Graduate Program in Food and Nutrition, Federal University of Paraná, Curitiba, Paraná, Brazil.
Department of Nutrition, Health Sciences Sector, Federal University of Paraná, Curitiba, Paraná, Brazil.
Nutr Clin Pract. 2021 Jun;36(3):704-717. doi: 10.1002/ncp.10577. Epub 2020 Sep 25.
Little is known about the risk to patients' health when using home-prepared enteral tube feeding. The objective of this study was to explore the differences in hygiene conditions and microbial load of different types of home-prepared enteral tube feeding and explore associations between those differences and food handlers' characteristics.
We evaluated 96 enteral formulations, considering 3 types used by adult patients: homemade enteral preparations (HEPs), blended enteral preparations (BEPs), and commercial enteral formulas (CEFs). Enteral formulations were collected from homes and microbiologically analyzed. Hygiene criteria were assessed using a checklist, applied during the handling stages. The profile of the food handler was reviewed using a questionnaire.
82.3% (79/96) exceeded acceptable bacterial counts, which was 10³ colony-forming units per gram for aerobic mesophilic microorganisms and for total coliforms (35 °C), Escherichia coli, Staphylococcus sp, and Staphylococcus coagulase-positive, if present in the enteral formulations. The number of inadequate samples was higher in HEPs and BEPs than in CEFs. Considering the hygiene criteria, the home-prepared enteral tube feedings did not differ significantly. There was a significant difference among hygiene conditions considering the variables "monthly family income" and "food training."
Regardless of the type of enteral formulations used by patients, when handled at home, there was a risk of contamination. However, contaminants present in enteral formulations can be easily controlled with improvements in hygiene measures as well as with greater guidance and control during the handling stages.
在家中制备肠内管饲喂养时，患者健康面临的风险知之甚少。本研究旨在探讨不同类型的自制肠内管饲喂养的卫生条件和微生物负荷差异，并探讨这些差异与食物处理者特征之间的关系。
我们评估了 96 种肠内制剂，考虑了三种用于成年患者的类型：自制肠内制剂（HEPs）、混合肠内制剂（BEPs）和商业肠内配方（CEFs）。从家庭中收集肠内制剂并进行微生物分析。使用清单评估卫生标准，该清单在处理阶段应用。使用问卷审查食物处理者的特征。
82.3%（79/96）超过可接受的细菌计数，即需氧嗜温微生物和总大肠菌群（35°C）、大肠杆菌、葡萄球菌和凝固酶阳性葡萄球菌每克 10³个菌落形成单位，如果肠内制剂中存在这些细菌。HEPs 和 BEPs 的不合格样本数量高于 CEFs。考虑到卫生标准，自制肠内管饲喂养之间没有显著差异。考虑到“家庭月收入”和“食物培训”等变量，卫生条件存在显著差异。
无论患者使用哪种类型的肠内制剂，在家中处理时都存在污染风险。然而，通过改善卫生措施以及在处理阶段提供更多指导和控制，可以很容易地控制肠内制剂中存在的污染物。
