Reprocessing endoscopes: national recommendations with a special emphasis on cleaning--the German perspective.

Transmission of pathogens through endoscopes or endoscopic procedures has been documented frequently, although reliable data on the incidence of endoscope-associated infections do not exist. In order to control such infections as well as to ensure adequate quality management in endoscopy, the German Robert Koch Institute has produced recommendations for hygienic processing of flexible endoscopes and accessory devices. Reprocessing using a washer disinfector is explicitly preferred to manual procedures. Control measures are focused on microbiological sampling and limiting values have been defined for rinsing fluids taken from the channels of the scopes. Although the guideline leaves a number of questions open, e.g. test methods to control the efficacy of the cleaning process. It helps to establish quality management in the field of endoscopy and to improve the level of safety both for patients and staff.