Infection Control During GI Endoscopy

Publication Date: May 1, 2018
Last Updated: March 14, 2022


Transmission of infection as a result of GI endoscopes is extremely rare, and most reported cases are attributable to lapses in currently accepted endoscope reprocessing protocols or to defective equipment. ()

Endoscopes should undergo HLD as recommended by governmental agencies and all pertinent professional organizations for the reprocessing of GI endoscopes. ()
(Category IB and IC)

Attention should be focused on preventing transmission of highly resistant organisms by duodenoscopes, in particular, on ensuring cleaning and HLD of the elevator mechanism and elevator wire channel. (IB)

Extensive training of staff involved in endoscope reprocessing is mandatory for quality assurance and for effective infection control, and documentation of this training is required. (IC)

The efficacy of manual cleaning and HLD is operator dependent, thus assignment of personnel responsible for endoscope reprocessing, extensive training of reprocessing personnel, process validation, and quality assurance is vital, and staff competency should be assessed at the very least on an annual basis. ()
(Category IB and IC)

In the event of reprocessing failure, the patient, the institution’s designated infection control personnel, local and/or state public health agencies, the FDA, the CDC, and the manufacturers of the involved equipment should be notified immediately. (IC)

General infection control principles should be complied with in the endoscopy unit. ()
(Category IA and IC)

Use of standard precautions reduces the transmission of infection from patients to endoscopy personnel. ()
(Category IA and IC)

Endoscopy units must have a qualified individual who directs their infection prevention plans. (II)

Recommendation Grading




Infection Control During GI Endoscopy

Authoring Organization

Publication Month/Year

May 1, 2018

Last Updated Month/Year

August 7, 2023

Supplemental Implementation Tools

Document Type


External Publication Status


Country of Publication


Document Objectives

The purpose of this document is to disseminate information and promote understanding of endoscopy-related transmission of infection in order to minimize its risk of occurrence.

Inclusion Criteria

Female, Male, Adolescent, Adult, Child, Infant, Older adult

Health Care Settings

Emergency care, Hospital, Outpatient

Intended Users

Nurse, nurse practitioner, physician, physician assistant


Prevention, Management

Diseases/Conditions (MeSH)

D001424 - Bacterial Infections, D017053 - Infection Control


gastrointestinal endoscopy, infection control, GI endoscopy

Source Citation

Calderwood, A. H., Day, L. W., Muthusamy, V. R., Collins, J., Hambrick, R. D., Brock, A. S., … Eisen, G. M. (2018). ASGE guideline for infection control during GI endoscopy. Gastrointestinal Endoscopy, 87(5), 1167–1179. doi:10.1016/j.gie.2017.12.009