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Bacterial and fungal contaminations in parenteral nutrition admixtures
P Jirapinyo1, S Boonnanakijsin, A Chaiprasert
1Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Abstract:
Parenteral nutrition admixtures prepared in the incubator for sick newborn infants from three wards were cultured for bacteria and fungi. Of the total samples of parenteral nutrition solution being studied, 4.7 per cent had fungi and 14.1 per cent had bacteria. Solutions prepared in the intensive care unit, in the ward for sick newborn, and in the ward for sick preterm revealed fungal contaminations at about 11.1, 5.8 and 0.0 per cent respectively. Bacterial contaminations were higher and had a percentage of 11.1 from the intensive care unit, 23.5 from the ward for sick newborn and 10.3 from the ward for sick preterm. It was concluded that another more sterilized technique should be implemented for reduction of such a high rate of bacterial and fungal contaminations in the parenteral nutrition admixtures.
Insights
Parenteral nutrition solutions for sick newborns showed significant bacterial and fungal contamination. Implementing enhanced sterile techniques is crucial to reduce these risks in neonatal intensive care settings.
Area of Science:
- Neonatal care
- Microbiology
- Pharmaceutical compounding
Background:
- Parenteral nutrition (PN) is vital for sick newborns unable to feed orally.
- Contamination of PN admixtures poses a serious risk to vulnerable infants.
- Standard preparation methods may not be sufficient to prevent microbial growth.
Purpose of the Study:
- To assess the rates of bacterial and fungal contamination in PN admixtures prepared in different neonatal wards.
- To identify specific wards with higher contamination levels.
- To advocate for improved sterile techniques in PN preparation.
Main Methods:
- Microbiological culturing of PN admixture samples.
- Analysis of contamination rates across three distinct neonatal care units (intensive care, sick newborn, sick preterm).
- Quantification of bacterial and fungal presence.
Main Results:
- Overall contamination: 4.7% fungi, 14.1% bacteria.
- Highest fungal contamination (11.1%) in the intensive care unit.
- Highest bacterial contamination (23.5%) in the ward for sick newborns.
- Zero fungal contamination in the ward for sick preterm infants.
Conclusions:
- Current PN admixture preparation methods result in unacceptably high rates of microbial contamination.
- Significant variations in contamination exist between different neonatal care units.
- Urgent need for enhanced, more sterile preparation techniques to safeguard infant health.