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Microbial biofilm development on neonatal enteral feeding tubes
Noha A Juma1, Stephen J Forsythe
1Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University, Jeddah, KSA.
Insights
Neonatal intensive care unit (NICU) patients are susceptible to infections from opportunistic pathogens colonizing feeding tubes. Many common bacteria found, like Enterobacteriaceae, exhibit multi-drug resistance, complicating treatment.
Area of Science:
- Microbiology
- Neonatal Intensive Care
- Infectious Diseases
Background:
- Neonates in intensive care units (NICUs) are vulnerable to infections due to immature immune systems and medical interventions.
- Opportunistic pathogens can colonize medical devices, leading to local or systemic infections.
- Antibiotic resistance in pathogens poses a significant challenge for treating neonatal infections.
Purpose of the Study:
- To review existing data on microbial colonization of feeding tubes in neonates.
- To identify common microorganisms found on these devices.
- To assess the antibiotic resistance patterns of isolated pathogens.
Main Methods:
- Literature review of studies reporting microbial colonization of neonatal feeding tubes.
- Identification and characterization of bacterial and fungal species recovered from feeding tubes.
- Analysis of antibiotic susceptibility data for identified isolates.
Main Results:
- A wide range of organisms, primarily bacteria (Staphylococcus spp., Enterobacteriaceae) and fungi (Candida), colonize neonatal feeding tubes.
- Predominant Enterobacteriaceae include Enterobacter cancerogenus, Serratia marcescens, Enterobacter hormaechei, Escherichia coli, and Klebsiella pneumoniae.
- Significant antibiotic resistance was observed, with E. hormaechei resistant to ceftazidime and cefotaxime, and S. marcescens resistant to amoxicillin and co-amoxiclav.
Conclusions:
- Neonatal feeding tubes serve as a reservoir for potentially pathogenic microorganisms.
- The prevalence of multi-drug resistant bacteria in this setting is a serious concern for neonatal healthcare.
- Effective infection control strategies and antimicrobial stewardship are crucial in NICUs.
Abstract:
Neonates in intensive care units often require supporting medical devices and antibiotic treatment. The intensive care treatment combined with their immature immune system, the increased permeability of mucosa, and the undeveloped microflora of the gut may render the neonates highly vulnerable to colonisation and subsequent infections when exposed to opportunistic pathogens. These infections may not only be local gastrointestinal infections, but also systematic following translocation from the gastrointestinal system. This could be particularly alarming considering that common antibiotics may not be effective if the causative strain is multi-drug resistant.This chapter reviews our information on the microbial colonization of neonatal feeding tubes. The range of organisms which have been recovered are wide, and while primarily bacterial, fungi such as Candida have also been found. The bacteria are principally Staphylococcus spp. and Enterobacteriaceae. The Enterobacteriaceae isolates are predominantly Enterobacter cancerogenus, Serratia marcescens, Enterobacter hormaechei, Escherichia coli and Klebsiella pneumoniae. Many of these isolates encode for antibiotic resistance; E. hormaechei (ceftazidine and cefotaxime) and S. marcescens strains (amoxicillin and co-amoxiclav).
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