Recommended changes to reprocessing and storage
— Endoscopes should be thoroughly rinsed with bacteria-free water after disinfection.
Alcohol flush and forced-air drying
‡ See below on drying cabinets.
Recommended changes for duodenoscopes
Volume of procedures
Dedicated staff and training
Duodenoscopes with positive surveillance bacterial cultures in which organisms of concern are detected should be sent for service (unless there is an alternative explanation — e.g., staff error).
Include appropriate risk notification of possible multidrug-resistant organism (MDRO) transmission in the informed consent information.
- Initial drying — All endoscopes should have a preliminary alcohol flush and forced-air channel drying for 10 minutes.
- Storing/drying cabinet — After initial drying, endoscopes should be promptly transferred to an approved endoscope forced-air storage/drying cabinet and channel-purge air drying should be started.
- This should continue until the endoscope is used again, or the safe storage period has elapsed.
- Storage/drying cabinets should comply with the relevant national standard or with European Standard EN 16442, “Controlled Environment Storage Cabinet for Processed Thermolabile Endoscopes.” Note: If needed, the duodenoscope can be used for another patient procedure after the initial forced-air drying, or before the drying cycle in the cabinet is completed.
Interventions to control carbapenem-producing Enterobacteriaceae (CPE) transmission in the facility
— CPE-infected patients, or those at high risk who have yet to have cultures taken, should be examined last on the list and managed in isolation from other patients, with use of a separate toilet or a commode.
— Clean and decontaminate the procedure room after the endoscopy procedure as per specific protocols for terminal cleaning of contaminated areas.
Infection control procedures
— Endoscopy units should provide regular education and should assess compliance with hand hygiene and environmental cleaning and decontamination.
- Ensure that the water quality is appropriate for the AFER.
- Ensure that a schedule of replacement for external water filters is established and that the internal submicron filters are replaced in accordance with the manufacturer’s instructions for use.
April 1, 2019
External Publication Status
Country of Publication
Female, Male, Adult, Older adult
Health Care Settings
Healthcare business administration, nurse, nurse practitioner, physician, physician assistant
D004203 - Disinfection
Disinfection, Endoscopic, Gastrointerology Endoscope