American Society for Microbiology:

SUMMARY Flexible endoscopy is a widely used diagnostic and therapeutic procedure. Contaminated endoscopes are the medical devices frequently associated with outbreaks of health care-associated infections. Accurate reprocessing of flexible endoscopes involves cleaning and high-level disinfection followed by rinsing and drying before storage. Most contemporary flexible endoscopes cannot be heat sterilized and are designed with multiple channels, which are difficult to clean and disinfect. The ability of bacteria to form biofilms on the inner channel surfaces can contribute to failure of the decontamination process. Implementation of microbiological surveillance of endoscope reprocessing is appropriate to detect early colonization and biofilm formation in the endoscope and to prevent contamination and infection in patients after endoscopic procedures. This review presents an overview of the infections and cross-contaminations related to flexible gastrointestinal endoscopy and bronchoscopy and illustrates the impact of biofilm on endoscope reprocessing and postendoscopic infection.

The consequences of the use of contaminated endoscopes are a recurrent topic in the endoscopy literature. Flexible endoscopes may become heavily contaminated with blood, secretions, and microorganisms during use. These instruments are difficult to clean and disinfect and easy to damage because of their complex design, with narrow lumens and multiple internal channels (Fig. 1) (1). If the instruments are not properly cleaned, the disinfection and drying procedures can fail and increase the possibility of transmission of infection from one patient to another (2). In addition, the ability of bacteria to form biofilms in the endoscope channels, especially when these become damaged, can contribute to failure of the decontamination process…

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