A randomized trial of single versus double high-level disinfection of duodenoscopes and linear echoendoscopes using standard automated reprocessing

In a pilot study (8) we demonstrated that current guidelines for duodenoscope and linear echoendoscope (DLE) reprocessing using a single cycle of high-level disinfection (HLD) in an automated reprocessor may be inadequate. In August 2015, the FDA offered double-HLD as a possible response to address this concern. As a result, Providence Health & Services adopted double-HLD as standard procedure for DLE, but no rigorous clinical studies supported this practice. We undertook a quality improvement (QI) study to compare single-HLD versus double-HLD at 4 of our 34 hospitals.

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