Infections transmitted by endoscopes used in gastroenterology practice are considered as one of the top 10 health technology hazards in 2018, according to the ECRI Institute (https://bit.ly/2yvHyq8). The issue is likely to increase over time due to the increasing number of invasive techniques using more and more sophisticated instruments, with the growing threat of multidrug antibiotic resistance (Lancet Gastroenterology and Hepatology 2018: 3:445). While invasive endoscopic gastrointestinal techniques are expanding, and the prevalence of resistant bacteria in the population is increasing, there has been little progress in improving the margin of safety with respect to reprocessing of endoscopes. It is clear from the preliminary FDA mandated postmarket clinical assessments, performed by the three major manufacturers of gastrointestinal endoscopes, that the rate of contamination in fully reprocessed duodenoscopes is much higher than expected (FDA Safety Communication Dec 10, 2018). The importance of routine monitoring of manual cleaning adequacy to ensure the adequacy of HLD or sterilization is underrecognized. Without addressing the cleaning shortcomings and other underlying issues such as removal of simethicone and adequate drying during storage, the recommended switch to sterilization instead of liquid chemical HLD will not improve the margin of safety for gastrointestinal endoscope reprocessing. Now is the time to draw the attention of the medical community to this neglected risk of gastrointestinal endoscopic procedures and to develop interdisciplinary approaches to increase the safety of patients treated in gastrointestinal endoscopy units.

This topic should attract the interest of gastroenterologists, specialists in microbiology, infectious diseases, and hospital devices, infection prevention and control specialists, healthcare administration, biofilm researchers, regulatory bodies, manufacturers of endoscopic devices, and manufacturers of materials and equipment used for the reprocessing of endoscopes. Both original articles and reviews are welcome.

Potential topics include but are not limited to the following:

• Microbiological monitoring of gastrointestinal endoscopes to prevent nosocomial infections
• Guidelines for the reprocessing of gastrointestinal endoscopes
• Assessment of cleaning methods to remove simethicone from sigmoidoscopy channels
• Efficacy of cleaning detergents for oesophagogastroduodenoscopes
• Novel approaches to cleaning of duodenoscopes
• The role of thorough drying of gastrointestinal endoscope channels in reducing the risk of biofilm formation
• Toward a new generation of partially or fully disposable colonoscopy to reduce infection risks
• A critical role for the nursing staff to ensure patient safety in gastrointestinal endoscopy units
• The infectious risk in gastrointestinal endoscopy: how can we do better?