Successful realisation of a fully automated endoscope cleaning system

T.D. Duong; R.K. Hartley; R.J. Hartley; R. Bromley; T. Worthington; H. O'Connor; A.J. Sutherland

doi:10.1016/j.jhin.2026.03.014

Successful realisation of a fully automated endoscope cleaning system

T.D. Duong
, R.K. Hartley
, R.J. Hartley
, R. Bromley
, T. Worthington
, H. O'Connor
, A.J. Sutherland

Chemical Engineering and Applied Chemistry, College of Engineering and Physical Sciences Aston University Birmingham B4 7ET United Kingdom

Research output: Contribution to journal › Article › peer-review

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Abstract

Background
Endoscopes, especially duodenoscopes, may still be contaminated after cleaning and thus have potential for transferral of infective agents from one patient to another. This study aimed to assess whether the manual stages in endoscope cleaning could be replaced with a fully automated cleaning process to give improved cleaning outcomes.

Methods
New materials were developed that act in concert to provide high levels of antimicrobial activity. A prototype automated endoscope cleaner was constructed to exploit these new materials and enable a fully automated endoscope cleaning system to be assessed against conventional manual cleaning protocols.

Findings
The new materials generated 107- to 108-fold reductions, equivalent to that observed in high-level disinfection, in microbial biofilms grown on endoscope tubing. The materials were active against all the main bacterial strains required by British Standard BS EN 13697:2015+A1:2019 and also the yeast, Candida albicans. A prototype automated endoscope cleaner, designed to use these materials, was built and assessed, in a non-human trial, for the ability to clean two different types of flexible endoscope (endoscopic retrograde cholangiopancreatography scope and gastrointestinal scope) contaminated with a bacterial-based artificial test soil (either Klebsiella pneumoniae or Pseudomonas aeruginosa). For both scope types, the fully automated endoscope cleaning system gave excellent reductions in levels of bacterial loadings (1010- to 108.8-fold) and was found to be generally about 100 times more effective than manual cleaning.

Conclusion
The results indicate that fully automated cleaning of endoscopes is now a realistic possibility, with potential for significant health and cost benefits.

Original language	English
Pages (from-to)	1-7
Number of pages	7
Journal	Journal of Hospital Infection
Volume	172
Early online date	19 Mar 2026
DOIs	https://doi.org/10.1016/j.jhin.2026.03.014
Publication status	Published - 1 Jun 2026

Bibliographical note

Copyright © 2026 The Authors. Published by Elsevier Ltd on behalf of The Healthcare Infection Society. This is an open access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/).

Data Access Statement

Supplementary data to this article can be found online at https://doi.org/10.1016/j.jhin.2026.03.014

Funding

We gratefully acknowledge financial support from Innovate UK through the provision of a Knowledge Transfer Partnership (KTP) grant reference number 511610 to Aston University and Partnership Medical Ltd — part of PFE Group.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Endoscope washer
Automatic endoscope cleaning system
Chemical cleaning mixture

Access to Document

10.1016/j.jhin.2026.03.014Licence: CC BY 4.0

Successful realisation of a fully automated endoscope cleaning system
Copyright © 2026 The Authors. Published by Elsevier Ltd on behalf of The Healthcare Infection Society. This is an open access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/).
Final published version, 1.95 MBLicence: CC BY 4.0

Cite this

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title = "Successful realisation of a fully automated endoscope cleaning system",

abstract = "Background Endoscopes, especially duodenoscopes, may still be contaminated after cleaning and thus have potential for transferral of infective agents from one patient to another. This study aimed to assess whether the manual stages in endoscope cleaning could be replaced with a fully automated cleaning process to give improved cleaning outcomes. Methods New materials were developed that act in concert to provide high levels of antimicrobial activity. A prototype automated endoscope cleaner was constructed to exploit these new materials and enable a fully automated endoscope cleaning system to be assessed against conventional manual cleaning protocols. Findings The new materials generated 107- to 108-fold reductions, equivalent to that observed in high-level disinfection, in microbial biofilms grown on endoscope tubing. The materials were active against all the main bacterial strains required by British Standard BS EN 13697:2015+A1:2019 and also the yeast, Candida albicans. A prototype automated endoscope cleaner, designed to use these materials, was built and assessed, in a non-human trial, for the ability to clean two different types of flexible endoscope (endoscopic retrograde cholangiopancreatography scope and gastrointestinal scope) contaminated with a bacterial-based artificial test soil (either Klebsiella pneumoniae or Pseudomonas aeruginosa). For both scope types, the fully automated endoscope cleaning system gave excellent reductions in levels of bacterial loadings (1010- to 108.8-fold) and was found to be generally about 100 times more effective than manual cleaning. Conclusion The results indicate that fully automated cleaning of endoscopes is now a realistic possibility, with potential for significant health and cost benefits.",

keywords = "Endoscope washer, Automatic endoscope cleaning system, Chemical cleaning mixture",

author = "T.D. Duong and R.K. Hartley and R.J. Hartley and R. Bromley and T. Worthington and H. O'Connor and A.J. Sutherland",

note = "Copyright {\textcopyright} 2026 The Authors. Published by Elsevier Ltd on behalf of The Healthcare Infection Society. This is an open access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/).",

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doi = "10.1016/j.jhin.2026.03.014",

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AU - Duong, T.D.

AU - Hartley, R.K.

AU - Hartley, R.J.

AU - Bromley, R.

AU - Worthington, T.

AU - O'Connor, H.

AU - Sutherland, A.J.

N1 - Copyright © 2026 The Authors. Published by Elsevier Ltd on behalf of The Healthcare Infection Society. This is an open access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/).

PY - 2026/6/1

Y1 - 2026/6/1

N2 - Background Endoscopes, especially duodenoscopes, may still be contaminated after cleaning and thus have potential for transferral of infective agents from one patient to another. This study aimed to assess whether the manual stages in endoscope cleaning could be replaced with a fully automated cleaning process to give improved cleaning outcomes. Methods New materials were developed that act in concert to provide high levels of antimicrobial activity. A prototype automated endoscope cleaner was constructed to exploit these new materials and enable a fully automated endoscope cleaning system to be assessed against conventional manual cleaning protocols. Findings The new materials generated 107- to 108-fold reductions, equivalent to that observed in high-level disinfection, in microbial biofilms grown on endoscope tubing. The materials were active against all the main bacterial strains required by British Standard BS EN 13697:2015+A1:2019 and also the yeast, Candida albicans. A prototype automated endoscope cleaner, designed to use these materials, was built and assessed, in a non-human trial, for the ability to clean two different types of flexible endoscope (endoscopic retrograde cholangiopancreatography scope and gastrointestinal scope) contaminated with a bacterial-based artificial test soil (either Klebsiella pneumoniae or Pseudomonas aeruginosa). For both scope types, the fully automated endoscope cleaning system gave excellent reductions in levels of bacterial loadings (1010- to 108.8-fold) and was found to be generally about 100 times more effective than manual cleaning. Conclusion The results indicate that fully automated cleaning of endoscopes is now a realistic possibility, with potential for significant health and cost benefits.

AB - Background Endoscopes, especially duodenoscopes, may still be contaminated after cleaning and thus have potential for transferral of infective agents from one patient to another. This study aimed to assess whether the manual stages in endoscope cleaning could be replaced with a fully automated cleaning process to give improved cleaning outcomes. Methods New materials were developed that act in concert to provide high levels of antimicrobial activity. A prototype automated endoscope cleaner was constructed to exploit these new materials and enable a fully automated endoscope cleaning system to be assessed against conventional manual cleaning protocols. Findings The new materials generated 107- to 108-fold reductions, equivalent to that observed in high-level disinfection, in microbial biofilms grown on endoscope tubing. The materials were active against all the main bacterial strains required by British Standard BS EN 13697:2015+A1:2019 and also the yeast, Candida albicans. A prototype automated endoscope cleaner, designed to use these materials, was built and assessed, in a non-human trial, for the ability to clean two different types of flexible endoscope (endoscopic retrograde cholangiopancreatography scope and gastrointestinal scope) contaminated with a bacterial-based artificial test soil (either Klebsiella pneumoniae or Pseudomonas aeruginosa). For both scope types, the fully automated endoscope cleaning system gave excellent reductions in levels of bacterial loadings (1010- to 108.8-fold) and was found to be generally about 100 times more effective than manual cleaning. Conclusion The results indicate that fully automated cleaning of endoscopes is now a realistic possibility, with potential for significant health and cost benefits.

KW - Endoscope washer

KW - Automatic endoscope cleaning system

KW - Chemical cleaning mixture

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M3 - Article

SN - 0195-6701

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SP - 1

EP - 7

JO - Journal of Hospital Infection

JF - Journal of Hospital Infection

ER -

Successful realisation of a fully automated endoscope cleaning system

Abstract

Bibliographical note

Data Access Statement

Funding

UN SDGs

Keywords

Access to Document

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