Are We Sampling Endoscopes the Right Way? New Review Highlights Gaps

Endoscopes - especially those without a working channel, like flexible laryngoscopes - are known to become contaminated during use and have the potential to transmit pathogens between patients. Routine reprocessing is critical, but so is verifying that reprocessing is effective. That’s where microbiological sampling comes in.

But just because an endoscope cultures negative doesn’t always mean it’s clean.

A new scoping review in Infection Control & Hospital Epidemiology looked at how facilities sample flexible endoscopes without a working channel. Across 12 studies, the authors identified three main sampling methods: immersion, swabbing, and wiping. All were capable of detecting microbial contamination after use - and, in some cases, even after high-level disinfection. But heres the key point: none of the studies directly compared these methods, and there’s little evidence on which technique is most sensitive or practical.

In other words, we're doing sampling - but we don’t really know which method works best.

This review highlights a critical gap: despite widespread use of these devices, there’s no consensus on optimal surveillance techniques, particularly for non-channeled scopes. That leaves infection prevention teams without clear guidance and device manufacturers without a benchmark for post-processing testing performance.

For infection preventionists and medical device developers, this is a real opportunity. Better data on sampling techniques could help standardize surveillance, validate reprocessing protocols, and support regulatory confidence in safety claims.

Here's a link to the study: https://doi.org/10.1017/ice.2025.56