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Investigation of environmental bacterial contamination associated with distilled water in a neonatal formula
Sibel Altunışık Toplu1, Elif Seren Tanrıverdi2, Funda Memişoğlu1
1Department of Infectious Diseases and Clinical Microbiology, İnönü University Faculty of Medicine, Malatya, Türkiye.
Insights
Environmental contamination in neonatal formula preparation was investigated. Distilled water, not powdered formula, was identified as the source of bacterial growth, highlighting the need for water source monitoring in neonatal care.
Area of Science:
- Microbiology
- Neonatal Care
- Environmental Health
Background:
- Healthcare-associated outbreaks can stem from environmental microorganisms in neonatal feeding areas.
- Investigating environmental sources of contamination is crucial for neonatal patient safety.
Purpose of the Study:
- To identify the source of bacterial contamination detected during routine microbiological surveillance of neonatal formula.
- To assess the potential environmental reservoirs for microbial growth in formula preparation.
Main Methods:
- Routine microbiological surveillance of prepared neonatal formula.
- Sampling and analysis of powdered formula, prepared formula, and distilled water.
- Bacterial identification and genetic relatedness evaluation using AP-PCR (Amplified Fragment Length Polymorphism Polymerase Chain Reaction).
Main Results:
- Bacterial growth was repeatedly detected in prepared formula and distilled water, but not in powdered formula.
- Herbaspirillum species isolates showed clonal relatedness, indicating a common environmental source.
- No clinical infections were identified in neonates linked to the detected environmental microorganisms.
Conclusions:
- Distilled water used in formula preparation was identified as the source of environmental bacterial contamination.
- Molecular typing confirmed a common environmental source and guided corrective actions.
- Continuous monitoring of water sources is essential for maintaining safety in neonatal intensive care units.
Background:
Environmental microorganisms detected in neonatal feeding preparation areas may raise concern for healthcare-associated outbreaks and warrant investigation to identify potential environmental sources of contamination.
Methods:
Between July 2025 and February 2026, repeated bacterial growth was detected during routine microbiological surveillance of formula prepared for neonates. An investigation was conducted, including sampling of powdered formula, prepared formula, and distilled water. Bacterial identification was performed using routine methods, and genetic relatedness among selected Herbaspirillum isolates was evaluated using arbitrarily primed polymerase chain reaction.
Results:
Environmental microorganisms were isolated from prepared formula and distilled water, while powdered formula showed no growth. Repeated isolation of Herbaspirillum species demonstrated clonal relatedness, suggesting a common environmental source. No clinical infections associated with these microorganisms were identified among neonates during the study period.
Conclusions:
This study identified environmental bacterial contamination associated with distilled water used during formula preparation. Molecular typing was valuable in confirming a common environmental source and guiding corrective interventions. Monitoring water sources is critical in neonatal care.
