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Bacterial safety of reconstituted continuous drip tube feeding
Abstract:
Chemically defined diets require reconstitution and transfer to a delivery system. When reconstituted High Vivonex was noted in our Medical Center to be bacteriologically contaminated, we instituted a series of control procedures. We then reevaluated bacterial growth in reconstituted High Nitrogen Vivonex and diluted Isocal under ward conditions. The mixtures were prepared with sterile water versus tap water, using a hand washed blender versus a machine washed blender. We also investigated the bacteriological effect of blast freezing reconstituted High Nitrogen Vivonex. All preparations of the nonfrozen High Nitrogen Vivonex showed occasional low level contamination, although quantitative cultures did not show logarithmic growth over eight hours of observation. No growth occurred in the blast frozen High Nitrogen Vivonex or in the Isocal. We conclude that reconstituted High Nitrogen Vivonex and diluted Isocal may be prepared and hung safely for eight hours, and that blast freezing of High Nitrogen Vivonex is bacteriologically safe. As a result of our initial findings of bacteriologic contamination, we believe a program for bacterial monitoring of the tube feeding is desirable.
Insights
Bacteriological contamination in reconstituted High Nitrogen Vivonex was investigated. Blast freezing High Nitrogen Vivonex and using Isocal proved safe for eight-hour tube feeding preparation.
Area of Science:
- Clinical Nutrition
- Microbiology
- Food Safety
Background:
- Chemically defined diets require careful preparation and handling to prevent contamination.
- Initial observations indicated potential bacterial contamination in reconstituted High Vivonex within a medical center.
Purpose of the Study:
- To evaluate bacterial growth in reconstituted High Nitrogen Vivonex and diluted Isocal under ward conditions.
- To assess the impact of preparation methods (water type, blender cleaning) and blast freezing on bacterial contamination.
Main Methods:
- Reconstituted High Nitrogen Vivonex and diluted Isocal were prepared using sterile vs. tap water and hand-washed vs. machine-washed blenders.
- Bacterial growth was monitored over eight hours for nonfrozen preparations.
- The bacteriological effect of blast freezing reconstituted High Nitrogen Vivonex was investigated.
Main Results:
- Occasional low-level bacterial contamination was observed in nonfrozen High Nitrogen Vivonex preparations.
- No significant logarithmic bacterial growth occurred in nonfrozen preparations over eight hours.
- No bacterial growth was detected in blast-frozen High Nitrogen Vivonex or in Isocal preparations.
Conclusions:
- Reconstituted High Nitrogen Vivonex and diluted Isocal can be safely prepared and administered for up to eight hours.
- Blast freezing of High Nitrogen Vivonex is a bacteriologically safe procedure.
- Implementing a bacterial monitoring program for tube feeding is recommended due to initial contamination findings.