Risk of infection following semi-invasive ultrasound procedures in Scotland, 2010 to 2016: a retrospective cohort study using linked national datasets

David Scott, Eilidh Fletcher, Hayley Kane, William Malcolm, Kimberley Kavanagh, A-Lan Banks, Annette Rankin

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Introduction

Outbreak reports indicate a risk of cross-infection following medical procedures using semi-invasive ultrasound probes. This study aimed to evaluate the risk of infection, using microbiological reports and antibiotic prescriptions as proxy measures, associated with semi-invasive ultrasound probe procedures, including transoesophageal echocardiography, transvaginal and transrectal ultrasound.
Methods

Patient records from the Electronic Communication of Surveillance in Scotland and the Prescribing Information System were linked with the Scottish Morbidity Records for cases in Scotland between 2010 and 2016. Three retrospective cohorts were created to include inpatients/day-cases and outpatients in the following specialties: Cardiology, Gynaecology and Urology. Cox regression was used to quantify the association between semi-invasive ultrasound probe procedures and the risk of positive microbiological reports and community antibiotic prescriptions in the 30-day period following the procedure.
Results

There was a greater hazard ratio of microbiological reports for patients who had undergone transoesophageal echocardiography (HR: 4.92; 95% CI: 3.17–7.63), transvaginal (HR: 1.41; 95% CI: 1.21–1.64) and transrectal ultrasound (HR: 3.40; 95% CI: 2.90–3.99), compared with unexposed cohort members after adjustment for age, co-morbidities, previous hospital admissions and past care home residence. Similarly, there was a greater hazard ratio of antibiotic prescribing for those who had received transvaginal (HR: 1.26; 95% CI: 1.20–1.32) and transrectal (HR: 1.75; 95% CI: 1.66–1.84) ultrasound, compared with unexposed patients.
Conclusion

Analysis of linked national datasets demonstrated a greater risk of infection within 30 days of undergoing semi-invasive ultrasound probe procedures, using microbiological reports and antibiotic prescriptions as proxy measures of infection.

LanguageEnglish
Pages168-177
Number of pages10
JournalUltrasound
Volume26
Issue number3
Early online date3 May 2018
DOIs
Publication statusPublished - 31 Aug 2018

Fingerprint

Scotland
Cohort Studies
Retrospective Studies
Anti-Bacterial Agents
Prescriptions
Infection
Transesophageal Echocardiography
Proxy
Morbidity
Urology
Home Care Services
Cross Infection
Cardiology
Gynecology
Information Systems
Inpatients
Outpatients
Communication
Datasets

Keywords

  • cross infection
  • infection control
  • ultrasound
  • endosonography
  • endocavitary probe
  • echocardiography

Cite this

Scott, David ; Fletcher, Eilidh ; Kane, Hayley ; Malcolm, William ; Kavanagh, Kimberley ; Banks, A-Lan ; Rankin, Annette. / Risk of infection following semi-invasive ultrasound procedures in Scotland, 2010 to 2016 : a retrospective cohort study using linked national datasets. 2018 ; Vol. 26, No. 3. pp. 168-177.
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title = "Risk of infection following semi-invasive ultrasound procedures in Scotland, 2010 to 2016: a retrospective cohort study using linked national datasets",
abstract = "IntroductionOutbreak reports indicate a risk of cross-infection following medical procedures using semi-invasive ultrasound probes. This study aimed to evaluate the risk of infection, using microbiological reports and antibiotic prescriptions as proxy measures, associated with semi-invasive ultrasound probe procedures, including transoesophageal echocardiography, transvaginal and transrectal ultrasound.MethodsPatient records from the Electronic Communication of Surveillance in Scotland and the Prescribing Information System were linked with the Scottish Morbidity Records for cases in Scotland between 2010 and 2016. Three retrospective cohorts were created to include inpatients/day-cases and outpatients in the following specialties: Cardiology, Gynaecology and Urology. Cox regression was used to quantify the association between semi-invasive ultrasound probe procedures and the risk of positive microbiological reports and community antibiotic prescriptions in the 30-day period following the procedure.ResultsThere was a greater hazard ratio of microbiological reports for patients who had undergone transoesophageal echocardiography (HR: 4.92; 95{\%} CI: 3.17–7.63), transvaginal (HR: 1.41; 95{\%} CI: 1.21–1.64) and transrectal ultrasound (HR: 3.40; 95{\%} CI: 2.90–3.99), compared with unexposed cohort members after adjustment for age, co-morbidities, previous hospital admissions and past care home residence. Similarly, there was a greater hazard ratio of antibiotic prescribing for those who had received transvaginal (HR: 1.26; 95{\%} CI: 1.20–1.32) and transrectal (HR: 1.75; 95{\%} CI: 1.66–1.84) ultrasound, compared with unexposed patients.ConclusionAnalysis of linked national datasets demonstrated a greater risk of infection within 30 days of undergoing semi-invasive ultrasound probe procedures, using microbiological reports and antibiotic prescriptions as proxy measures of infection.",
keywords = "cross infection, infection control, ultrasound, endosonography, endocavitary probe, echocardiography",
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Risk of infection following semi-invasive ultrasound procedures in Scotland, 2010 to 2016 : a retrospective cohort study using linked national datasets. / Scott, David; Fletcher, Eilidh; Kane, Hayley; Malcolm, William ; Kavanagh, Kimberley; Banks, A-Lan; Rankin, Annette.

Vol. 26, No. 3, 31.08.2018, p. 168-177.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Risk of infection following semi-invasive ultrasound procedures in Scotland, 2010 to 2016

T2 - a retrospective cohort study using linked national datasets

AU - Scott, David

AU - Fletcher, Eilidh

AU - Kane, Hayley

AU - Malcolm, William

AU - Kavanagh, Kimberley

AU - Banks, A-Lan

AU - Rankin, Annette

PY - 2018/8/31

Y1 - 2018/8/31

N2 - IntroductionOutbreak reports indicate a risk of cross-infection following medical procedures using semi-invasive ultrasound probes. This study aimed to evaluate the risk of infection, using microbiological reports and antibiotic prescriptions as proxy measures, associated with semi-invasive ultrasound probe procedures, including transoesophageal echocardiography, transvaginal and transrectal ultrasound.MethodsPatient records from the Electronic Communication of Surveillance in Scotland and the Prescribing Information System were linked with the Scottish Morbidity Records for cases in Scotland between 2010 and 2016. Three retrospective cohorts were created to include inpatients/day-cases and outpatients in the following specialties: Cardiology, Gynaecology and Urology. Cox regression was used to quantify the association between semi-invasive ultrasound probe procedures and the risk of positive microbiological reports and community antibiotic prescriptions in the 30-day period following the procedure.ResultsThere was a greater hazard ratio of microbiological reports for patients who had undergone transoesophageal echocardiography (HR: 4.92; 95% CI: 3.17–7.63), transvaginal (HR: 1.41; 95% CI: 1.21–1.64) and transrectal ultrasound (HR: 3.40; 95% CI: 2.90–3.99), compared with unexposed cohort members after adjustment for age, co-morbidities, previous hospital admissions and past care home residence. Similarly, there was a greater hazard ratio of antibiotic prescribing for those who had received transvaginal (HR: 1.26; 95% CI: 1.20–1.32) and transrectal (HR: 1.75; 95% CI: 1.66–1.84) ultrasound, compared with unexposed patients.ConclusionAnalysis of linked national datasets demonstrated a greater risk of infection within 30 days of undergoing semi-invasive ultrasound probe procedures, using microbiological reports and antibiotic prescriptions as proxy measures of infection.

AB - IntroductionOutbreak reports indicate a risk of cross-infection following medical procedures using semi-invasive ultrasound probes. This study aimed to evaluate the risk of infection, using microbiological reports and antibiotic prescriptions as proxy measures, associated with semi-invasive ultrasound probe procedures, including transoesophageal echocardiography, transvaginal and transrectal ultrasound.MethodsPatient records from the Electronic Communication of Surveillance in Scotland and the Prescribing Information System were linked with the Scottish Morbidity Records for cases in Scotland between 2010 and 2016. Three retrospective cohorts were created to include inpatients/day-cases and outpatients in the following specialties: Cardiology, Gynaecology and Urology. Cox regression was used to quantify the association between semi-invasive ultrasound probe procedures and the risk of positive microbiological reports and community antibiotic prescriptions in the 30-day period following the procedure.ResultsThere was a greater hazard ratio of microbiological reports for patients who had undergone transoesophageal echocardiography (HR: 4.92; 95% CI: 3.17–7.63), transvaginal (HR: 1.41; 95% CI: 1.21–1.64) and transrectal ultrasound (HR: 3.40; 95% CI: 2.90–3.99), compared with unexposed cohort members after adjustment for age, co-morbidities, previous hospital admissions and past care home residence. Similarly, there was a greater hazard ratio of antibiotic prescribing for those who had received transvaginal (HR: 1.26; 95% CI: 1.20–1.32) and transrectal (HR: 1.75; 95% CI: 1.66–1.84) ultrasound, compared with unexposed patients.ConclusionAnalysis of linked national datasets demonstrated a greater risk of infection within 30 days of undergoing semi-invasive ultrasound probe procedures, using microbiological reports and antibiotic prescriptions as proxy measures of infection.

KW - cross infection

KW - infection control

KW - ultrasound

KW - endosonography

KW - endocavitary probe

KW - echocardiography

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U2 - 10.1177/1742271X18774594

DO - 10.1177/1742271X18774594

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