Transesophageal Echocardiography (TOE, TEE)
infection risk

Research Studies

Various outbreaks associated with Transoesophageal echocardiography TOE /TEE ultrasound probes are found in various literature:

  • In England, the death of a patient due to hepatitis B may have been associated with a failure to appropriately decontaminate the probe (used with a probe cover according to medical director declarations in general public press). MHRA alert released due to patient death from hepatitis B infection attributed contamination to improperly reprocessed transoesophageal echocardiography probe. 1
  • In Belgium, 42 patients colonized or infected (9), Mortality rate 40% among infected patients; costs, 266,550 euros. 2
  • A nosocomial Outbreak of Legionella pneumophila Caused by Contaminated Transesophageal Echocardiography Probes. 3
  • An increased incidence of Enterobacter cloacae in a cardiovascular ward. 4
  • Serratia marcescens pulmonary infections in a cardiothoracic intensive care unit. 5
  • An outbreak of Pseudomonas aeruginosa respiratory tract infections associated with intrinsically contaminated ultrasound transmission gel. 6
  1. Medicines and Healthcare products Regulatory Agency (MHRA). Medical Device Alert: Reusable transoesophageal echocardiography, transvaginal and transrectal ultrasound probes (transducers). 2012. https://assets.publishing.service.gov.uk/media/5485abf1ed915d4c0d000261/con160567.pdf
  2. Belgium, 42 patients colonized or infected (9), Mortality rate 40% among infected patients ; costs, 266,550 euros, Noel A, et al.  J Hosp Infect 2019 Jan (Epub)
  3. A Nosocomial Outbreak of Legionella pneumophila Caused by Contaminated Transesophageal Echocardiography Probes, Infect Control Hosp Epidemiol 2003;24:619-622, Levy and al.
  4. An increased incidence of Enterobacter cloacae in a cardiovascular ward ; K. Kanemitsu ; Journal of Hospital Infection (2007) 66, 130-134 ;
  5. Serratia marcescens pulmonary infections in a cardiothoracic intensive care unit; Abstract ID 54322 Monday, June 20 ; AJIC, E120 Vol. 33 No. 5 ; J Voth ;
  6. An outbreak of Pseudomonas aeruginosa respiratory tract infections associated with intrinsically contaminated ultrasound transmission gel ; Chittick, Infection control and hospital epidemiology. 2013/08; 34(8) : 850-853
  7.  TRANSESOPHAGEAL ECHOCARDIOGRAPHY, INSUFFICIENT CLEANING PRACTICES AND LAX EQUIPMENT MAINTENANCE, AND ESCHERICHIA COLI – A BREAKDOWN IN INFECTION CONTROL; Acute Communicable Disease Control Program 2006 Special Studies Report
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