Prospective study of the incidence and complications of bacterial contamination of enteral feeding in neonates.
OBJECTIVE
The goal of this study was to determine incidence of, and complications resulting from, bacterial contamination of enteral feedings in neonates.


METHODS
A prospective study of 50 tube-fed neonates was conducted. Infants were bolus fed via an open gravity drained system; demographic and clinical data were gathered. The lumen of the tube was cultured quantitatively after 7 days. All organisms were isolated, identified, frozen, and stored to correlate with clinical cultures.


RESULTS
The 50 neonates were fed for a mean of 17.6 days each and represent 125 patient weeks (1 tube per patient per week). A total of 71 of 125 tubes were "contaminated" (>1,000 colony forming units [CFU]/mL), with a mean 908,173 CFU and 3 different bacteria types. Among formula-fed infants, feeding intolerance occurred in 24 of 32 weeks with contaminated tubes versus 0 of 44 weeks with noncontaminated tubes (P <.05). Contamination occurred in 41 of 48 weeks in patients on H2 antagonists versus 32 of 66 weeks in patients with normal gastric acidity (P <.05). Necrotizing enterocolitis developed in 7 patients; all were fed formula contaminated with greater than 100,000 CFU/mL of Gram-negative bacteria. Four required operation; intraoperative cultures found the same organism as cultured previously in the tube in all 4 infants.


CONCLUSIONS
Bacterial contamination of enteral feeding occurs frequently, causes significant feeding intolerance, and may contribute to NEC.
Mehall
John R
JR
Department of Pediatric Surgery, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, AR 72202, USA.
Kite
Cheryl A
CA
Saltzman
Daniel A
DA
Wallett
Traci
T
Jackson
Richard J
RJ
Smith
Samuel D
SD
D001424:Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology*; D004750:Enteral Nutrition / Q000009:adverse effects*; D004866:Equipment Contamination / Q000706:statistics & numerical data; D005506:Food Contamination / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D011446:Prospective Studies