Evaluation of adenosine triphosphate test for cleaning assessment of gastroscopes and the effect on workload in a busy endoscopy center.

•Adenosine triphosphate (ATP) test failed more than culture and protein tests.•The inclusion of ATP testing after a single cleaning increased the length of time for the whole procedure (cleaning plus testing cleanliness) by 50%.•First cleaning: 70.8% of gastroscopes failed the ATP test; 58.3% of gastroscopes had no microbial growth; and in 91.7% of gastroscopes the protein was undetectable.•Second cleaning: 64.7% of gastroscopes still failed the ATP test. Two samples had bacterial growth, and none had protein detected.•Poor correlation was found between ATP test and culture.