<abstract> <p>Improper use of antibiotics to treat or prevent infections, and as a stimulant for livestock growth, can affect public health and the dairy industry due to the spread of antibiotic residues in milk. This systematic review and meta-analysis aimed to investigate antibiotic residues in raw and pasteurized milk in Iran. Data were collected through searching the databases, including Scopus, PubMed, Science Direct, Web of Science, Google Scholar, SID, and Magiran using the following keywords: "pasteurized milk", "raw milk", "milk", "antibiotic residues", " antibiotic", and "Iran". Finally, 40 eligible studies were selected for the systematic review and meta-analysis. According to the reviewed studies, the prevalence of antibiotic residues in raw and pasteurized milk was 26% (95% CI: 20–33%) and 21% (95% CI: 15-27%), respectively. It seems that the control measures are inefficient in dairy industry and milk collection centers for the presence of antibiotic residues and the time of antibiotic withdrawal during milk delivery. Permanent control of milk in the collection centers by the responsible organizations along with implementation of Hazard Analysis Critical Control Point system in milk factories can be very effective in reducing antibiotic residues.</p> </abstract>

Background: Enteral feeding (EF) is the delivery of liquid nutritional support through a tube for hospitalized patients with gastrointestinal dysfunction who are incapable of eating or unable to meet their nutritional requirements via the oral route. Hospitals’ reports indicate an increased interest and demand for blenderized tube feeding (BTF) as an alternative to commercial enteral formulas particularly in families of tube fed children. In particular, by increasing food sensitivity and more complex identification in children, BTF allows families to adjust their diet to their children's needs. This systematic review aimed to summarize the published evidence regarding BTF in pediatric patients. Methods: Literature search was conducted in four databases, including Scopus, PubMed, Science Direct, and Google Scholar, using multiple keywords, such as blenderized tube feeding, blended formula, homemade enteral nutrition, pediatric, and children. Out of 103 retrieved articles, 6 were selected and reviewed. Results: Six articles were eligible to be included in the current review. The results showed that calories were approximately 1kcal/g, protein 13 -22%, fat 30 - 34%, and carbohydrates intake 45-55% of total energy intake. Conclusions: The results indicated that BTF is acceptable and can be administered to children; however, due to concerns about calorie and macronutrients deficiency, it should be providing under the supervision of a nutritionist.  BTFs are a good choice among children; since they can improve gastrointestinal symptoms and are a good option for families who use EF for their children at home. Most pediatric patients use BTFs as a portion of their EF, making it necessary that nutritionists and physicians expand their knowledge about BTFs to appropriately care for these pediatric patients.

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Background Due to the benefits of blenderized tube feeding (BTF) diets, the interest in using them is increasing. This study aimed to design BTFs for children and investigate their physicochemical and microbial properties, as well as Dietary Inflammatory Index (DII). Methods Five BTF diets were formulated mainly with fresh foods; their DII, physical (viscosity), and chemical (moisture, ash, protein, fat, energy, and micronutrients) characteristics were assessed. Also, the Hazard Analysis and Critical Control Points (HACCP) system was implemented for quality assurance of preparation, storage, and delivery of BTFs to patients in hospital. The microbial contamination (total count, Salmonella, Escherichia coli, Bacillus cereus, Listeria monocytogenes, coliforms, Staphylococcus aureus coagulase positive, mold, and yeast) was analyzed. Results Energy and percentages of protein, fat, and carbohydrate in BTFs were in the range of 103–112 kcal/100 ml, 16%–22%, 28%–34%, and 48%–52%, respectively. The viscosity of the five developed BTFs was between 29 and 64 centipoises, which allows the formulas to flow without syringe pressure. The DII of all BTFs was between −0.73 and −2.24. Due to the implementation of HACCP, monitoring the production line of BTFs, and performance of corrective measures, no microbial contamination was observed by indicator pathogenic microorganisms. Conclusion A planned BTF diet can be an excellent selection for children using enteral nutrition with tube feeding especially when they are made from fresh and anti‐inflammatory foods such as recipes prepared in this study.

Background: All types of enteral feeding (EF) formulations, whether blenderized tube feeding (BTF) at hospital kitchen, or commercial enteral feeding (CEF), contains nutrients. The nature of these foods (in terms of pH, nutrient contents, water activity, etc.) is so that if they become contaminated, would immediately grow pathogens inside and put the patient at the risk of infection. This systematic review aimed to investigate the microbial safety of BTF and CEF used in hospitals. Methods: Literature search was conducted in four English databases, including Scopus, PubMed, Science Direct, and Google Scholar, using multiple keywords, such as enteral nutrition, blenderized formulas, home enteral nutrition, enteral formula, EF, blenderized enteral formula, blended feeds, blenderized home-made food, CEF, microbial contamination, and bacterial contamination. Finally, 16 eligible studies were selected for the systematic review. Results: Out of 132 retrieved articles, 16 were selected and reviewed CEF was mostly exposed to contamination with total coliforms, Staphylococcus aureus, mesophilic bacteria, and Escherichia coli. In addition, contamination with gram-negative bacteria, Bacillus cereus, mold, and yeast was detected. Most BTF contamination was caused by total coliforms, mesophilic bacteria, Listeria spp., B. cereus, mold, and yeast. Conclusion: Due to the nonconformity of hygienic guidelines, the microbial safety of EF solutions in hospitals and homes are relatively low, which may lead to foodborne diseases. Therefore, a hazard analysis and critical control point (HACCP) system is essential in every hospital kitchen.