Schabrun Siobhan, Chipchase Lucy, Rickard Heather
School of Health Sciences, University of South Australia, North Terrace, Adelaide, Australia.
Physiother Res Int. 2006 Jun;11(2):61-71. doi: 10.1002/pri.329.
Nosocomial infections present a widespread problem in today's healthcare environment, with a significant number of patients acquiring an infection annually. With the contemporary transition of immunocompromised and high-risk patients to community-based care, therapeutic ultrasound has the potential to be a vector of infection in the physiotherapy setting. The purpose of the present study was to determine the degree of contamination on therapeutic ultrasound transducer heads and ultrasound gel after routine clinical use, and to evaluate the efficacy of recommended infection control procedures.
The study consisted of two phases. Using a prospective cross-sectional design, microbiological cultures were obtained from 44 transducer heads and 43 gels. Subjects were drawn from a variety of physiotherapy practice settings. All samples containing more than five colony forming units per cm2 were considered contaminated. Following these measurements, a repeated-measures design was used to re-evaluate the 44 transducer heads for the amount and type of bacteria present after cleaning with a 70% alcohol wipe.
Twenty-seven per cent of transducer heads and 28% of gels were contaminated. Transducer heads showed fairly low levels of contamination across the sample, with the majority of organisms isolated found in normal skin and environmental flora. Gels were heavily contaminated with opportunistic and potentially pathogenic organisms, including Stenotrophomonas maltophilia, Staphylococcus aureus, Acinetobacter baumannii and Rhodotorula mucilaginosa. No multi-resistant organisms were identified. Cleaning with 70% alcohol significantly reduced the level of contamination on transducer heads (p < 0.01).
Therapeutic ultrasound equipment is a potential vector for nosocomial infection in physiotherapy patients. The risk of infection from transducer heads can be effectively removed by cleaning with 70% alcohol between patients. Further research into possible strategies to reduce the risk of infection from ultrasound gels is needed.
在当今的医疗环境中，医院感染是一个普遍存在的问题，每年有大量患者发生感染。随着免疫功能低下和高危患者向社区护理的现代转变，治疗性超声在物理治疗环境中有可能成为感染的传播媒介。本研究的目的是确定治疗性超声换能器探头和超声凝胶在常规临床使用后的污染程度，并评估推荐的感染控制程序的效果。
该研究包括两个阶段。采用前瞻性横断面设计，从44个换能器探头和43种凝胶中获取微生物培养物。研究对象来自各种物理治疗实践场所。所有每平方厘米含有超过5个菌落形成单位的样本被视为受污染。在进行这些测量之后，采用重复测量设计，对44个换能器探头在用70%酒精擦拭清洁后存在的细菌数量和类型进行重新评估。
27%的换能器探头和28%的凝胶被污染。换能器探头在整个样本中显示出相当低的污染水平，分离出的大多数微生物存在于正常皮肤和环境菌群中。凝胶被机会性和潜在致病性微生物严重污染，包括嗜麦芽窄食单胞菌、金黄色葡萄球菌、鲍曼不动杆菌和粘红酵母。未鉴定出多重耐药菌。用70%酒精清洁显著降低了换能器探头的污染水平（p < 0.01）。
治疗性超声设备是物理治疗患者医院感染的潜在传播媒介。通过在患者之间用70%酒精清洁，可以有效消除换能器探头的感染风险。需要进一步研究降低超声凝胶感染风险的可能策略。
