Appropriate handling and storage reduce the risk of bacterial growth in enteral feeding systems reused within 24 hours

Author:

Hubbard Gary P.1ORCID,Van Wyk Johanna1,Grinyer Louise2,Onley Richard2,White Sean3,Fleming Carole‐Anne4,Baxter Janet5,Forwood Laura1,Stratton Rebecca J.16ORCID

Affiliation:

1. Nutricia Ltd Trowbridge UK

2. Leatherhead Research Ltd Epsom UK

3. Department of Dietetics Sheffield Teaching Hospitals NHS Foundation Trust Sheffield UK

4. NHSGGC Adult Acute Dietetic Service Beatson West of Scotland Cancer Centre Glasgow UK

5. Upper Constitution Street Dundee UK

6. School of Medicine University of Southampton Southampton UK

Abstract

AbstractBackgroundEnteral tube feeding can require considerable amounts of plastic equipment including delivery sets and containers, often disposed of after a single feeding session because of bacterial contamination concerns. The aim of this research was to assess whether reuse of delivery sets and containers for up to 24 h is safe from a microbiological perspective.MethodsFour enteral tube feeding systems (FS) were tested under hygienic controlled or repeated inoculation challenge conditions using key foodborne pathogens, to assess bacterial growth over time (FS1: ready‐to‐hang, closed 1‐L system with delivery set reused, stored at room temperature [RT]; FS2: a prepared, powdered, open 1‐L system with delivery set and container reused, stored at RT; FS3 and FS4: prepared, powdered, open 200‐ml bolus systems with delivery set and container reused, stored at RT [FS3] and refrigeration [FS4]). Feed samples were cultured at 0.5, 6.5, 12.5, 18.5, and 24.5 h with >2 Δlog considered significant bacterial growth.ResultsUnder hygienic control, FS1, FS3, and FS4 were below the level of enumeration (<5 CFU/g) for all bacteria tested, at all time points. In FS2, significant bacterial growth was observed from 18.5 h. Under repeated bacterial inoculation challenge, no significant growth was observed in FS1 and FS4 over 24.5 h; however, significant growth was observed in FS2 after 6.5 h and in FS3 after 10–12 h.ConclusionWith hygienic handling technique, there is limited bacterial growth with reuse of delivery sets and containers over 24 h. Refrigeration between feeding sessions and using boluses of reconstituted powdered feed reduce bacterial growth risk.

Publisher

Wiley

Subject

Nutrition and Dietetics,Medicine (miscellaneous)

Reference64 articles.

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3. SmithT MicklewrightA AmandaH RebeccaS Baxter.J. Artificial nutrition support in the UK 2000–2010.2011. Accessed August 14 2023.www.bapen.org.uk

4. RebeccaS EvillR SmithT. Home enteral tube feeding (HETF) in adults (2010‐2015). A report by the British Artificial Nutrition Survey (BANS)—a committee of BAPEN.2018. Accessed August 14 2023.www.bapen.org.uk

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