Sterilization and High-Level Disinfection in 2026: New and Emerging Topics.

Sterilization and high-level disinfection (HLD) of critical and semicritical medical devices, respectively, has garnered close attention by infection preventionists, sterile processing experts, regulators, clinicians, and patients due to increasing recognition that lapses in processing can result in increased infection transmission risk. The current evidence addressing many challenges in sterilization and HLD was recently summarized in the 2025 Multisociety Guidance for sterilization and high-level disinfection. Here, we provide updates and expand on new and emerging topics related to lumened endoscopes including use of borescopes and ATP for assessing cleanliness, surface and endocavity ultrasound probes including where low-level disinfection is appropriate.