Low-cost antimicrobial fortification of ultrasound coupling gel: An ergonomic innovation to combat sonology-acquired nosocomial infections

BACKGROUND: Recent outbreaks of highly contagious diseases have prompted hospital departments to adopt preventive hygiene protocols. Use of shared equipment, including ultrasound transducers and coupling gels, potentially exposes patients to these microbes. Inexpensive means of microbicide fortification of plain/non-sterile ultrasound gel may be useful in interrupting nosocomial infections. The purpose of this study was to evaluate the effectiveness of low-cost antimicrobial fortification of ultrasound coupling gel in preventing nosocomial infections during ultrasound examinations. METHODS: Volunteer patients, 20 in number, who presented for an ultrasound scan in a busy radiology clinic in Enugu, Nigeria, were randomly divided into 2 groups of 10 each and were scanned using plain non-sterile gel and gel-fortified with 0.5% chlorhexidine and 70% ethyl alcohol (in a volume ratio of 20:2:1) respectively. Swabs were taken from the patients' skin, gel-laden transducer, and the cleaned transducer and subjected to microbiology analysis. Subsequently, plain and fortified gel samples were allowed to stand in their respective dispensers for 72 hours. The plain and fortified gel samples were subjected to microbiology analysis. Fisher's Exact Test was utilised to compare outcomes in the 2 groups of volunteers. RESULTS: With fortified gel, swab cultures from patients' skin and gel-laden transducer, and from the cleaned transducer, significantly yielded no growth (P= <0.0001 and P= 0.0001 respectively) while swab cultures from the plain gel yielded a total of 19 microbial isolates from 5 micro-organisms. CONCLUSION: Low-cost fortification of ultrasound coupling gel with 0.5% chlorhexidine and 70% ethyl alcohol renders it hostile to microorganisms encountered at sonology thus preventing nosocomial transmission.