Non-United States guidelines for endoscope reprocessing.

A worldwide concern has emerged with regard to endoscope disinfection, and many gastrointestinal endoscopy associations have guidelines for proper disinfection of endoscopes and endoscopic accessories. They are not much different from those of the American Society of Gastrointestinal Endoscopy and include mechanical cleaning as the first and most important step followed by immersion in 2% glutaraldehyde for periods ranging from 5 to 20 minutes. Lack of compliance with these guidelines has been noted, however, in 20 to 70% of centers in Europe, the United Kingdom, Australia, and Asia. Automated disinfectors are being universally recommended to ensure better compliance. Two other improvements are use of peracetic acid as an alternative disinfectant and use of a disposable sheath over the endoscope.