title: Prospective study of the incidence and complications of bacterial contamination of enteral feeding in neonates.
abstract: 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.
authors.affiliation: Department of Pediatric Surgery, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, AR 72202, USA.
authors.forename: John R
authors.initials: JR
authors.lastname: Mehall
authors.forename: Cheryl A
authors.initials: CA
authors.lastname: Kite
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Saltzman
authors.forename: Traci
authors.initials: T
authors.lastname: Wallett
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Jackson
authors.forename: Samuel D
authors.initials: SD
authors.lastname: Smith
mesh_terms: 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