- •Fully reprocessed flexible endoscopes frequently harbor viable microbes.
- •High-level disinfectants commonly fail minimum effective concentration tests.
- •Instructions for using and testing high-level disinfectants are complex.
- •Human factors contribute to widespread non-adherence with guidelines.
- •New approaches are needed from manufacturers and infection preventionists.
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Conflicts of interest: None to report.
Funding/support: The research team received a research grant from Advanced Sterilization Products for the International Association of Healthcare Central Service Materiel Management survey and additional financial support for the research described in this paper. The sponsor did not have input on the study design, data collection, analysis, interpretation of findings, or content of this manuscript. The authors have also received research grants, study materials, educational materials, or consulting contracts from 3M Company, Ambu, Auris Health, Advanced Sterilization Products, Boston Scientific, Cogentix, Convergascent, Endoscopy Repair Specialists, Fortive, Healthmark, Invendo Medical, Laborie, Medivators, Mobile Instrument, Nanosonics, and Steris.