A non-inferiority trial comparing manual and automated high-level disinfection for reprocessing of transabdominal and transvaginal ultrasound probes

Manual chemical methods are commonly used for ultrasound probe disinfection but are known to be operator dependent and subject to variability. Automated ultraviolet-C (UV-C) light - emitting diode (LED) disinfection represents a chemical and mercury free alternative, however, clinical evidence comparing UV-C LED to conventional disinfectants for high-level disinfection of ultrasound probes remains limited. In this single-centre non-inferiority study conducted in the departments of gynaecology, obstetrics and urology of a Belgian university hospital, automated UV-C LED disinfection was compared to manual chlorine dioxide disinfection for the reprocessing of transabdominal and transvaginal ultrasound probes. Following clinical use, probes were decontaminated by healthcare practitioners alternating between both reprocessing methods. Samples were collected after treatment and processed for microbial analysis to assess the effectiveness of the decontamination process. A total of 296 probes were included, comprising 86 transabdominal and 210 transvaginal probes. UV-C LED disinfection achieved effectiveness rates of 92.86% for transabdominal probes and 97.17% for transvaginal probes, compared with 79.49% and 93.27%, respectively for chlorine dioxide disinfection. Positive samples following UV-C disinfection yielded single colonies whereas chlorine dioxide treated probes showed greater variability in colony counts and species diversity. Although the total reprocessing time for UV-C disinfection was longer, manual handling times were comparable between both methods. Here, we demonstrated that UV-C LED disinfection was non-inferior to chlorine dioxide disinfection for reprocessing of transabdominal and transvaginal ultrasound probes under routine conditions.