Background Guidelines on prevention of bacterial resistance and quality of microbiology labs have been promoted by HAS.

Objectives Analysis of implementation of guidelines in 2011 versus 2009.

Methods Checklists for practices of 230 representative hospital labs.

Results Between 2009 and 2011, there was an increase in (i) survey of bacterial resistance by labs (98% vs 95%), (ii) internal quality control (88% vs 85% of public, 71% vs 64% of private labs -p = 0.01), (iii) evaluation of procedures (67% vs 57% -p = 0.01), (iv) basic service maintained in 89% vs 85% of labs, (v) information system (96% vs 88% of public, 82% vs 75% of private labs -p = 0.003), (vi) liaison with the pharmacy (86% vs 78% of public, 76% vs 63% of private labs), (vii) epidemiological surveillance (96% vs 87%), (viii) alert system (97% vs 93%) mostly by computer in public or by phone in private labs). Results on resistance rates were more often submitted to the committee for the prevention of hospital infection (97% vs 93%) or of anti-infectives (77% vs 71%), to the clinical departments in 62% vs 50% of public, 85% vs 75% of private hospitals (p = 0.018). Bacterial resistances were more often compared with antibiotic consumption in 57% vs 45% of general, 86% vs 61% of university, 37% vs 34% of private hospitals (p = 0.002)

Conclusions Quality of microbiology laboratory practices increased since 2009 but efforts have to be continued in evaluation of internal quality procedures, communication about bacterial resistances to clinical departments and comparison resistances-antibiotic consumption.