ESGE–ESGENA guideline: Cleaning and disinfection in gastrointestinal endoscopy

Contents 1. Introduction 2. Definition of terms 3. Endoscopy-related infections 4. Principles of infection control 5. Chain of infection 6. Health and safety of endoscopy personnel 7. General requirements 7.1. Classification of endoscopic equipment 7.2. Aims of the reprocessing procedure 7.3. Staff requirements 7.4. Reprocessing room 7.5. The reprocessing procedure 7.6. Manual versus automated reprocessing 8. Process chemicals 8.1. Detergents 8.1.1. Detergents with enzymatic boosters 8.1.2. Detergents with alkaline boosters 8.1.3. Detergents with enzymatic and alkaline boosters 8.1.4. Detergents containing antimicrobial active substances 8.2. Disinfectants 8.2.1. Glutaraldehyde 8.2.2. Orthophthalaldehyde (OPA) 8.2.3. Peracetic acid (PAA) 8.2.4. Chlorine dioxide 8.2.5. Electrolytically generated disinfectants 8.3. Rinse aid 8.4. Combination of products from different manufacturers 8.5. Change of products 9. Reprocessing of endoscopes 9.1. Manual cleaning 9.1.1. Pre-cleaning in the endoscopy room 9.1.2. Manual cleaning in the reprocessing room 9.2. Reprocessing in washer-disinfectors 9.2.1. Definition and process basics for washer-disinfectors 9.2.2. Process specifications for washer-disinfectors 9.2.3. Specific recommendations for washer-disinfectors 9.2.4. Advantages and disadvantages of washer-disinfectors 9.3. Reprocessing in automated disinfection devices 9.3.1. Definition and process basics for automated disinfection devices 9.3.2. Process specifications for automated disinfection devices 9.3.3. Specific recommendations for automated disinfection devices 9.3.4. Advantages and disadvantages of automated disinfection devices 9.4. Manual reprocessing of endoscopes 9.4.1. Definition and process basics for manual reprocessing 9.4.2. Process specifications for manual reprocessing 9.4.3. Advantages and disadvantages of manual reprocessing 9.5. Drying, storage and reuse of endoscope 10. Quality assurance 10.1. Documentation 10.2. Maintenance of washer-disinfectors and automated disinfection devices 10.3. Process validation and microbiological surveillance 10.4. Outbreak management 11. Reprocessing of endoscopic accessories 11.1. General recommendations 11.2. Process specifications 11.2.1. Manual cleaning 11.2.2. Reprocessing in washer-disinfectors 11.2.3. Manual reprocessing 11.2.4. Sterilization 11.2.5. Storage 11.3. Specific recommendations 11.3.1. Biliary and pancreatic procedures 11.3.2. Injection needles 11.3.3. Biopsy forceps 11.3.4. Water bottle and its connectors 12. Appendices Appendix 1: Manual cleaning of flexible endoscopes Appendix 2: Reprocessing of flexible endoscopes in washer-disinfectors and automated disinfection devices Appendix 3: Manual reprocessing of flexible endoscopes Appendix 4: Manual reprocessing of reusable endoscopy accessories Appendix 5: Reprocessing of endoscopic accessories in washer-disinfectors and automated disinfection devices 13. References