Microbiological safety of nutrition formulas with different feeding systems

Enteral nutrition (EN) is a form of nutrition therapy indicated for patients who cannot eat or do not tolerate oral nutrition. However, because of their nutrient-rich composition, EN formulas provide a favorable environment for microbial growth and present a risk for contamination by pathogens, potentially leading to gastrointestinal disorders and delaying patient recovery. This study analyzed the microbiological safety of two EN feeding systems (the open-system [OS] and the ready-to-hang [RTH] system) using liquid and powdered formulas over different infusion periods.

In the laboratory, RTH formulas were administered via infusion pumps without manual handling, whereas OS formulas were prepared manually and administered by gravity. Samples were collected and analyzed for mesophilic aerobic count, an indicator of microbiological quality, at different infusion intervals.

RTH formulas maintained microbial counts below safety limits after 24 and 48 h of infusion. Both liquid and powdered OS formulas remained microbiologically safe for up to 8 h of administration.

This study demonstrated that both the RTH and OS can maintain microbiological safety within the recommended infusion times of 24 and 4 h, respectively, without significant bacterial growth. The safety of these systems is contingent on the implementation of good handling practices, underscoring the need for continuous training of handlers.