Lack of specific protocols and high workload of some BLSAs might explain this problem.
Moreover, the existence of BLSAs with a lower microbial load suggests that it is possible to reduce bacterial contamination of the BLSA environment to minimize cross- transmission of MDROs.
Therefore, identification of potential so-called black spots inside BLSAs that act as microbe reservoirs may be useful to emphasize their decontamination in standardized cleaning protocols that highlight the importance of cleaning and disinfecting these specific areas .