Children's Mercy Hospital, 2401 Gillham Rd, Kansas City, MO 64108, USA.
Nutr Clin Pract. 2011 Aug;26(4):451-6. doi: 10.1177/0884533611413891.
Enteral nutrition has been an accepted mode of pediatric care for more than 40 years. Early reports in the literature documented high levels of bacterial contamination in enteral formulas delivered to patients. Safety standards for formula administration have not been universally followed. Evidence demonstrates that increased manipulation of the delivery system contributes to bacterial contamination.
A prospective, descriptive study was conducted with 30 pediatric patients. They received continuous enteral feedings using decanted formula over a minimum hang time of 12 hours. Formula was delivered according to current practice recommendations. Cultures were obtained and sent to the laboratory initially and every 4 hours.
Cultures from 30 patients (average age 6.4 years) were obtained at baseline, 4, 8, and 12 hours. Nasogastric, nasojejunal, gastrostomy, or gastrojejunostomy feeding tubes were used. Formulas administered were polymeric and peptide based. Of the 119 cultures obtained, 8 were either collected improperly or revealed a contaminant. Of the 111 useable cultures, 100 showed no growth, 6 had growth below the Food and Drug Administration threshold for contamination (95% acceptable), and 5 (5%) in 2 patients were considered positive, with all cultures growing coliforms. No patient had any clinical signs of bacterial gastroenteritis (increased stool output, fever, or clinical deterioration) over the 48 hours after data collection.
Decanted enteral formula administered continuously over 12 hours in a pediatric hospital setting has a lower than expected rate of bacterial growth when recommended handling practices are followed.
肠内营养作为一种儿科护理方式已经被认可超过 40 年。早期文献报道，输送给患者的肠内配方中存在高水平的细菌污染。配方管理的安全标准并未得到普遍遵循。有证据表明，输送系统的操作增加会导致细菌污染。
对 30 名儿科患者进行了一项前瞻性描述性研究。他们使用倾析后的配方进行持续肠内喂养，最短悬挂时间为 12 小时。配方按照现行实践建议进行输送。最初和每 4 小时采集一次样本并送到实验室进行培养。
从 30 名患者（平均年龄 6.4 岁）中获得了基线、4 小时、8 小时和 12 小时的样本。使用了鼻胃管、鼻空肠管、胃造口管或胃空肠造口管。所使用的配方为聚合型和肽型。在获得的 119 个培养物中，有 8 个采集不当或显示有污染物。在 111 个可用的培养物中，有 100 个显示无生长，有 6 个生长低于食品和药物管理局规定的污染阈值（95%可接受），有 5 个（5%）在 2 名患者中被认为是阳性，所有培养物均生长出大肠菌群。在数据收集后 48 小时内，没有患者出现细菌性胃肠炎的任何临床迹象（粪便量增加、发热或临床恶化）。
在儿科医院环境中，连续 12 小时倾析肠内配方，在遵循推荐的处理方法时，细菌生长率低于预期。
