Endoscope Cleaning Verification Testing

Published on:

December 4, 2025

Last updated on:

December 16, 2025

• Expert Q&A

Question:

What is endoscope cleaning verification testing?

Answer:

Cleaning verification is performed after manual cleaning and before an endoscope undergoes high-level disinfection (HLD) or sterilization. Its purpose is to detect residual organic soils that are not identifiable through visual inspection. Depending on the test, it may be checking for adenosine triphosphate (ATP), protein, carbohydrate, and/or hemoglobin. The goal of cleaning verification testing is to inform reprocessing technicians whether additional manual cleaning should be performed to further reduce soil levels on the endoscope. This is especially important given reported challenges in performing, and variability in time spent, manual cleaning ^{[1 - 3]}.

Recognizing these challenges, some guidelines and standards now recommend or require the implementation of cleaning verification tests as part of quality control in reprocessing.^[4] Residual soil can compromise the effectiveness of HLD and sterilization by forming a barrier that blocks disinfectants, vapor, or steam from contacting the device surface. Additionally, soil can promote biofilm formation, which may lead to persistent contamination ^{[5 - 7]}.

By incorporating cleaning verification, end-users gain a measure of cleaning effectiveness. This data point can help determine whether manual cleaning is being performed thoroughly, supported by proper training and tools. However, not all cleaning verification tests are created equal. Facilities should carefully evaluate available products and consult relevant scientific literature when selecting a test. Key considerations include ease of use, compatibility with the facility’s workflow, and the benchmark or threshold values associated with the analyte. Always refer to the manufacturer's IFU for proper test execution and interpretation of results.