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The U.S. Food and Drug Administration is offering hospitals advice on how to avoid spreading drug-resistant superbugs with reusable medical scopes that have proven difficult to clean.

The instructions aren’t mandatory, and some hospitals may not even be equipped to follow them. But the advice may help avert future infections from contaminated scopes, known as duodenoscopes, that have been linked to at least 13 deaths and dozens of infections at several U.S. hospitals, including UCLA Medical Center and Seattle’s Virginia Mason Medical Center. The instruments are used in more than 600,000 procedures each year to diagnose and treat disorders of the bile ducts in the small intestine.

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