Kozow Julia Fernanda Costa, Rabito Estela Iraci, Kruger Jenifer Faria, Medeiros Caroline Opolski, da Costa Rayane Luizi, Beux Márcia Regina, Stangarlin-Fiori Lize
Graduate Program in Nutrition, Federal University of Paraná, Curitiba, Paraná, Brazil.
Postgraduate Program in Food and Nutrition, Department of Nutrition, Federal University of Parana, Curitiba, Paraná, Brazil.
Nutr Rev. 2024 Sep 1;82(9):1226-1238. doi: 10.1093/nutrit/nuad123.
The safety of enteral formulas is important to restore and maintain the health of patients.
A systematic review of the literature was conducted to assess the microbiological contamination present in enteral tube feeding prepared in hospitals and/or at home.
A systematic search was conducted of the Medline, Scopus, BVS, CAPES/MEC, Embase, Science Direct, and SciELO databases and gray literature.
Eligible studies that analyzed the contamination of enteral formulas manipulated in hospitals and/or at home were selected; a quality assessment tool was used.
Twenty-three studies evaluated 1099 enteral formulations. Of these, 44.67% of enteral formulas (n = 491) exceeded the acceptable bacterial count. Samples of homemade enteral formulation preparations (86.03%; n = 191) had the highest bacterial counts, followed by mixed preparations (79.72%; n = 59), and commercial formulas (30.01%; n = 241). The number of samples of enteral formulations that exceeded the bacterial count at home was 70.79% (n = 160 at the hospital was 37.91% (n = 331). Total coliforms (82.68%; n = 406) and mesophilic aerobes (79.22%; n = 389) were the most common microorganisms. Samples with bacterial pathogens were also identified, with Bacillus cereus (4.07%; n = 20) and Listeria monocytogenes (3.66%; n = 18) being the most prevalent.
A high number of samples of enteral formulations exceeded the bacterial count, but the risk to patient's health when consuming enteral tube feeding prepared in hospitals or at home may be low. This is because the bacteria present in the samples are not considered potential causes of disease but rather indicators of hygiene conditions.
PROSPERO registration no. CRD42022367573.
肠内营养制剂的安全性对于恢复和维持患者健康至关重要。
进行文献系统综述，以评估医院和/或家庭配制的肠内管饲制剂中的微生物污染情况。
对Medline、Scopus、BVS、CAPES/MEC、Embase、Science Direct和SciELO数据库以及灰色文献进行系统检索。
选择分析医院和/或家庭中操作的肠内营养制剂污染情况的合格研究；使用质量评估工具。
23项研究评估了1099种肠内营养制剂。其中，44.67%的肠内营养制剂（n = 491）细菌计数超过可接受范围。自制肠内营养制剂样本（86.03%；n = 191）细菌计数最高，其次是混合制剂（79.72%；n = 59）和商业制剂（30.01%；n = 241）。家庭中细菌计数超标的肠内营养制剂样本数量为70.79%（n = 160），医院为37.91%（n = 331）。总大肠菌群（82.68%；n = 406）和嗜温需氧菌（79.22%；n = 389）是最常见的微生物。还鉴定出含有细菌病原体的样本，其中蜡样芽孢杆菌（4.07%；n = 20）和单核细胞增生李斯特菌（3.66%；n = 18）最为普遍。
大量肠内营养制剂样本细菌计数超标，但食用医院或家庭配制的肠内管饲制剂时对患者健康的风险可能较低。这是因为样本中存在的细菌不被认为是潜在的致病原因，而是卫生状况的指标。
PROSPERO注册号CRD42022367573。
