Munkstrup Charlotte, Krogfelt Karen A, Greisen Gorm, Juhl Sandra M
Department of Neonatology, Copenhagen University Hospital - Rigshospitalet.
Department of Bacteria, Parasites and Fungi, Statens Serum Institut.
Dan Med J. 2022 Jul 13;69(8):A06210494.
We aimed to determine if changing nasogastric feeding tubes more often would impact colonisation of the upper gastrointestinal tract of the premature infant.
We included 22 neonates born less-than 32 weeks gestation within 48 hours after birth. The neonates were randomised to have their feeding tubes changed on day seven or daily during the first week of life. We determined the bacterial concentration by the culture method in maternal milk samples, gastric aspirates and feeding tube flushes. Bacteria were identified by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF). The primary outcome was the concentration of bacteria in the gastric aspirate from a freshly placed nasogastric tube on day seven of life.
Data from only 11 neonates were eligible for primary outcome analysis. We found no difference in bacterial concentration between the two groups with a mean colony-forming unit count per ml aspirate of 4.62 log10 (standard deviation (SD): ± 3.43) in the intervention group and 2.76 log10 (SD: ± 3.13) in the control group. Data from 19 neonates were eligible for analysis of secondary outcome measures. We found no statistically significant differences in the composition of the bacterial load between the two groups. Infants with a lower gastric pH had lower gastric bacterial counts.
Changing the feeding tube daily rather than weekly in the first week of life did not result in reduced bacterial concentration in gastric aspirates. The bacterial load from the feeding tubes was low suggesting that contamination of feeding tubes did not affect early colonisation of the upper gastrointestinal tract.
none.
ClinicalTrials identification number NCT02830503.
我们旨在确定更频繁地更换鼻胃管是否会影响早产儿上消化道的定植情况。
我们纳入了22例出生后48小时内孕周小于32周的新生儿。这些新生儿被随机分为两组，一组在出生后第一周的第7天更换喂养管，另一组每天更换。我们通过培养法测定母乳样本、胃吸出物和喂养管冲洗液中的细菌浓度。细菌通过基质辅助激光解吸/电离飞行时间质谱（MALDI-TOF）进行鉴定。主要结局是出生后第7天新放置的鼻胃管吸出物中的细菌浓度。
仅有11例新生儿的数据符合主要结局分析的条件。我们发现两组之间的细菌浓度没有差异，干预组每毫升吸出物的平均菌落形成单位数为4.62 log10（标准差（SD）：±3.43），对照组为2.76 log10（SD：±3.13）。19例新生儿的数据符合次要结局指标分析的条件。我们发现两组之间细菌载量的组成没有统计学上的显著差异。胃pH值较低的婴儿胃内细菌数量较少。
在出生后第一周每天而非每周更换喂养管并不会降低胃吸出物中的细菌浓度。喂养管的细菌载量较低，表明喂养管的污染并未影响上消化道的早期定植。
无。
ClinicalTrials识别号NCT02830503。
