الفهرس 
Laboratory Acquired InfectionsOnly 14 pages are availabe for public view
Abstract
We documented that visual assessment of cleaning adequacy complemented by other quantitative methods such as swab cultures can guide better practice and inform evidence-based interventions. Based on the results of this study, applying a higher concentration (500 ppm) of household bleach gave better results and reduced the microbial load considerably.
More studies are needed to identify bacterial communities within the laboratory, which will help provide guidance for the types, proper concentrations, and appropriateness of in-use disinfectants for the bacterial composition within the laboratory. Furthermore, large-scale studies on the acceptable level of residual contamination following any decontamination process are urgently recommended.
Recommendation
1-More research is required to improve our understanding of the true extent to which surface contamination contributes to the transmission of infection.
2-Policies guiding decontamination practices should be based on risk assessments.
3-Education and training on cleaning and decontamination procedures should be provided regularly to housekeeping staff that mostly rely on verbal instructions rather than written guidance.
4-The potential to develop resistance to in-use disinfectants, the optimum concentration and the contact time according to local microbial compositions and types of laboratory surfaces need to be addressed.
5-Monitoring of the efficacy of decontamination practices should include the examination of cleaning tools such as cleaning cloths or mops which, if not sanitized properly or stored in wet conditions, can serve as niches and harborage sites for spreading contaminating bacteria over laboratory surfaces (Cua et al., 2002).
I
Summary
n order to evaluate practices, this research aims to objectively evaluate routine disinfection practices in the Medical Microbiology Research Laboratory, Faculty of Medicine, Ain Shams University, and improve them in the event of a significant failure in these practices.
This was done by means of environmental swabs of high-touch surface that were determined by occult observation, which indicated that two sides of the workbench and one incubator to be high-touch surfaces while the biosafety cabinet occupied the least touching surfaces inside the laboratory.
For initial evaluation, the three high-touch surfaces were sampled and cultured before the start of routine disinfection practices procedures, and 15 minutes after application of 200 ppm of 5% sodium hypochlorite (household bleach).
Then, two cleaning staff received updated training in the use of a higher concentration of sodium hypochlorite in the decontamination procedure (500 ppm).
Staphylococcus aureus and Anthracoid bacilli were found equally on laboratory surfaces (92%), followed by Salmonella (33%), and the equal contribution of each of Proteus spp, E.coli, and Aspergillus falvus (8.3% each).
Residual bacterial contamination was detected on 69% of the three surfaces sampled, of which 60% were classified as ”extremely heavy growth”, 32% as ”heavy growth”, and 8% as ”moderate growth” ”.
The data confirmed that the introduction of a higher concentration (500 ppm) of sodium hypochlorite significantly (P = <0.027) reduced the total number of bacteria. However, residual bacterial contamination was detected in 44% of the surfaces sampled with 33 % classified as ”very heavy growth” and 11% as ”heavy growth”.