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Microbiological quality of reconstituted enteral formulations used in hospitals
M H Oliviera1, R Bonelli, K E Aidoo
1Endereço do Hospital Governador Celso Ramos, Rua Irmã Benvards s/n, Florianópolis, Santa Catarina, Brazil.
Abstract:
Contamination of enteral feeds may occur during preparation, storage, decanting, and administration to patients. The aim of this study was to investigate the microbiological quality of reconstituted enteral feeds, residual feeds from feed delivery systems, and the water used to reconstitute powdered feeds in hospital. Hazard Analysis Critical Control Points (HACCP) system was implemented to control microbiological contamination of the enteral feeding formulations. Before the implementation of the HACCP system microbiological analyses of feeds showed the presence of indicator organisms such as coliforms and Enterococcus spp. and unacceptably high levels of mesophilic aerobic microorganisms (>10(4) cfu/mL). After the implementation of the HACCP, the microbial quality of the feeds improved significantly, with counts of <10(1) cfu/mL. Blenders used in reconstituting feeds were found to be the main source of bacterial contamination.
Insights
Implementing a Hazard Analysis Critical Control Points (HACCP) system significantly improved the microbiological quality of hospital enteral feeds. Blenders were identified as a primary source of bacterial contamination, highlighting critical control points for feed safety.
Area of Science:
- Microbiology
- Food Safety
- Hospital Infection Control
Background:
- Enteral feeds are susceptible to microbial contamination during preparation, storage, and administration.
- Maintaining microbiological quality is crucial for patient safety in healthcare settings.
Purpose of the Study:
- To assess the microbiological quality of reconstituted enteral feeds, residual feeds, and water used in hospitals.
- To evaluate the effectiveness of a Hazard Analysis Critical Control Points (HACCP) system in controlling microbial contamination of enteral feeding formulations.
Main Methods:
- Microbiological analyses were performed on enteral feeds, residual feeds, and reconstitution water before and after HACCP implementation.
- The Hazard Analysis Critical Control Points (HACCP) system was implemented to identify and control contamination sources.
Main Results:
- Before HACCP, feeds showed high levels of mesophilic aerobic microorganisms (>10(4) cfu/mL) and indicator organisms like coliforms and Enterococcus spp.
- After HACCP implementation, microbial counts in feeds significantly decreased to <10(1) cfu/mL.
- Blenders used for feed reconstitution were identified as the primary source of bacterial contamination.
Conclusions:
- The HACCP system is effective in improving the microbiological quality of hospital enteral feeds.
- Targeting contamination sources, such as blenders, is essential for ensuring the safety of enteral nutrition.
- Strict adherence to HACCP protocols can significantly reduce the risk of microbial contamination in enteral feeding practices.