[Endoscope disinfection]

Economic considerations currently limit the idea of the disposable flexible endoscope, which would guarantee absolute safety against the transmission of infections. Since the endoscope is made of a heat-sensitive material, it is impossible to sterilize it by autoclave. A disinfection procedure must therefore be applied, which, although it does not guarantee the same level of safety as classical sterilization, provides a sufficient reduction in the microorganism load. This procedure is carried out in two steps: first cleaning by mechanical action using a detergent, then the actual disinfection by soaking in a disinfectant bath. As urine is a sterile milieu, a high-level disinfection--bactericide, virucide, fungicide, and sporicide--should be implemented by soaking for 30 min in a peracetic acid bath. Prion risk, which must systematically be taken into account, can be controlled by a double cleaning method eliminating all proteic debris and by replacing glutaraldehyde with peracetic acid.