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[儿科肿瘤服务中中性粒细胞减少症患者的饮食;斯特拉斯堡大学医院(HUS)的经验]

[Diet of neutropenic patients in pediatric oncology service; the experience of the university hospital of Strasbourg (HUS)].

作者信息

Mutel T, Foeglé J, Belotti L, Sery V, Bourneton O, Hernandez C, Lutz P, Lavigne T

机构信息

Service d'hygiène hospitalière, hôpital civil, CHU de Strasbourg, 3 rue Koeberlé, Strasbourg cedex, France.

出版信息

Pathol Biol (Paris). 2012 Dec;60(6):340-6. doi: 10.1016/j.patbio.2011.11.007. Epub 2011 Dec 28.

Abstract

OBJECTIVE

This article clarifies the choices made by the HUS concerning the ways of preparing food reserved to neutropenic children hospitalized in pediatric oncology service. We will describe the results of microbiological analysis of food realized from 2002 to 2007.

METHODS

A specific team prepares this food which is canned and treated by "appertisation" (autoclaving). Each dish portion produced is provided to the service only if the microbiological results are conform, that is to say free of organisms.

RESULTS

Three thousand and seventy-eight dishes were analysed: 82.9% of the analysed packs were conform. The contamination ratio decreased significantly (P<0.001) from 2002 to 2007. The organisms which cause the majority of dishes contamination are Bacillus (44.7%) and environmental mould exhibiting sterile mycelium (8.7%). The food which is the most frequently "nonconform" is the dry food with a contamination rate of 37.9%. The identified concentrations remain mainly lower than 50 colony-forming units per millilitre (CFU/mL): 66.2% for the bacteria and 97.2% for the fungi.

CONCLUSION

Considering the lack of consensus on the acceptable microbiological thresholds and on the food protection level, the HUS make it a rule to have a maximal precautionary principle. Currently, this principle appears to us to be a safety option required for the patients hospitalized in pediatric oncology service.

摘要

目的

本文阐明了大学医院中心(HUS)在为儿科肿瘤服务中住院的中性粒细胞减少儿童准备食物的方式上所做的选择。我们将描述2002年至2007年期间食物微生物分析的结果。

方法

由一个特定团队准备这种食物,食物经罐装并采用“常压高温灭菌法”(高压灭菌)处理。只有微生物检测结果合格,即不含微生物时,所生产的每份菜肴才会提供给该科室。

结果

共分析了3078份菜肴:82.9%的分析包装合格。从2002年到2007年,污染率显著下降(P<0.001)。导致大多数菜肴污染的微生物是芽孢杆菌(44.7%)和呈现无菌菌丝体的环境霉菌(8.7%)。最常“不合格”的食物是干粮,污染率为37.9%。所确定的浓度主要仍低于每毫升50个菌落形成单位(CFU/mL):细菌为66.2%,真菌为97.2%。

结论

鉴于在可接受的微生物阈值和食品保护水平方面缺乏共识,大学医院中心(HUS)将最大预防原则作为一项规则。目前,在我们看来,这一原则对于在儿科肿瘤服务中住院的患者而言是一项必要的安全选择。

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