Pneumonia frequencies with different enteral tube feeding access sites

In a retrospective review at a long-term care facility serving persons with mental retardation, I discovered a noteworthy difference in the frequency of pneumonia experienced by persons receiving nutrition via a surgically created jejunostomy as compared to a gastrostomy. Over a 24-month period, 25 people being fed via a gastrostomy tube experienced 40 cases of pneumonia during 508 person-months of observation, whereas 5 individuals being fed via a jejunostomy tube did not experience any cases of pneumonia during 96 person-months of observation. The enteral feeding access sites for these individuals were established at various times as long ago as 12 years prior to this review period. Selection of the specific access site for each individual was not randomized.