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Bacillus anthracis is a large, gram-positive, spore-forming bacterium responsible for human anthrax. Review of the medical literature indicates specific instrument reprocessing instructions addressing the prevention of B. anthracis transmission are limited. Although nosocomial anthrax infection has not been reported, strict adherence to well-established instrument reprocessing guidelines for cleaning and high-level disinfection is recommended to prevent patient-to-patient transmission of B. anthracis (or any other pathogen) via gastrointestinal endoscopes or bronchoscopes. All liquid chemical sterilants labeled for high-level disinfection of endoscopes would be expected to destroy B. anthracis. Additional instrument cleaning or disinfection procedures appear to be unnecessary. Reprocessing the endoscope immediately following the procedure is emphasized.