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Bacterial Contamination of Ultrasound and Stethoscope Surfaces in Low- and High-Resource Settings

Micah L. A. HeldewegDepartment of Intensive Care Medicine, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands;
Department of Internal Medicine, Sint Elisabeth Hospital, Willemstad, Curaçao;

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Kenrick BerendDepartment of Internal Medicine, Sint Elisabeth Hospital, Willemstad, Curaçao;

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Laura CadenauDepartment of Medical Microbiology, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands;

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Andert RosinghDepartment of Medical Microbiology, Curaçao Medical Center, Willemstad, Curaçao

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Ashley J. DuitsDepartment of Medical Microbiology, Curaçao Medical Center, Willemstad, Curaçao

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Rosa van MansfeldDepartment of Medical Microbiology, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands;

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Pieter R. TuinmanDepartment of Intensive Care Medicine, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands;

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ABSTRACT.

Point-of-care ultrasound is an accurate diagnostic and monitoring tool. Its increasing affordability, portability, and versatility make it an excellent component of standard clinical evaluation alongside the stethoscope. However, like the stethoscope, ultrasound carries risks of surface contamination and potential cross-infection. In this international observational study, we compared the surface contamination of ultrasound equipment to stethoscopes in two medical centers: a tropical low-resource hospital and academic high-resource hospital. Ultrasound equipment and coupling gel had similar prevalence of microbial surface contamination compared with observed stethoscopes. Most microbes were commensal Gram-positive, but some were opportunistic and pathogenic microbes (such as Escherichia coli and Staphylococcus aureus). In conclusion, it is crucial to appreciate and reduce the risk of ultrasound device contaminations. When ultrasound is used bedside, similar to stethoscopes, conscientious hygiene measures are equally fundamental.

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Author Notes

Address correspondence to Micah L. A. Heldeweg, VU University Medical Center Amsterdam, PO Box 7507, 1007MB, Amsterdam, The Netherlands. E-mail: m.heldeweg@amsterdamumc.nl

Financial support: The processing of 36 cultures by ADC (3.823,97 ANG) was paid for by the Netherlands–Caribbean Foundation for Clinical Higher Education (NASKHO).

Authors’ addresses: Micah L. A. Heldeweg, Department of Intensive Care Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands, and Department of Internal Medicine, Sint Elisabeth Hospital, Willemstad, Curaçao, E-mail: m.heldeweg@amsterdamumc.nl. Kenrick Berend, Department of Internal Medicine, Sint Elisabeth Hospital, Willemstad, Curaçao, E-mail: kenber2@me.com. Laura Cadenau, Department of Medical Microbiology, Amsterdam University Medical Centers, Amsterdam, The Netherlands, E-mail: l.cadenau@amsterdamumc.nl. Andert Rosingh and Ashley J. Duits, Department of Medical Microbiology, Curaçao Medical Center, Willemstad, Curaçao, E-mails: rosingh@hotmail.com and ajduits@gmail.com. Rosa van Mansfeld, Department of Medical Microbiology, Amsterdam University Medical Centers, Amsterdam, The Netherlands, E-mail: r.vanmansfeld@amsterdamumc.nl. Pieter R. Tuinman, Department of Intensive Care Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands, E-mail: p.tuinman@amsterdamumc.nl.

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