Ascending contamination of a jejunostomy feeding reservoir

Area of Science:

• Microbiology
• Gastroenterology
• Clinical Nutrition

Background:

• Enteral feeding solutions are typically contaminated exogenously.
• Catheter jejunostomy presents a potential for endogenous contamination of feeding solutions.
• Previous studies have not extensively explored dual contamination sources in this context.

Purpose of the Study:

• To investigate the source of frequent bacterial contamination in enteral feeding solutions administered via catheter jejunostomy.
• To evaluate the clinical and nutritional impact of this contamination.
• To differentiate between exogenous and endogenous contamination pathways.

Main Methods:

• Microbiological analysis of multiple feeding solution samples from a patient with catheter jejunostomy.
• Assessment of contamination levels related to aseptic technique versus endogenous sources.
• Monitoring of clinical and laboratory parameters, including glucose concentration in the feed.

Main Results:

• Contamination of feeding solutions was found to be of dual origin: exogenous (aseptic manipulation) and endogenous (ascending from the gut).
• The endogenous source was identified as the primary contributor to significant contamination.
• No clinical or laboratory deterioration was observed in the patient, despite frequent contamination.
• A significant reduction in glucose concentration was noted in contaminated feeding samples.

Conclusions:

• Catheter jejunostomy feeding carries a risk of endogenous bacterial contamination from the patient's gastrointestinal tract.
• While contamination reduced nutritional value (glucose), it did not lead to adverse clinical outcomes in this case.
• This highlights the importance of considering endogenous sources in enteral feeding contamination protocols.