ultrasound guided manoeuvres – a security profile. Med Ultrason 2014; 16: 214-221
• 68 Cervini P, Hesley GK, Thompson RL. et al. Incidence of infectious complications after an ultrasound-guided intervention. Am J Roentgenol 2010; 195: 846-850
• 69 Knudsen JM. Persönliche Mitteilung. 2017
• 70 Reisenauer C, Fazzio RT, Hesley G. JOURNAL CLUB: Ultrasound-Guided Breast Interventions: Low Incidence of Infectious Complications With Use of an Uncovered Probe. Am J Roentgenol 2017; 208: 1147-1153
• 71 Cartier V, Haenny A, Inan C. et al. No association between ultrasound-guided insertion of central venous catheters and bloodstream infection: a prospective observational study. J Hosp Infect 2014; 87: 103-108
• 72 Karakitsos D, Labropoulos N, De Groot E. et al. Real-time ultrasound-guided catheterisation of the internal jugular vein: a prospective comparison with the landmark technique in critical care patients. Crit Care 2006; 10: R162
• 73 Giorgio A, Tarantino L, de Stefano G. et al. Complications after percutaneous saline-enhanced radiofrequency ablation of liver tumors: 3-year experience with 336 patients at a single center. Am J Roentgenol 2005; 184: 207-211
• 74 Leroy S. Infectious risk of endovaginal and transrectal ultrasonography: systematic review and meta-analysis. J Hosp Infect 2013; 83: 99-106
• 75 Masood J, Voulgaris S, Awogu O. et al. Condom perforation during transrectal ultrasound guided (TRUS) prostate biopsies: a potential infection risk. Int Urol Nephrol 2007; 39: 1121-1124
• 76 Anderson E, Leahy O, Cheng AC. et al. Risk factors for infection following prostate biopsy – a case control study. BMC Infect Dis 2015; 15: 580
• 77 Borghesi M, Ahmed H, Nam R. et al. Complications After Systematic, Random, and Image-guided Prostate Biopsy. Eur Urol 2017; 71: 353-365
• 78 Liss MA, Ehdaie B, Loeb S. et al. An Update of the American Urological Association White Paper on the Prevention and Treatment of the More Common Complications Related to Prostate Biopsy. J Urol 2017; 198: 329-334
• 79 Loeb S, Vellekoop A, Ahmed HU. et al. Systematic review of complications of prostate biopsy. Eur Urol 2013; 64: 876-892
• 80 Patel U, Dasgupta P, Amoroso P. et al. Infection after transrectal ultrasonography-guided prostate biopsy: increased relative risks after recent international travel or antibiotic use. BJU Int 2012; 109: 1781-1785
• 81 Raaijmakers R, Kirkels WJ, Roobol MJ. et al. Complication rates and risk factors of 5802 transrectal ultrasound-guided sextant biopsies of the prostate within a population-based screening program. Urology 2002; 60: 826-830
• 82 Rudzinski JK, Kawakami J. Incidence of infectious complications following transrectal ultrasound-guided prostate biopsy in Calgary, Alberta, Canada: A retrospective population-based analysis. Can Urol Assoc J 2014; 8: E301-E305
• 83 Simsir A, Kismali E, Mammadov R. et al. Is it possible to predict sepsis, the most serious complication in prostate biopsy?. Urol Int 2010; 84: 395-399
• 84 Nam RK, Saskin R, Lee Y. et al. Increasing hospital admission rates for urological complications after transrectal ultrasound guided prostate biopsy. J Urol 2013; 189: S12-S17 ; discussion S17–18
• 85 Loeb S, Carter HB, Berndt SI. et al. Complications after prostate biopsy: data from SEER-Medicare. J Urol 2011; 186: 1830-1834
• 86 Williamson DA, Barrett LK, Rogers BA. et al. Infectious complications following transrectal ultrasound-guided prostate biopsy: new challenges in the era of multidrug-resistant Escherichia coli. Clin Infect Dis 2013; 57: 267-274
• 87 Gillespie JL, Arnold KE, Noble-Wang J. et al. Outbreak of Pseudomonas aeruginosa infections after transrectal ultrasound-guided prostate biopsy. Urology 2007; 69: 912-914
• 88 Akduman B, Akduman D, Tokgöz H. et al. Long-term fluoroquinolone use before the prostate biopsy may increase the risk of sepsis caused by resistant microorganisms. Urology 2011; 78: 250-255
• 89 Kamdar C, Mooppan UMM, Gulmi FA. et al. Multi-drug-resistant bacteremia after transrectal ultrasound guided prostate biopsies in hospital employees and their relatives. Urology 2008; 72: 34-36
• 90 Liss MA, Taylor SA, Batura D. et al. Fluoroquinolone resistant rectal colonization predicts risk of infectious complications after transrectal prostate biopsy. J Urol 2014; 192: 1673-1678
• 91 Mosharafa AA, Torky MH, El Said WM. et al. Rising incidence of acute prostatitis following prostate biopsy: fluoroquinolone resistance and exposure is a significant risk factor. Urology 2011; 78: 511-514
• 92 Yang L, Gao L, Chen Y. et al. Prophylactic Antibiotics in Prostate Biopsy: A Meta-Analysis Based on Randomized Controlled Trials. Surg Infect 2015; 16: 733-747
• 93 Zani EL, Clark OAC, Rodrigues Netto N. Antibiotic prophylaxis for transrectal prostate biopsy. Cochrane Database Syst Rev; 2011 CD006576.
• 94 Leitlinienprogramm Onkologie. Interdisziplinäre Leitlinie der Qualität S3 zur Früherkennung, Diagnose und Therapie der verschiedenen Stadien des Prostatakarzinoms. http://www.awmf.org/uploads/tx_szleitlinien/043-022OLl_S3_Prostatakarzinom_2016-12.pdf Letzter Zugriff 12.12.2017
• 95 Mottet N, Bellmunt J, Bolla M. et al. EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent. Eur Urol 2017; 71: 618-629
• 96 Cussans A, Somani BK, Basarab A. et al. The role of targeted prophylactic antimicrobial therapy before transrectal ultrasonography-guided prostate biopsy in reducing infection rates: a systematic review. BJU Int 2016; 117: 725-731
• 97 Fahmy A, Rhashad H, Mohi M. et al. Optimizing prophylactic antibiotic regimen in patients admitted for transrectal ultrasound-guided prostate biopsies: A prospective randomized study. Prostate Int 2016; 4: 113-117
• 98 Roberts MJ, Williamson DA, Hadway P. et al. Baseline prevalence of antimicrobial resistance and subsequent infection following prostate biopsy using empirical or altered prophylaxis: A bias-adjusted meta-analysis. Int J Antimicrob Agents 2014; 43: 301-309
• 99 Walker JT, Singla N, Roehrborn CG. Reducing Infectious Complications Following Transrectal Ultrasound-guided Prostate Biopsy: A Systematic Review. Rev Urol 2016; 18: 73-89
• 100 Yang L, Tang Z, Gao L. et al. The augmented prophylactic antibiotic could be more efficacious in patients undergoing transrectal prostate biopsy: a systematic review and meta-analysis. Int Urol Nephrol 2016; 48: 1197-1207
• 101 Pu C, Bai Y, Yuan H. et al. Reducing the risk of infection for transrectal prostate biopsy with povidone-iodine: a systematic review and meta-analysis. Int Urol Nephrol 2014; 46: 1691-1698
• 102 AbuGhosh Z, Margolick J, Goldenberg SL. et al. A Prospective Randomized Trial of Povidone-Iodine Prophylactic Cleansing of the Rectum Before Transrectal Ultrasound Guided Prostate Biopsy. J Urol 2013; 189: 1326-1331
• 103 Issa MM, Al-Qassab UA, Hall J. et al. Formalin disinfection of biopsy needle minimizes the risk of sepsis following prostate biopsy. J Urol 2013; 190: 1769-1775
• 104 Aryanti C. Contamination level of transvaginal ultrasound probes in standard setting: A meta-analysis. J Physiol Pharm Pharmacol 2017; 7: 1-12
• 105 Abramowicz JS, Evans DH, Fowlkes JB. et al. Guidelines for Cleaning Transvaginal Ultrasound Transducers Between Patients. Ultrasound Med Biol 2017; 43: 1076-1079
• 106 AG Praxishygiene der Deutschen Gesellschaft für Krankenhaushygiene. Hygienische Aspekte in der gynäkologischen Praxis. Hyg Med 2015; 40: 104-115
• 107 Buescher DL, Möllers M, Falkenberg MK. et al. Disinfection of transvaginal ultrasound probes in a clinical setting: comparative performance of automated and manual reprocessing methods. Ultrasound Obstet Gynecol 2016; 47: 646-651
• 108 Merz E. Is Transducer Hygiene sufficient when Vaginal Probes are used in the Clinical Routine?. Ultraschall in Med 2016; 37: 137-139
• 109 Ngu A, McNally G, Patel D. et al. Reducing transmission risk through high-level disinfection of transvaginal ultrasound transducer handles. Infect Control Hosp Epidemiol 2015; 36: 581-584
• 110 Geißdörfer W, Böhmer C, Pelz K. et al. Tuboovarian Abscess Caused by Atopobium vaginae following Transvaginal Oocyte Recovery. J Clin Microbiol 2003; 41: 2788-2790
• 111 Lesourd F, Izopet J, Mervan C. et al. Transmissions of hepatitis C virus during the ancillary procedures for assisted conception. Hum Reprod 2000; 15: 1083-1085
• 112 Sharpe K, Karovitch AJ, Claman P. et al. Transvaginal oocyte retrieval for in vitro fertilization complicated by ovarian abscess during pregnancy. Fertil Steril 2006; 86: 219.e11-219.e13
• 113 Ludwig AK, Glawatz M, Griesinger G. et al. Perioperative and post-operative complications of transvaginal ultrasound-guided oocyte retrieval: prospective study of >1000 oocyte retrievals. Hum Reprod 2006; 21: 3235-3240
• 114 Hignett M, Claman P. High rates of perforation are found in endovaginal ultrasound probe covers before and after oocyte retrieval for in vitro fertilization-embryo transfer. J Assist Reprod Genet 1995; 12: 606-609
• 115 Klett S, Heeg P. Zur Notwendigkeit der regelhaften Aufbereitung von transvaginalen Ultraschallsonden/Ultraschallsonden mit Schleimhautkontakt. Hyg Med 2006; 31: 348-349
• 116 Schwebke I, Eggers M, Gebel J. et al. Prüfung und Deklaration der Wirksamkeit von Desinfektionsmitteln gegen Viren zur Anwendung im human-medizinischen Bereich: Stellungnahme des Arbeitskreises Viruzidie beim Robert Koch-Institut. Bundesgesundheitsbl 2017; 60: 353-363
• 117 Combs CA, Fishman A. A proposal to reduce the risk of transmission of human papilloma virus via transvaginal ultrasound. Am J Obstet Gynecol 2016; 215: 63-67
• 118 M’Zali F, Bounizra C, Leroy S. et al. Persistence of microbial contamination on transvaginal ultrasound probes despite low-level disinfection procedure. PloS One 2014; 9: e93368
• 119 Meyers J, Ryndock E, Conway MJ. et al. Susceptibility of high-risk human papillomavirus type 16 to clinical disinfectants. J Antimicrob Chemother 2014; 69: 1546-1550
• 120 Heeg P, Gauer J. Automatische, validierte, nicht-toxische High-level-Desinfektion (HLD) von Ultraschallsonden. Krankenh-Hyg Infekt 2014; 36: 126-135
• 121 Ryndock E, Robison R, Meyers C. Susceptibility of HPV16 and 18 to high level disinfectants indicated for semi-critical ultrasound probes. J Med Virol 2016; 88: 1076-1080
• 122 Bloc S, Mercadal L, Garnier T. et al. Evaluation of a new disinfection method for ultrasound probes used for regional anesthesia: ultraviolet C light. J Ultrasound Med 2011; 30: 785-788
• 123 Meyers C, Milici J, Robison R. UVC radiation as an effective disinfectant method to inactivate human papillomaviruses. PLOS ONE 2017; 12: e0187377
• 124 Côté G, Denault A. Transesophageal echocardiography-related complications. Can J Anaesth J Can Anesth 2008; 55: 622-647
• 125 Janssen J, König K, Knop-Hammad V. et al. Frequency of bacteremia after linear EUS of the upper GI tract with and without FNA. Gastrointest Endosc 2004; 59: 339-344
• 126 Levy MJ, Norton ID, Wiersema MJ. et al. Prospective risk assessment of bacteremia and other infectious complications in patients undergoing EUS-guided FNA. Gastrointest Endosc 2003; 57: 672-678
• 127 Levy PY, Teysseire N, Etienne J. et al. A nosocomial outbreak of Legionella pneumophila caused by contaminated transesophageal echocardiography probes. Infect Control Hosp Epidemiol 2003; 24: 619-622
• 128 Werner M, Valenza G, Castellanos I. et al. Eine schadhafte Echokardiografie-Sonde als Ursache für einen Kolonisations- und Infektionsausbruch mit 3 MRGN E. coli auf einer interdisziplinären operativen Intensivstation. http://www.krankenhausinfektionen-ulmer-symposium.de/index.php?eID=tx_nawsecuredl&u=0&g=0&t=901487342700&hash=19f48777d844bb807652b383ed8ebaeed57fd64d&file=fileadmin/congress/media/usk2017/pdf/USK2017_Programmheft.pdf Letzter Zugriff 27.12.2017
• 129 Steinfort DP, Johnson DF, Irving LB. Incidence of bacteraemia following endobronchial ultrasound-guided transbronchial needle aspiration. Eur Respir J 2010; 36: 28-32
• 130 Dietrich CF, Lorentzen T, Appelbaum L. et al. EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part III – Abdominal Treatment Procedures (Long Version). Ultraschall in Med 2016; 37: E1-E32
• 131 Sidhu PS, Brabrand K, Cantisani V. et al. EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part II. Diagnostic Ultrasound-Guided Interventional Procedures (Long Version). Ultraschall in Med 2015; 36: E15-E35
• 132 Barawi M, Gottlieb K, Cunha B. et al. A prospective evaluation of the incidence of bacteremia associated with EUS-guided fine-needle aspiration. Gastrointest Endosc 2001; 53: 189-192
• 133 Levy MJ, Abu Dayyeh BK, Fujii LL. et al. Prospective evaluation of adverse events following lower gastrointestinal tract EUS FNA. Am J Gastroenterol 2014; 109: 676-685
• 134 Levy MJ, Norton ID, Clain JE. et al. Prospective study of bacteremia and complications With EUS FNA of rectal and perirectal lesions. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc 2007; 5: 684-689
• 135 Fernández-Esparrach G, Sendino O, Araujo I. et al. Incidence of bacteremia in cirrhotic patients undergoing upper endoscopic ultrasonography. Gastroenterol Hepatol 2014; 37: 327-333
• 136 Li N, Qi H, Liu Z. et al. Effect of Povidone-iodine Washing of Gastrointestinal Mucosa or Taking Proton Pump Inhibitors on Bacteremia after Endoscopic Ultrasonography-guided Fine Needle Aspiration. Endosc Ultrasound 2012; 1: 90-95
• 137 Wang KX, Ben QW, Jin ZD. et al. Assessment of morbidity and mortality associated with EUS-guided FNA: a systematic review. Gastrointest Endosc 2011; 73: 283-290
• 138 Jenssen C, Alvarez-Sánchez MV, Napoléon B. et al. Diagnostic endoscopic ultrasonography: assessment of safety and prevention of complications. World J Gastroenterol 2012; 18: 4659-4676
• 139 Fujii LL, Levy MJ. Basic techniques in endoscopic ultrasound-guided fine needle aspiration for solid lesions: Adverse events and avoiding them. Endosc Ultrasound 2014; 3: 35-45
• 140 Gleeson FC, Clain JE, Rajan E. et al. EUS-FNA assessment of extramesenteric lymph node status in primary rectal cancer. Gastrointest Endosc 2011; 74: 897-905
• 141 von Bartheld MB, van Breda A, Annema JT. Complication rate of endosonography (endobronchial and endoscopic ultrasound): a systematic review. Respir Int Rev Thorac Dis 2014; 87: 343-351
• 142 Asano F, Aoe M, Ohsaki Y. et al. Complications associated with endobronchial ultrasound-guided transbronchial needle aspiration: a nationwide survey by the Japan Society for Respiratory Endoscopy. Respir Res 2013; 14: 50
• 143 Kim SY, Lee JW, Park YS. et al. Incidence of Fever Following Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration. Tuberc Respir Dis 2017; 80: 45-51
• 144 Çağlayan B, Yılmaz A, Bilaçeroğlu S. et al. Complications of Convex-Probe Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: A Multi-Center Retrospective Study. Respir Care 2016; 61: 243-248
• 145 von Bartheld MB, Annema JT. Endosonography-related mortality and morbidity for pulmonary indications: a nationwide survey in the Netherlands. Gastrointest Endosc 2015; 82: 1009-1015
• 146 Vaidya PJ, Munavvar M, Leuppi JD. et al. Endobronchial ultrasound-guided transbronchial needle aspiration: Safe as it sounds. Respirol 2017; 22: 1093-1101
• 147 DeWitt J, Al-Haddad M, Fogel E. et al. Endoscopic transduodenal drainage of an abscess arising after EUS-FNA of a duodenal GI stromal tumor. Gastrointest Endosc 2009; 70: 185-188
• 148 Eckardt AJ, Adler A, Gomes EM. et al. Endosonographic large-bore biopsy of gastric subepithelial tumors: a prospective multicenter study. Eur J Gastroenterol Hepatol 2012; 24: 1135-1144
• 149 Grandval P, Picon M, Coste P. et al. Infection of submucosal tumor after endosonography-guided needle biopsy. Gastroenterol Clin Biol 1999; 23: 566-568
• 150 Polkowski M, Gerke W, Jarosz D. et al. Diagnostic yield and safety of endoscopic ultrasound-guided trucut [corrected] biopsy in patients with gastric submucosal tumors: a prospective study. Endoscopy 2009; 41: 329-334
• 151 Sing J, Erickson R, Fader R. An in vitro analysis of microbial transmission during EUS-guided FNA and the utility of sterilization agents. Gastrointest Endosc 2006; 64: 774-779
• 152 Zhu H, Jiang F, Zhu J. et al. Assessment of morbidity and mortality associated with endoscopic ultrasound-guided fine-needle aspiration for pancreatic cystic lesions: A systematic review and meta-analysis. Dig Endosc 2017; 29: 667-675
• 153 Iwashita T, Yasuda I, Uemura S. et al. Infected mediastinal cyst following endoscopic ultrasonography-guided fine-needle aspiration with rupture into the esophagus. Dig Endosc 2012; 24: 386
• 154 Mahady SE, Moss A, Kwan V. EUS-guided drainage of a mediastinal collection complicating FNA of a bronchogenic cyst. Gastrointest Endosc 2011; 73: 1306-1308
• 155 Maturu VN, Dhooria S, Agarwal R. Efficacy and Safety of Transbronchial Needle Aspiration in Diagnosis and Treatment of Mediastinal Bronchogenic Cysts: Systematic Review of Case Reports. J Bronchol Interv Pulmonol 2015; 22: 195-203
• 156 Onuki T, Kuramochi M, Inagaki M. Mediastinitis of bronchogenic cyst caused by endobronchial ultrasound-guided transbronchial needle aspiration. Respirol Case Rep 2014; 2: 73-75
• 157 Westerterp M, van der Berg JG, van der Lanschot JJB. et al. Intramural bronchogenic cysts mimicking solid tumors. Endoscopy 2004; 36: 1119-1122
• 158 Wildi SM, Hoda RS, Fickling W. et al. Diagnosis of benign cysts of the mediastinum: the role and risks of EUS and FNA. Gastrointest Endosc 2003; 58: 362-368
• 159 ten Berge J, Hoffman BJ, Hawes RH. et al. EUS-guided fine needle aspiration of the liver: indications, yield, and safety based on an international survey of 167 cases. Gastrointest Endosc 2002; 55: 859-862
• 160 Early DS, Acosta RD. ASGE Standards of Practice Committee. et al. Adverse events associated with EUS and EUS with FNA. Gastrointest Endosc 2013; 77: 839-843
• 161 Denzer U, Beilenhoff U, Eickhoff A. et al. S2k guideline: quality requirements for gastrointestinal endoscopy, AWMF registry no. 021-022. Z Gastroenterol 2015; 53: E1-E227
• 162 Jenssen C, Hocke M, Fusaroli P. et al. EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part IV – EUS-guided Interventions: General aspects and EUS-guided sampling (Long Version). Ultraschall in Med 2016; 37: E33-E76
• 163 Polkowski M, Jenssen C, Kaye P. et al. Technical aspects of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: ESGE Technical Guideline. Endoscopy 2017; 49: 989-1006
• 164 Wani S, Wallace MB, Cohen J. et al. Quality indicators for EUS. Gastrointest Endosc 2015; 81: 67-80
• 165 Wani S, Wallace MB, Cohen J. et al. Quality indicators for EUS. Am J Gastroenterol 2015; 110: 102-113
• 166 Guarner-Argente C, Shah P, Buchner A. et al. Use of antimicrobials for EUS-guided FNA of pancreatic cysts: a retrospective, comparative analysis. Gastrointest Endosc 2011; 74: 81-86
• 167 Klein A, Qi R, Nagubandi S. et al. Single-dose intra-procedural ceftriaxone during endoscopic ultrasound fine-needle aspiration of pancreatic cysts is safe and effective: results from a single tertiary center. Ann Gastroenterol 2017; 30: 237-241
• 168 Marinos E, Lee S, Jones B. et al. Outcomes of single-dose peri-procedural antibiotic prophylaxis for endoscopic ultrasound-guided fine-needle aspiration of pancreatic cystic lesions. United Eur Gastroenterol J 2014; 2: 391-396
• 169 Ignee A, Jenssen C, Hocke M. et al. Contrast-enhanced (endoscopic) ultrasound and endoscopic ultrasound elastography in gastrointestinal stromal tumors. Endosc Ultrasound 2017; 6: 55-60
• 170 Piscaglia F, Nolsøe C, Dietrich CF. et al. The EFSUMB Guidelines and Recommendations on the Clinical Practice of Contrast Enhanced Ultrasound (CEUS): update 2011 on non-hepatic applications. Ultraschall in Med 2012; 33: 33-59
• 171 Seicean A, Jinga M. Harmonic contrast-enhanced endoscopic ultrasound fine-needle aspiration: Fact or fiction?. Endosc Ultrasound 2017; 6: 31-36
• 172 Yamashita Y, Kato J, Ueda K. et al. Contrast-Enhanced Endoscopic Ultrasonography for Pancreatic Tumors. BioMed Res Int 2015; 2015: 491782
• 173 Alvarez-Sánchez MV, Jenssen C, Faiss S. et al. Interventional endoscopic ultrasonography: an overview of safety and complications. Surg Endosc 2014; 28: 712-734
• 174 Fusaroli P, Jenssen C, Hocke M. et al. EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part V. Ultraschall in Med – Eur J Ultrasound 2016; 37: 77-99
• 175 Fabbri C, Luigiano C, Lisotti A. et al. Endoscopic ultrasound-guided treatments: are we getting evidence based--a systematic review. World J Gastroenterol 2014; 20: 8424-8448
• 176 Chantarojanasiri T, Aswakul P, Prachayakul V. Uncommon complications of therapeutic endoscopic ultrasonography: What, why, and how to prevent. World J Gastrointest Endosc 2015; 7: 960-968
• 177 Moshkanbaryans L, Meyers C, Ngu A. et al. The importance of infection prevention and control in medical ultrasound. Australas J Ultrasound Med 2015; 18: 96-99
• 178 Koibuchi H, Fujii Y, Kotani K. et al. Degradation of ultrasound probes caused by disinfection with alcohol. J Med Ultrason 2001 2011; 38: 97-100
• 179 Shukla B, Howell V, Griffiths A. et al. Superiority of chlorhexidine 2%/alcohol 70% wipes in decontaminating ultrasound equipment. Ultrasound 2014; 22: 135-140