Parker Leslie A, Magalhães Marina, Desorcy-Scherer Katelyn, Torrez Lamberti Monica, Lorca Graciela L, Neu Josef
Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL, United States.
Department of Microbiology and Cell Science, Genetics Institute, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL, United States.
Front Nutr. 2022 Feb 24;9:775014. doi: 10.3389/fnut.2022.775014. eCollection 2022.
Infants in the neonatal intensive care unit (NICU) often require feeding tubes (FT) for weeks to months. Because FTs are in near constant contact with human milk and/or formula, rapid and extensive bacterial growth is possible. Due to their immature immunologic and gastrointestinal (GI) systems, infants may be at significant health risk due to FT colonization. In adults, length of time FTs remain in place (dwell time) affects the degree of colonization and biofilm formation which is important in infants whose tubes remain in place up to 30 days.
The purpose of this review was to describe and summarize the evidence regarding FT bacterial colonization in infants and identify gaps needing further investigation.
Medline, CINAHL, and Embase databases were searched for clinical and/or laboratory-based observational and randomized controlled studies investigating the presence of bacteria in neonatal FTs.
This review of 10 studies found evidence that neonatal FTs may contain high quantities of potentially pathogenic and antibiotic resistant bacteria and longer dwell times may increase the bacterial load. Furthermore, evidence suggests FT colonization may be nosocomial in origin and contribute to adverse infant health. Feeding tubes are an unrecognized source of bacterial colonization which may increase morbidity in premature infants and thus the presence of bacteria in FTs is an important area of investigation in the nutritional care of vulnerable infants in the NICU.
Further appropriately powered studies which are clinically based, use appropriate analyses, and control for potential covariates are necessary to make clinical recommendations.
新生儿重症监护病房（NICU）中的婴儿通常需要使用喂养管（FT）数周甚至数月。由于喂养管几乎持续与母乳和/或配方奶接触，细菌可能会迅速大量生长。由于婴儿的免疫和胃肠（GI）系统不成熟，喂养管定植可能会给他们带来重大健康风险。在成年人中，喂养管留置的时间长度（驻留时间）会影响定植程度和生物膜形成，这对于喂养管留置长达30天的婴儿来说很重要。
本综述的目的是描述和总结有关婴儿喂养管细菌定植的证据，并确定需要进一步研究的空白。
检索了Medline、CINAHL和Embase数据库，以查找基于临床和/或实验室的观察性和随机对照研究，这些研究调查了新生儿喂养管中细菌的存在情况。
对10项研究的综述发现，有证据表明新生儿喂养管可能含有大量潜在致病和耐药细菌，较长的驻留时间可能会增加细菌负荷。此外，有证据表明喂养管定植可能源于医院感染，并对婴儿健康产生不利影响。喂养管是未被认识的细菌定植源，可能会增加早产儿的发病率，因此喂养管中细菌的存在是NICU中脆弱婴儿营养护理的一个重要研究领域。
需要进行进一步的、有足够样本量的、基于临床的研究，采用适当的分析方法，并控制潜在的协变量，以便提出临床建议。
