Healthcare-Associated Infections (HAIs)

It can only take one poorly disinfected ultrasound probe to put your patients at risk of cross-contamination.

Healthcare-associated infections (HAIs) are infections associated with the treatment of patients in healthcare settings, either as a direct result of interventions or from being in contact with a healthcare setting.1,2 This means a patient acquired a new infection from their healthcare stay or treatment.

The Most Frequent Medical Adverse Event

HAIs are the most frequently occurring medical adverse event worldwide, with a prevalence of around 7-10%.3,4

HAIs can cause significant morbidity and are a risk to patients, staff and visitors.2 Facilities and practitioners may also suffer financial as well as reputational damage as a result of HAIs associated with their facility.

HAIs Add Considerable Cost to Delivering Healthcare

HAIs add considerably to the cost of delivering healthcare.2 It’s estimated that every 300,000 HAIs cost the NHS over ₤1 billion.5

HAIs are Preventable

An estimated 300,000 people acquire an HAI in England each year, with a prevalence of 6.4%.5 A 2017 survey found HAI prevalence in the Welsh acute hospital sector to be 5.5%, and 6% in the non-acute sector.5 In Europe, around 4,100,000 patients acquire HAIs each year.6

A systematic review and meta-analysis found 35-55% of HAIs are preventable with existing multifaceted infection prevention and control interventions, regardless of a country’s income level.7

The Role of Medical Devices in HAIs

Sterilisation and disinfection of medical devices play an important role in the prevention of HAIs. Multiple studies document failures in medical device reprocessing, some of which have led to outbreaks and patient exposure.8-10

Population Level Study: Infection Risk after Ultrasound

In the first of its kind, a study commissioned by UK National Health Authorities (Scotland) revealed an "unacceptable risk" of patient infection following ultrasound. The study revealed an increased infection risk in the 30 days following endocavitary ultrasound. Commissioned by a national health authority, the study revealed an increased infection risk in the 30 days following endocavitary ultrasound.11

90.5% of facilities were not performing high level disinfection (HLD) of these probes at the time of the study.

Public Health Risk Reality

Of the 982,911 patients followed, 330,500 were gynaecological patients.

60,698 of these patients had undergone transvaginal ultrasound.

The national health authority now recommends HLD for endocavitary ultrasound probes.

The increased rates of infection risk following transvaginal ultrasound were startling:11

Prevent HAIs from Medical Devices

The Spaulding Classification identifies the level of disinfection or sterilisation required for medical devices based on the expected patient tissue the device will contact.

The Spaulding Classification forms the basis of international ultrasound probe reprocessing guidelines.

Internationally, Federal authorities and professional societies provide guidance on the proper reprocessing of ultrasound probes, to help keep patients safe from HAIs.

These guidelines are based on The Spaulding Classification. 

Learn when to HLD ultrasound probes

Learn about the clinical risks from improper ultrasound probe reprocessing

  1. World Health Organization (WHO) 2020. Infection prevention and control. The burden of health care-associated infection worldwide. Webpage accessed October 2020:
  2. NHS Improvement 2017. Healthcare Associated Infections. Webpage accessed October 2020:
  3. Currie K, et al. Am J Infect Control. 2018;46(8):936-42.
  4. WHO. Healthcare Associate Infections Fact Sheet. Accessed online October 2020:
  5. House of Commons Library 2018. Debate Pack Number CDP-2018-0116, 14 May 2018. Raising standards of infection prevention and control in the NHS. Authors: A. Mackley, C. Baker and A. Bate.
  6. Currie K, et al. Am J Infect Control. 2018;46(8):936-42.
  7. Schreiber PW, et al. Infect Control Hosp Epidemiol. 2018;39(11):1277-95
  8. WHO 2016. Decontamination and Reprocessing of Medical Devices for Health-care Facilities.
  9. CDC 2008. Guideline for Disinfection and Sterilization in Healthcare Facilities.
  10. Rutala WA, Weber DJ. Infect Dis Clin North Am. 2016 Sep;30(3):609-37.
  11. Scott D et al. Ultrasound 2018;26(3): 168-177.
Clinical Use of Ultrasound