Evaluation of “Closed” vs “Open” Systems for the Delivery of Peptide‐Based Enteral Diets

Wagner, David R.; Elmore, Michael F.; Knoll, Donna M.

doi:10.1177/0148607194018005453

Cited by 46 publications

(19 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…64,65 Different administration sets have been evaluated for risk of inadvertent contamination in the process of filling the container. 43,66 The authors concluded that the adherence to strict aseptic technique is the key to prevention of contamination during the filling process.…”

Section: Reducing Contaminationmentioning

confidence: 99%

“…63 A recent Spanish article reports a randomized trial of immediate feeding in over 30 patients with no increase in complications. 64 In the pediatric literature, the shortest time course to using a PEG was described in a clinical report by Werlin et al 65 This study was uncontrolled, but the authors reported no unusual complications that led to feeding discontinuation in 24 pediatric patients started on Pedialyte ® (Abbott Laboratories) 6 hours after PEG placement. …”

mentioning

confidence: 98%

See 1 more Smart Citation

A.S.P.E.N. Enteral Nutrition Practice Recommendations

Bankhead¹,

Boullata²,

Brantley³

et al. 2009

J Parenter Enteral Nutr

492

509

View full text Add to dashboard Cite

Section: Reducing Contaminationmentioning

confidence: 99%

mentioning

confidence: 98%

A.S.P.E.N. Enteral Nutrition Practice Recommendations

Bankhead¹,

Boullata²,

Brantley³

et al. 2009

J Parenter Enteral Nutr

492

509

View full text Add to dashboard Cite

“…7). This level, 10 4 cfu ml -1 , has been quoted as a critical value above which feed is unacceptable for patient consumption (Fagerman 1992, Wagner et al 1994, Food and Drug Administration 1995. However, 10 4 cfu has also been reported as the number of organisms required for gut colonization (Pottecher et al, 1979) and it has been stated that consumption of 1 g of food containing 10 3 Gram negative bacilli can lead to persistent gut colonization in patients receiving systemic doses of antimicrobial agents (Remington and Schimpff 1981).…”

Section: Discussionmentioning

confidence: 99%

Decanting versus sterile pre-filled nutrient containers ‐ the microbiological risks in enteral feeding

Beattie

Anderton

2001

International Journal of Environmental Health Research

View full text Add to dashboard Cite

A simulated ward study was carried out to compare the microbiological risk of assembling and running four different enteral feeding systems for 24 h. Assembly was carried out, (i) according to manufacturers' instructions with hands either covered by disposable gloves or deliberately contaminated with a test organism, or (ii) touching both the nutrient container top and pump set connector with hands deliberately contaminated with K. aerogenes. Two of the systems were ready-to-hang types (pack and bottle), the other two required feed to be decanted from either bottles or cans. When manufacturers' instructions were followed and disposable gloves worn, organisms were only detected in feeds decanted from cans and at levels < or = 20 cfu ml(-1). However, when systems were assembled following manufacturers' instructions, but with contaminated hands, no organisms were found in either of the ready-to-hang systems but average bacterial counts in samples from systems where the feed was decanted from bottles were 1.8 x 10(3) cfu ml(-1) at 24 h and 9.3 x 10(5) cfu ml(-1) for those where feed was decanted from cans. When systems were deliberately touched with contaminated hands, no organisms were detected in any feed samples from the pack system at 24 h, while bacterial counts for the other three systems ranged from 10(1) to 10(5) cfu ml(-1). The results highlight the important role played by system design in reducing both the level and incidence of bacterial contamination of enteral tube feeds and indicate that ready-to-hang feeding systems should be the preferred choice. However, if decanting of feeds cannot be avoided then strict adherence to manufacturers' instructions and the use of disposable gloves is to be advised.

show abstract

“…The most likely vehicle was believed to be the hands of staff (Schreiner et al 1979 ). Epidemiological and microbiological links between enteral nutrition and feeding intolerance, abdominal distention, aspiration pneumonia, diarrhoea, necrotizing enterocolitis, and even systemic infections such as sepsis caused by bacterial contamination have been reported (Anderson et al 1984 ;Anderton 1993 ;Freedland et al 1989 ;Wagner et al 1994 ).…”

Section: Biofi Lms On Enteral Feeding Tubes and Antimicrobial Resistancementioning

confidence: 99%

“…Feeding procedures and practices such as the Hazard Analysis Critical Control Point system (Bryan 1990 ) need to be monitored (Anderton 1995 ). The closed ready-to hang enteral nutrition delivery system is believed to be an effective method for contamination-free enteral feeding (Chan et al 1994 ;Curtas et al 1991 ;Wagner et al 1994 ).…”

Section: Prevention Of Neonatal Infections Caused Be Contaminated Entmentioning

confidence: 99%

Microbial Biofilm Development on Neonatal Enteral Feeding Tubes

Juma

Forsythe

2014

Advances in Experimental Medicine and Biology

View full text Add to dashboard Cite

Neonates in intensive care units often require supporting medical devices and antibiotic treatment. The intensive care treatment combined with their immature immune system, the increased permeability of mucosa, and the undeveloped microflora of the gut may render the neonates highly vulnerable to colonisation and subsequent infections when exposed to opportunistic pathogens. These infections may not only be local gastrointestinal infections, but also systematic following translocation from the gastrointestinal system. This could be particularly alarming considering that common antibiotics may not be effective if the causative strain is multi-drug resistant.This chapter reviews our information on the microbial colonization of neonatal feeding tubes. The range of organisms which have been recovered are wide, and while primarily bacterial, fungi such as Candida have also been found. The bacteria are principally Staphylococcus spp. and Enterobacteriaceae. The Enterobacteriaceae isolates are predominantly Enterobacter cancerogenus, Serratia marcescens, Enterobacter hormaechei, Escherichia coli and Klebsiella pneumoniae. Many of these isolates encode for antibiotic resistance; E. hormaechei (ceftazidine and cefotaxime) and S. marcescens strains (amoxicillin and co-amoxiclav).

show abstract

Evaluation of “Closed” vs “Open” Systems for the Delivery of Peptide‐Based Enteral Diets

Abstract: Nonvented closed-delivery containers may be safely infused for up to 48 hours. They are associated with reduced labor and contamination.

Cited by 46 publications

References 16 publications

A.S.P.E.N. Enteral Nutrition Practice Recommendations

A.S.P.E.N. Enteral Nutrition Practice Recommendations

Decanting versus sterile pre-filled nutrient containers ‐ the microbiological risks in enteral feeding

Microbial Biofilm Development on Neonatal Enteral Feeding Tubes

Contact Info

Product

Resources

About