title: Problems associated with the microbiological control of the breast milk from hospital milk bank units.
abstract: The microbiological tests on breast milk performed when samples of pasteurized breast milk are added to hospital milk banks are covered by French regulations dating from December 3rd2007. They involve counts of the aerobic total flora and of Staphylococcus aureus in a sample of milk before pasteurization, and culture after pasteurization to check that the treated milk is sterile. The regulations specify the nature of the agar plates to be used, together with the conditions for plating and incubation, but they lack detail in other areas. We developed a quality assurance system, modified our process to meet the statutory requirements, prepared for COFRAC certification of the laboratory for this parameter, and proposed solutions to overcome the inadequacies of the regulations. The modifications of the process associated with the quality approach led to a successful initial certification visit. However, the preparation for this certification highlighted other inadequacies of the regulations that might affect the final results obtained for total flora and S. aureus counts. We think that the text should be modified to overcome these problems and to ensure high-quality counting such that those running hospital milk banks can have confidence in the laboratory results they receive.
authors: Unité fonctionnelle d'hygiène hospitalière et de lutte contre les infections nosocomiales.
authors: Didier
authors: D
authors: Lecointe
authors: Unité fonctionnelle d'hygiène hospitalière et de lutte contre les infections nosocomiales.
authors: Jade
authors: J
authors: Assoukpa
authors: Lactarium à usage intérieur.
authors: Lauriane
authors: L
authors: Cezard
authors: Unité fonctionnelle d'hygiène hospitalière et de lutte contre les infections nosocomiales.
authors: Carole
authors: C
authors: Descaves
authors: Unité fonctionnelle d'hygiène hospitalière et de lutte contre les infections nosocomiales.
authors: Armelle
authors: A
authors: Gouot
authors: Unité fonctionnelle d'hygiène hospitalière et de lutte contre les infections nosocomiales.
authors: Sandrine
authors: S
authors: Bourgeois
authors: Unité fonctionnelle d'hygiène hospitalière et de lutte contre les infections nosocomiales.
authors: Monique
authors: M
authors: Bergeon
authors: Atelier biomédical.
authors: Stéphane
authors: S
authors: Koutcherenko
authors: Lactarium à usage intérieur.
authors: Yasmine
authors: Y
authors: Lakhdari
authors: Direction de la qualité - Gestion des risques, Centre Hospitalier Sud-Francilien, Corbeil-Essonnes, France.
authors: Noura
authors: N
authors: Kassidi
mesh_terms: D000068:Accreditation; D000328:Adult; D005260:Female; D006757:Hospital Units / Q000331:legislation & jurisprudence / Q000592:standards; D006801:Humans; D007231:Infant, Newborn; D007883:Legislation, Medical; D008828:Microbiological Techniques / Q000379:methods / Q000592:standards; D017784:Milk Banks / Q000331:legislation & jurisprudence / Q000592:standards*; D008895:Milk, Human / Q000382:microbiology*; D061352:Pasteurization / Q000331:legislation & jurisprudence / Q000592:standards; D011786:Quality Control
keywords: accreditation; maternal milk; microbiological control; quality; standard NF EN ISO/CEI 17025