An Evidence-Based Discussion of the Problems and Possible Solutions
Flexible endoscopes, due to their complex design and exposure to biological materials during procedures, are challenging to reprocess effectively. They are heavily exposed to blood, mucus, and other secretions during procedures and may harbor billions of microbes before processing. Guidelines recommend thorough cleaning and high-level disinfection (HLD) or sterilization after each use. While HLD is intended to eliminate most pathogens, Ofstead’s review of real-world evidence from 2019 to 2024 found that HLD often failed to eradicate all microbes, leaving patients at risk of infection.
Acknowledgements
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*“Endoscope processing effectiveness: A reality check and call to action for infection preventionists and clinicians.” American Journal of Infection Control (AJIC), 2025.
