Implementing Endoscope Sampling and Culturing

Published on:

November 3, 2025

Last updated on:

December 10, 2025

• Expert Q&A

Question:

Why should my facility implement an endoscope sampling and culturing protocol?

Answer:

Implementation of an endoscope sampling and culturing protocol can be a beneficial way for a facility to add an extra layer of quality assurance to their flexible endoscope reprocessing program. The process involves sampling different components of an endoscope, such as channels and the distal end, to check for growth of microorganisms. The identification of microorganisms after reprocessing can help end-users understand where potential issues in reprocessing or endoscope handling may occur. For example:

• Presence of waterborne organisms, such as Pseudomonas aeruginosa, could indicate potential issues with final rinse water or ineffective drying processes.

• Presence of skin organisms, such as Staphylococcus epidermidis, could indicate potential areas for improvement in transport and handling (e.g., hand hygiene and glove use).

• Presence of human organisms from the site of examination, such as Escherichia coli or Klebsiella pneumoniae on a colonoscope used in the gastrointestinal tract, could indicate potential deviations in cleaning that enabled patient residue to remain on the endoscope (i.e., insufficient time spent manually cleaning, inappropriate brush size, etc.).

Additionally, sampling and culturing can help prevent the use of contaminated endoscopes on patients, which further enhances patient safety. It is important to note that sampling and culturing protocols vary greatly depending on the region of the world where your facility is located. There is currently an International Organization for Standardization (ISO) committee draft under development to provide a global sampling and culturing protocol for reuseable, thermolabile flexible endoscopes. If accepted and approved, this will be the first global endoscope sampling and culturing protocol. Here are a few examples of endoscope sampling and culturing protocols that are currently in use internationally.

• US FDA/CDC/ASM Duodenoscope Surveillance Sampling and Culturing Protocols (2018).

• Gastrointestinal Society of Australia (GESA). Clinical Update: Infection Prevention and Control in Endoscopy 2025 Update.

• Ministère des affaires sociales et de la santé. DGOS/PF2/DGS/VVS1/PP3/2018/195 du 2 août 2018 relative à l’actualisation du traitement des endoscopes souples thermosensibles à canaux de type duodénoscope au sein des structures de soins (2018). https://www.legifrance.gouv.fr/download/pdf/circ?id=43880.