Contemporary Management of Cleaning and Disinfection Processes for Echocardiographic Equipment and Probes: National Real-world Data from an Italian Society of Echocardiography and Cardiovascular Imaging Survey.

Effective hygiene practices are crucial to mitigate infection risks in echocardiographic procedures. We conducted a nationwide survey to assess real-world disinfection standards in Italian echocardiography laboratories, measure adherence to core hygiene indicators, and identify structural determinants of compliance. A 35-item questionnaire was distributed to 331 accredited centers. Compliance was defined as adherence to ≥5 of 7 core hygiene indicators. Multivariable logistic regression identified predictors of high compliance. Glove use (92.7%) and probe sheathing (34%-38%) were common, but high-level disinfection (HLD) remained underused (38.2% for surface probes and 64.7% for transesophageal echocardiography [TEE] probes). Only 48.3% of centers had traceability for TEE probe cleaning. Overall, 43.8% of centers achieved high compliance. Independent predictors included female gender (odds ratio [OR]: 2.37, 95% confidence interval [CI]: 1.49-3.75), hospital setting (OR: 2.50, 95% CI: 1.22-5.12), and high procedural volume (OR: 2.32, 95% CI: 1.45-3.71). Compliance varied by care setting, with outpatient clinics generally showing better adherence than emergency and intensive care units. Significant heterogeneity exists in disinfection practices across Italian echo laboratories, with persistent gaps in HLD, traceability, and environmental hygiene. Compliance was driven by operator characteristics and center-level factors rather than general institutional policies. These findings call for workflow-integrated protocols and targeted training to ensure standardized practice.