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Microbial contamination of enteral feed administration sets in a pediatric institution
Anne Matlow1, Rick Wray, Carol Goldman
1Division of Infectious Diseases, The Hospital For Sick Childre, Toronto, Ontario, Canada.
Background:
Enteral feeding tubes have been associated with outbreaks of antimicrobial-resistant organisms, but the pathogenesis of this association has not been investigated. We hypothesized that the enteral feed administration sets become colonized externally by microbes grown from the enteral tube hub, and therefore serve as a reservoir of organisms that can be crosstransmitted.
Methods:
We conducted a prospective observational cohort pilot study, obtaining bacterial cultures from the external enteral feed administration set and from the hub of nasogastric, gastric, or gastrojejunal tubes in children receiving enteral feeding while hospitalized in a tertiary care pediatric hospital.
Results:
Thirty-six of 37 hubs cultured had bacterial growth. Twenty-nine of 36 administration sets (78%) sampled had at least 1 microbe isolated that was also cultured from the hub. No significant risk factors for colonization were identified.
Conclusions:
Enteral feed administration sets are frequently colonized by organisms in the enteral tube hub. These sets can serve as a reservoir of organisms that can be crosstransmitted between patients. Adherence to Standard Precautions is critical when handling enteral feeding apparatuses.
Insights
Enteral feeding administration sets frequently harbor microbes from feeding tube hubs, potentially spreading infections. Strict adherence to Standard Precautions is vital to prevent cross-transmission of organisms.
Area of Science:
- Microbiology
- Infectious Disease Epidemiology
- Pediatric Hospital Care
Background:
- Enteral feeding tubes are linked to antimicrobial-resistant organism outbreaks.
- The mechanism of this association, specifically microbial colonization of feeding apparatuses, remains under-investigated.
Purpose of the Study:
- To investigate the hypothesis that enteral feed administration sets become externally colonized by microbes originating from the enteral tube hub.
- To determine if these sets act as reservoirs for cross-transmission of organisms.
Main Methods:
- Prospective observational cohort pilot study conducted in a tertiary care pediatric hospital.
- Bacterial cultures were obtained from the external enteral feed administration sets.
- Cultures were also taken from the hubs of nasogastric, gastric, or gastrojejunal tubes in pediatric patients receiving enteral feeding.
Main Results:
- Bacterial growth was observed in 36 out of 37 (97%) cultured hubs.
- Microbial colonization was found on 29 out of 36 (78%) sampled administration sets, with organisms matching those from the hub.
- No significant risk factors for colonization were identified in this pilot study.
Conclusions:
- Enteral feed administration sets are commonly colonized by microorganisms present in the enteral tube hub.
- These colonized sets can function as a reservoir, facilitating the cross-transmission of microbes between patients.
- Emphasizes the critical importance of adhering to Standard Precautions when managing enteral feeding equipment.