Bacterial contamination of enteral feeds and feeding systems

Abstract

It is now widely recognised that enteral feeds may become contaminated with microorganisms during preparation and administration. Evidence is presented illustrasting the role of this contamination in the development of infectious complications, including bacteraemia, septicaemia, pneumonia, diarrhoea and infectious entercolitis. Details are given of potential sources of microbial contamination including the feed ingredients, inadequately cleaned equipment, personnel and the patients themselves. Routes by which the microorganisms may gain access to the feeds, such as the procedures involved in the preparation and mixing of ingredients, decanting of both mixed and sterile ready-to-use feeds and assembly and subsequent manipulation of the feeding systems, are considered. Factors affecting the rate of growth of microorganisms in feeds and feeding systems are discussed and suggestions are made as to the procedures that can be implemented to reduce the risk of contamination.