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[Clinical study of the bacterial contamination of 2 differently prepared enteral feeding solutions]
Abstract:
The incidence of bacterial contamination under ICU-conditions of two solutions designed for enteral feeding; the oligopeptide mixture Peptisorb and the nutrient defined diet Biosorb, were investigated. 54% of the specimens taken prior to use from the oligopeptide mixture, which is marketed as a powder and brought into solution before application, were found to be bacterially contaminated. At the end of the 6-12 h application period this percentage has risen to 79%. Prior to use the sterile packed prepared nutrient defined diet was found to be free of bacterial contamination in 97% of cases, while at the end of the period of application 21% of the samples taken contained bacteria. In most instances the solutions prepared on ICU were contaminated with gram positive spore forming bacteria and typical gram negative hospital flora. Based on the results of this investigation, only those enteral feeds which are marketed as sterile solutions should be used, in order to protect ICU patients from potential sources of contamination.
Insights
Bacterial contamination is a significant risk in enteral feeding solutions used in intensive care units (ICUs). Ready-to-use sterile liquid enteral feeds are recommended to minimize bacterial exposure for critically ill patients.
Area of Science:
- Clinical Microbiology
- Intensive Care Medicine
- Nutritional Support
Background:
- Enteral feeding is crucial for critically ill patients in intensive care units (ICUs).
- Bacterial contamination of enteral feeding solutions poses a potential risk to vulnerable patients.
- Two common enteral feeding preparations, an oligopeptide powder and a sterile-packed nutrient-defined diet, were evaluated.
Purpose of the Study:
- To investigate the incidence of bacterial contamination in two enteral feeding solutions under ICU conditions.
- To compare the contamination rates of a powdered oligopeptide mixture versus a sterile-prepared nutrient-defined diet.
- To provide recommendations for safe enteral feeding practices in ICUs.
Main Methods:
- Bacterial cultures were performed on enteral feeding solutions (Peptisorb and Biosorb) before and after a 6-12 hour administration period in an ICU setting.
- Samples were analyzed for the presence of bacterial contamination.
- Microbial identification focused on common ICU pathogens, including gram-positive spore-forming bacteria and gram-negative hospital flora.
Main Results:
- The oligopeptide mixture (Peptisorb), prepared from powder, showed high initial contamination rates (54%) which increased significantly by the end of administration (79%).
- The sterile-packed nutrient-defined diet (Biosorb) had low initial contamination (3%) but showed a notable increase by the end of administration (21%).
- Contaminating bacteria included gram-positive spore-formers and typical gram-negative hospital-acquired microorganisms.
Conclusions:
- Powdered enteral formulas reconstituted in the ICU are highly susceptible to bacterial contamination.
- Even sterile-packed liquid formulas can become contaminated during administration.
- To protect ICU patients, exclusively using enteral feeds supplied as sterile solutions is strongly recommended.