Current Status of Endoscope Reprocessing in Korea

(GI) endoscopy has been widely used as a clinical diagnostic procedure in Korea since the introduction of the National Cancer Screening Program in 1999. Moreover, the use of endoscopic procedures to treat GI disorders is increasing rapidly. A review article published in 1993 reported 281 instances of pathogen transmission attributed to GI en-doscopy between 1966 and 1992. 1 A recent review found only 35 cases of infection transmission attributable to GI endosco-py since 1993. 2 However, the actual infection rate may have been underestimated because of underreporting, incomplete surveillance, asymptomatic infections, and infections with long incubation periods. In Korea, public concern over the risk of pathogen transmission during endoscopy has escalated following recent media reports of inadequate endoscope reprocessing. Recognition of the infection risks associated with inadequate cleaning and disinfection led several scientific societies to develop guidelines to minimize this risk and ensure maximum safety. 3,4 In 1995, the Korean Society of Gas-trointestinal Endoscopy developed cleaning and disinfection guidelines for GI endoscopes, which were revised and repub-5 The guidelines emphasized the importance of strict adherence to cleaning, disinfection, and surveillance procedures to improve reprocessing quality. Moreover, survey reports on GI endoscope and accessory reprocessing practices have been conducted in several countries to improve reprocessing practices. In this issue of Clinical Endoscopy, Park et al. 6 present a survey report on reprocessing practices in Korea. The survey was administered to practitioners, including nurses and health technicians, involved in endoscope reprocessing at eight en-doscopy units in academic or teaching hospitals. Sterilization may seriously damage flexible endoscopes; thus, high-level disinfection using liquid chemical disinfectants is accepted as the standard of care in reprocessing flexible endoscopes. En-doscope reprocessing, whether manual or automated, includes the following steps: precleaning, manual cleaning, disinfection, rinsing, drying, and storage. Park et al. 6 found that most practitioners (98.9%) complied with the established disinfection guidelines. Previous surveys on reprocessing practices conducted by the Disinfection Committee of the Korean Society of Gastrointestinal Endoscopy in 2002 and 2004 found that guideline compliance rates for reprocessing were 27% and 50%, respectively. 7 However, because the Park et al. 6 survey participants were restricted to academic or teaching hospitals, the results cannot be directly compared with those of the previous surveys. Among the steps for endoscope reprocessing, transporting soiled endoscopes to reprocessing rooms in enclosed containers had the lowest compliance (56%) in the present survey. The 2011 American Multisociety guidelines recommend that soiled endoscopes …