{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T16:29:38Z","timestamp":1786984178916,"version":"build-2736575974"},"reference-count":52,"publisher":"Elsevier BV","issue":"5","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T00:00:00Z","timestamp":1738800000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["ajicjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["American Journal of Infection Control"],"published-print":{"date-parts":[[2025,5]]},"DOI":"10.1016\/j.ajic.2025.02.003","type":"journal-article","created":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T11:58:46Z","timestamp":1739361526000},"page":"537-547","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":15,"title":["Unseen threats: Lumens 2.0 study reveals the hidden challenges of cleaning lumened surgical instruments"],"prefix":"10.1016","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1807-6324","authenticated-orcid":false,"given":"Cori L.","family":"Ofstead","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7283-566X","authenticated-orcid":false,"given":"Abigail G.","family":"Smart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7039-3530","authenticated-orcid":false,"given":"Jill E.","family":"Holdsworth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4210-4548","authenticated-orcid":false,"given":"Brandon M.","family":"Gantt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larry A.","family":"Lamb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Kevin M.","family":"Bush","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ajic.2025.02.003_bib1","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1186\/s13756-024-01445-x","article-title":"Surgical site infection surveillance in knee and hip arthroplasty: optimizing an algorithm to detect high-risk patients based on electronic health records","volume":"13","author":"Guedes","year":"2024","journal-title":"Antimicrob Resist Infect Control"},{"key":"10.1016\/j.ajic.2025.02.003_bib2","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.bjps.2024.07.023","article-title":"What did we catch? Predictors of infection after tissue expander-based breast reconstruction in a safety-net system","volume":"96","author":"Obinero","year":"2024","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"10.1016\/j.ajic.2025.02.003_bib3","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1016\/j.ajic.2024.04.007","article-title":"International Nosocomial Infection Control Consortium (INICC) report of health care-associated infections, data summary of 25 countries for 2014 to 2023, Surgical Site Infections Module","volume":"52","author":"Rosenthal","year":"2024","journal-title":"Am J Infect Control"},{"key":"10.1016\/j.ajic.2025.02.003_bib4","article-title":"Comparison of surgical site infection after instrumented spine surgery in patients with high risk of infection according to different antibiotic prophylaxis protocols: a cohort study of 132 patients with a minimum follow-up of 1 year","author":"Ferrer Pomares","year":"2024","journal-title":"Glob Spine J"},{"key":"10.1016\/j.ajic.2025.02.003_bib5","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1086\/662712","article-title":"Outbreak of Pseudomonas aeruginosa surgical site infections after arthroscopic procedures: Texas, 2009","volume":"32","author":"Tosh","year":"2011","journal-title":"Infect Control Hosp Epidemiol"},{"key":"10.1016\/j.ajic.2025.02.003_bib6","doi-asserted-by":"crossref","first-page":"1884","DOI":"10.1111\/os.14106","article-title":"Is aggressive surgery always necessary for suspected early-onset surgical site infection after lumbar surgery? A 10-year retrospective analysis","volume":"16","author":"Zou","year":"2024","journal-title":"Orthop Surg"},{"key":"10.1016\/j.ajic.2025.02.003_bib7","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.jhin.2022.05.002","article-title":"Burden of surgical management of prosthetic joint infections following hip and knee replacements in Alberta, Canada: an analysis and comparison of two major urban centres","volume":"150","author":"Mponponsuo","year":"2024","journal-title":"J Hosp Infect"},{"key":"10.1016\/j.ajic.2025.02.003_bib8","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1016\/j.ajic.2023.11.005","article-title":"An update on a persisting challenge: a systematic review and meta-analysis of the risk factors for surgical site infection post craniotomy","volume":"52","author":"Magni","year":"2024","journal-title":"Am J Infect Control"},{"key":"10.1016\/j.ajic.2025.02.003_bib9","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1097\/PRS.0000000000010574","article-title":"Impact of intraoperative hypothermia on incidence of infection in implant-based breast reconstruction","volume":"153","author":"Andersen","year":"2024","journal-title":"Plast Reconstr Surg"},{"key":"10.1016\/j.ajic.2025.02.003_bib10","article-title":"Marijuana's impact on implant-based breast reconstruction: a retrospective cohort study","volume":"12","author":"Al-Saghir","year":"2024","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"10.1016\/j.ajic.2025.02.003_bib11","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.1017\/ice.2021.202","article-title":"Does blood on \"dirty\" instruments interfere with the effectiveness of sterilization technologies?","volume":"43","author":"Rutala","year":"2022","journal-title":"Infect Control Hosp Epidemiol"},{"key":"10.1016\/j.ajic.2025.02.003_bib12","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1016\/j.ajic.2018.02.024","article-title":"Is retained bone debris in cannulated orthopedic instruments sterile after autoclaving?","volume":"46","author":"Smith","year":"2018","journal-title":"Am J Infect Control"},{"key":"10.1016\/j.ajic.2025.02.003_bib13","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.jhin.2023.03.021","article-title":"Evaluation of cleaning and sterilization of liposuction cannulas after intentional contamination with human fat, Mycobacterium abscessus subspecies bolletii, and Geobacillus stearothermophilus","volume":"136","author":"Bronzatti","year":"2023","journal-title":"J Hosp Infect"},{"key":"10.1016\/j.ajic.2025.02.003_bib14","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.jhin.2022.08.010","article-title":"Prevalence of bacterial burden on macroscopic contaminants of orthopaedic surgical instruments following sterilization","volume":"130","author":"Wellington","year":"2022","journal-title":"J Hosp Infect"},{"key":"10.1016\/j.ajic.2025.02.003_bib15","first-page":"34","article-title":"Impact of microscopic foreign debris on post-surgical complications","volume":"12","author":"Truscott","year":"2004","journal-title":"Surg Technol Int"},{"key":"10.1016\/j.ajic.2025.02.003_bib16","unstructured":"FDA. Ongoing safety review of arthroscopic shavers: FDA safety communication; 2009."},{"key":"10.1016\/j.ajic.2025.02.003_bib17","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.aorn.2012.03.018","article-title":"Uphill grime: process improvement in surgical instrument cleaning","volume":"96","author":"Azizi","year":"2012","journal-title":"AORN J"},{"key":"10.1016\/j.ajic.2025.02.003_bib18","doi-asserted-by":"crossref","first-page":"25","DOI":"10.2345\/0899-8205-58.1.25","article-title":"Beyond endoscopes: pilot study of surgical instrument lumen inspection","volume":"58","author":"Hopkins","year":"2024","journal-title":"Biomed Instrum Technol"},{"key":"10.1016\/j.ajic.2025.02.003_bib19","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1016\/j.ajic.2017.10.022","article-title":"Residual bioburden after standard cleaning of the reusable orthopedic depth gauge","volume":"46","author":"Wanke","year":"2018","journal-title":"Am J Infect Control"},{"key":"10.1016\/j.ajic.2025.02.003_bib20","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.idh.2017.08.004","article-title":"Evaluation of stainless steel surgical instruments subjected to multiple use\/processing","volume":"23","author":"Costa","year":"2018","journal-title":"Infect Dis Health"},{"key":"10.1016\/j.ajic.2025.02.003_bib21","doi-asserted-by":"crossref","first-page":"e53","DOI":"10.1016\/j.jhin.2018.11.001","article-title":"Complex design of surgical instruments as barrier for cleaning effectiveness, favouring biofilm formation","volume":"103","author":"Lopes","year":"2019","journal-title":"J Hosp Infect"},{"key":"10.1016\/j.ajic.2025.02.003_bib22","doi-asserted-by":"crossref","first-page":"A72","DOI":"10.1016\/j.ajic.2023.01.019","article-title":"Risk of disease transmission to patients from \"contaminated\" surgical instruments and immediate use steam sterilization","volume":"51","author":"Rutala","year":"2023","journal-title":"Am J Infect Control"},{"key":"10.1016\/j.ajic.2025.02.003_bib23","doi-asserted-by":"crossref","first-page":"844","DOI":"10.15585\/mmwr.mm7231a2","article-title":"Cluster of carbapenemase-producing carbapenem-resistant Pseudomonas aeruginosa among patients in an adult intensive care unit - Idaho, 2021-2022","volume":"72","author":"Cahill","year":"2023","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"3","key":"10.1016\/j.ajic.2025.02.003_bib24","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1017\/ice.2023.270","article-title":"Sink-traps are a major source for carbapenemase-producing Enterobacteriaceae transmission","volume":"45","author":"Regev-Yochay","year":"2024","journal-title":"Infect Control Hosp Epidemiol"},{"key":"10.1016\/j.ajic.2025.02.003_bib25","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.jhin.2023.06.013","article-title":"An intensive care unit outbreak with multidrug-resistant Pseudomonas aeruginosa - spot on sinks","volume":"139","author":"Sch\u00e4rer","year":"2023","journal-title":"J Hosp Infect"},{"issue":"7","key":"10.1016\/j.ajic.2025.02.003_bib26","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1016\/j.ajic.2024.02.013","article-title":"The outbreak of multispecies carbapenemase-producing Enterobacterales associated with pediatric ward sinks: IncM1 plasmids act as vehicles for cross-species transmission","volume":"52","author":"Tsukada","year":"2024","journal-title":"Am J Infect Control"},{"key":"10.1016\/j.ajic.2025.02.003_bib27","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1016\/j.ajic.2023.11.018","article-title":"Stenotrophomonas maltophilia outbreak originating from a pull-out faucet in a pediatric intensive care unit in Turkey: insights from clinical records and molecular typing","volume":"52","author":"Yashar","year":"2024","journal-title":"Am J Infect Control"},{"key":"10.1016\/j.ajic.2025.02.003_bib28","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1017\/ice.2015.266","article-title":"Effective high-level disinfection of cystoscopes: is perfusion of channels required?","volume":"37","author":"Rutala","year":"2016","journal-title":"Infect Control Hosp Epidemiol"},{"key":"10.1016\/j.ajic.2025.02.003_bib29","unstructured":"Arthrex. Adapeur Power System TM II (APS II) shaver handpieces (DFU-0154-5, Rev. 0). Naples, FL; 2021."},{"key":"10.1016\/j.ajic.2025.02.003_bib30","unstructured":"Stryker Endoscopy. Shaver handpieces user guide. San Jose, CA; 2012."},{"key":"10.1016\/j.ajic.2025.02.003_bib31","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1017\/ice.2018.263","article-title":"Bronchoscope-associated clusters of multidrug-resistant Pseudomonas aeruginosa and carbapenem-resistant Klebsiella pneumoniae","volume":"40","author":"Galdys","year":"2019","journal-title":"Infect Control Hosp Epidemiol"},{"key":"10.1016\/j.ajic.2025.02.003_bib32","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.jhin.2019.02.015","article-title":"Transmission of MDR Pseudomonas aeruginosa between two flexible ureteroscopes and an outbreak of urinary tract infection: the fragility of endoscope decontamination","volume":"102","author":"Kumarage","year":"2019","journal-title":"J Hosp Infect"},{"key":"10.1016\/j.ajic.2025.02.003_bib33","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1016\/j.gie.2019.05.016","article-title":"Independent root cause analysis of contributing factors, including dismantling of 2 duodenoscopes, to an outbreak of multidrug-resistant Klebsiella pneumoniae","volume":"90","author":"Rauwers","year":"2019","journal-title":"Gastrointest Endosc"},{"key":"10.1016\/j.ajic.2025.02.003_bib34","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1055\/a-1591-0258","article-title":"Initial application of deep learning to borescope detection of endoscope working channel damage and residue","volume":"10","author":"Barakat","year":"2022","journal-title":"Endosc Int Open"},{"key":"10.1016\/j.ajic.2025.02.003_bib35","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1089\/end.2022.0642","article-title":"Clinical evaluation of miniature flexible scope for diagnosis of ureteroscope working channel defects","volume":"37","author":"Chen","year":"2023","journal-title":"J Endourol"},{"key":"10.1016\/j.ajic.2025.02.003_bib36","doi-asserted-by":"crossref","first-page":"S19","DOI":"10.1016\/j.ajic.2024.04.024","article-title":"The scoop on scopes: microbial culturing and borescope examination of endoscopes to increase patients safety in an acute care hospital","volume":"52","author":"Kinzler","year":"2024","journal-title":"Am J Infect Control"},{"key":"10.1016\/j.ajic.2025.02.003_bib37","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.ajic.2022.08.026","article-title":"The utility of lighted magnification and borescopes for visual inspection of flexible endoscopes","volume":"51","author":"Ofstead","year":"2023","journal-title":"Am J Infect Control"},{"key":"10.1016\/j.ajic.2025.02.003_bib38","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1097\/SLE.0000000000001141","article-title":"Investigation of the internal conditions of 213 reprocessed endoscopic channels","volume":"33","author":"Zhou","year":"2023","journal-title":"Surg Laparosc Endosc Percutan Tech"},{"key":"10.1016\/j.ajic.2025.02.003_bib39","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/j.ajic.2022.09.009","article-title":"Borescope examination and microbial culture results of endoscopes in a tertiary care hospital led to changes in storage protocols to improve patient safety","volume":"51","author":"Wallace","year":"2023","journal-title":"Am J Infect Control"},{"key":"10.1016\/j.ajic.2025.02.003_bib40","doi-asserted-by":"crossref","first-page":"5","DOI":"10.2345\/0899-8205-57.s1.5","article-title":"Lint fiber-associated medical complications following invasive procedures","volume":"57","author":"Truscott","year":"2023","journal-title":"Biomed Instrum Technol"},{"key":"10.1016\/j.ajic.2025.02.003_bib41","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1016\/j.gie.2017.05.014","article-title":"A novel polytetrafluoroethylene-channel model, which simulates low levels of culturable bacteria in buildup biofilm after repeated endoscope reprocessing","volume":"86","author":"Alfa","year":"2017","journal-title":"Gastrointest Endosc"},{"key":"10.1016\/j.ajic.2025.02.003_bib42","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1093\/asj\/sjad094","article-title":"Stopping traffic: an analysis of number of scrubbed personnel and infection in implant-based breast reconstruction","volume":"43","author":"Miller","year":"2023","journal-title":"Aesthet Surg J"},{"key":"10.1016\/j.ajic.2025.02.003_bib43","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.ajic.2023.05.018","article-title":"Improvement of operating room air quality and sustained reduction of surgical site infections in an orthopedic specialty hospital","volume":"52","author":"Mullen","year":"2024","journal-title":"Am J Infect Control"},{"key":"10.1016\/j.ajic.2025.02.003_bib44","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1097\/PRS.0000000000010574","article-title":"Impact of intraoperative hypothermia on incidence of infection in implant-based breast reconstruction","volume":"153","author":"Andersen","year":"2024","journal-title":"Plast Reconstr Surg"},{"key":"10.1016\/j.ajic.2025.02.003_bib45","article-title":"Marijuana's impact on implant-based breast reconstruction: a retrospective cohort study","volume":"12","author":"Al-Saghir","year":"2024","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"10.1016\/j.ajic.2025.02.003_bib46","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.bjps.2024.07.023","article-title":"What did we catch? Predictors of infection after tissue expander-based breast reconstruction in a safety-net system","volume":"96","author":"Obinero","year":"2024","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"10.1016\/j.ajic.2025.02.003_bib47","doi-asserted-by":"crossref","first-page":"1765","DOI":"10.1007\/s00586-020-06622-1","article-title":"Does preoperative prognostic nutrition index predict surgical site infection after spine surgery?","volume":"30","author":"Ushirozako","year":"2021","journal-title":"Eur Spine J"},{"key":"10.1016\/j.ajic.2025.02.003_bib48","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1016\/j.ajic.2021.12.021","article-title":"Important interventions in the operating room to prevent bacterial contamination and surgical site infections","volume":"50","author":"Wistrand","year":"2022","journal-title":"Am J Infect Control"},{"key":"10.1016\/j.ajic.2025.02.003_bib49","unstructured":"Lingle B, Christenson S. 'Unacceptable risk': BAMC surgeons complain about human tissue on surgical tools. San Antonio Express News. October 25, 2024. Accessed January 29, 2025. https:\/\/www.expressnews.com\/news\/texas\/article\/bamc-sterile-problems-18252999.php."},{"key":"10.1016\/j.ajic.2025.02.003_bib50","unstructured":"Pennsylvania Department of Health. Lancaster General Hospital Health Inspection Results. December 6, 2023. Accessed January 29, 2025. \u3008https:\/\/sais.health.pa.gov\/commonpoc\/content\/publiccommonpoc\/PDF\/45NQ1130850334500L.PDF\u3009."},{"key":"10.1016\/j.ajic.2025.02.003_bib51","unstructured":"Sterner v. Portercare Adventist Health System. Notice of Class Settlement: Case No. 2018CV34766. Denver, CO;2022:1-5."},{"key":"10.1016\/j.ajic.2025.02.003_bib52","doi-asserted-by":"crossref","first-page":"49","DOI":"10.2345\/0899-8205-12.1.49","article-title":"Doubt and proof: the need to verify the cleaning process. Validation studies","volume":"46","author":"Azizi","year":"2012","journal-title":"Biomed Instrum Technol"}],"container-title":["American Journal of Infection Control"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0196655325000574?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0196655325000574?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T13:31:50Z","timestamp":1762263110000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0196655325000574"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5]]},"references-count":52,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["S0196655325000574"],"URL":"https:\/\/doi.org\/10.1016\/j.ajic.2025.02.003","relation":{},"ISSN":["0196-6553"],"issn-type":[{"value":"0196-6553","type":"print"}],"subject":[],"published":{"date-parts":[[2025,5]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Unseen threats: Lumens 2.0 study reveals the hidden challenges of cleaning lumened surgical instruments","name":"articletitle","label":"Article Title"},{"value":"American Journal of Infection Control","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ajic.2025.02.003","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 The Author(s). Published by Elsevier Inc. on behalf of Association for Professionals in Infection Control and Epidemiology, Inc.","name":"copyright","label":"Copyright"}]}}