[Infection control practices while performing prostate biopsies in France: A CIAFU survey]
P Leduc1, J D Doublet2, F Bruyère3
1Unité d'épidémiologie et hygiène hospitalière, CHU Toulouse-Rangueil, 1, avenue Jean-Poulhès, 31059 Toulouse cedex 9, France.
Abstract:
In 2008, the French Public Health Committee admitted that associating ultrasound probe protection, and related precautions, and low-level disinfection would be equivalent to the intermediate level disinfection. In 2010, the French Urology Association (AFU) updated guidelines regarding trans-rectal prostate biopsies, namely preventive measures related to cross-transmission of infections. We report an evaluation of compliance to them, driven in 2016 by AFU's infection committee. Although not recommended, almost one third of the urologists still perform biopsies under general anesthesia, and two thirds of them ask for a urine culture before biopsies. Several improvements are still needed: sterilization of needle guide should always be done when not of single use, the ultrasonography gel should be sterile, probes protection should be EC labeled, and compliance to probe processing between two patients should increase. Most of urologists happened to experience blood or feces contamination of probes. Less than half of probes are entirely floodable, and when intermediate level disinfection is done, glutaraldehyde is still referred as disinfectant by one third of the urologists.
Level Of Evidence:
4.
Insights
French urologists need to improve infection control during trans-rectal prostate biopsies. Key areas include sterile ultrasound gel, probe sterilization, and EC-labeled probe covers to prevent cross-transmission.
Area of Science:
- Urology
- Infectious Disease Control
- Medical Device Sterilization
Background:
- French Public Health Committee (2008) suggested low-level disinfection with probe protection equals intermediate-level disinfection.
- French Urology Association (AFU) updated guidelines in 2010 for trans-rectal prostate biopsies to prevent infection cross-transmission.
Purpose of the Study:
- To evaluate compliance with AFU guidelines for infection prevention during trans-rectal prostate biopsies.
- To identify areas needing improvement in infection control practices among urologists.
Main Methods:
- An evaluation of compliance with AFU infection control guidelines was conducted in 2016.
- Data collected on practices such as anesthesia use, urine cultures, and probe processing.
Main Results:
- One-third of urologists still perform biopsies under general anesthesia, contrary to recommendations.
- Two-thirds request pre-biopsy urine cultures.
- Significant improvements needed in sterilization of needle guides, use of sterile ultrasound gel, and EC-labeled probe covers.
- Many urologists report probe contamination; less than half of probes are fully immersible.
- Glutaraldehyde remains a common disinfectant despite guidelines.
Conclusions:
- Compliance with AFU guidelines for infection prevention during trans-rectal prostate biopsies is suboptimal.
- Urgent improvements are required in sterilization, probe protection, and disinfection protocols.
- Enhanced adherence to guidelines is crucial to minimize infection risks and cross-transmission.
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