Risk of Infection Associated with Transesophageal Echocardiography and Prevention Measures: Literature Review

Background: Transesophageal echocardiography is an exam widely used in clinical practice for investigation and diagnosis of cardiac and noncardiac diseases. Although safe, it is a semi-invasive and non-risk-free examination. Cases of infection associated with transesophageal echocardiography were described and, due to the potential risk of transmission of infection during its implementation, the objective of this work was to review literature data regarding the transmission of infection during the examination, as well as prevention methods. Methods: Review of literature on the subject between December 2017 and January 2018, through research in public domain scientific portals, in the different health science databases, including original articles, guidelines, simple and systematic reviews, case reports, published in periodicals indexed in the last 20 years. Results: Thirteen articles fulfilled the established criteria: a systematic review of transesophageal echocardiography-related complications, six articles describing transesophageal echocardiography-related bacterial outbreaks, the British guideline on cleaning and disinfection for transesophageal echocardiography probes, four articles on adverse reactions to orthophthaldehyde residues in transesophageal echocardiography probes and an article regarding the use of protective covers for the probes. Conclusion: The risk of infection associated with transesophageal echocardiography exists, although poorly described in the literature. It is recommended to establish specific protocols for disinfection of transesophageal echocardiography probes and routine inspection of probes. The strengthening of infection control teams is also essential for the detection and resolution of transesophageal echocardiography-related outbreaks.