Biofilms on Flexible Ureteroscopes: A Challenge to Reprocessing Effectiveness and Infection Prevention

Abstract

Introduction: Reusable flexible ureteroscopes have structural characteristics that make cleaning difficult and may favor the persistence of organic residues and biofilm formation, compromising microbiological safety. Objective: To discuss the challenges associated with biofilms on flexible ureteroscopes, reprocessing effectiveness, and infection prevention. Methods: A narrative literature review addressing biofilm formation, residual contamination, reprocessing failures, and strategies to prevent infections associated with endoscopic devices. Results: Evidence has identified residual contamination on ureteroscopes after processing and documented infection outbreaks associated with reusable devices. Factors related to reprocessing failures include inadequate cleaning, delays in processing, insufficient drying, structural damage, and traceability deficiencies. Audits, inspection, cleaning verification, and professional training may improve reprocessing quality. Conclusion: Infection prevention depends on rigorous implementation of all processing steps, assessment of device integrity, and continuous quality monitoring. Further studies are needed to clarify biofilm prevalence and its relationship with clinical risk.