Photo Credit: YakobchukOlena

The following is a summary of “A prospective, quasi-experimental study on the efficacy of a novel double-headed endoscope cleaning brush for cleaning flexible endoscopes,” published in the February 2025 issue of the BMC Gastroenterology by Shen et al.

Thorough manual cleaning is the most critical step in the reprocessing of flexible gastrointestinal endoscopes, as inadequate removal of organic debris can compromise subsequent disinfection and increase the risk of infection transmission. The selection of an appropriate cleaning brush is essential for ensuring optimal decontamination. This study evaluates the efficacy of a novel double-headed disposable brush in comparison to conventional single-headed brushes for endoscope cleaning, with a primary focus on bacterial load reduction. A prospective, quasi-experimental study was conducted in a first-class hospital from January 2020 to August 2021. 

The effectiveness of endoscope cleaning was assessed using adenosine triphosphate (ATP) fluorescence detection, with bacterial load quantified by relative light unit (RLU) values before and after brushing. A total of 267 endoscopes were included, with 131 cleaned using the double-headed brush and 136 using conventional brushes. The reduction in RLU values after brushing was significantly greater in the double-headed brush group compared to the conventional brush group (ΔRLU: 116 [55, 251] vs. 76 [26, 181], P = 0.001). Subgroup analysis revealed a particularly pronounced effect in colonoscopes with a 3.8-mm channel (ΔRLU: 115 [34, 265] vs. 52 [19, 199], P = 0.007), whereas no significant difference was observed for gastroscopes (P = 0.363). Bacterial culture positivity rates were higher in endoscopes cleaned with the double-headed brush, regardless of whether the nylon or non-woven fabric end was used, compared to the single-headed brush (40.5% and 70.2% vs. 33.1%, P < 0.001). 

The enhanced cleaning efficiency of the double-headed brush may be attributed to its nylon bristle end, which facilitates superior debris removal from endoscope channels. These findings suggest that the novel double-headed disposable brush offers a significant advantage in improving the mechanical cleaning of flexible endoscopes, particularly colonoscopes, thereby reducing residual bioburden and potentially lowering the risk of infection. Further research is warranted to optimize brush design and assess its impact on clinical infection rates.

Source: bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-025-03680-x