Microbial contamination of enteral feeding solution and its prevention

Abstract

In an investigation of microbial contamination of enteral feeding solutions, all 22 residual solutions obtained immediately after administration were contaminated at concentrations of 10(3) to 10(6) viable counts/ml. Major contaminants were glucose-nonfermenting gram-negative bacilli such as Pseudomonas aeruginosa and Acinetobacter calcoaceticus var anitratus. Contamination seemed to have been caused by frequent reuse of bag-type containers and the infusion tubes connected to the bags, neither of which can be washed or dried. Decontamination methods were evaluated by using polypropylene containers that can be washed and disinfected for administration. Few Serratia marcescens on the inside wall of the container were removed by rinsing with tap water, alone or in combination with detergent scrub. Tap water and detergent plus air-drying at 56 degrees C for 1 hour reduced Serratia marcescens only somewhat. Tap water and detergent plus immersion in 0.01% sodium hypochlorite for 1 hour or in water at 70 degrees C for 3 minutes eliminated all 10(11) cells of Serratia marcescens.

Rapid detection of Candida parapsilosis contamination in the infusion fluid

“…[9] Since many drugs do not have adequate nutrients for microorganisms, their microbial contamination at a level allowing visual confirmation (about 10 7 cfu/ml for bacteria and about 10 6 cfu/ml for yeast-like fungi) does not normally occur. However, in this case, since an inline filter was used in the main route of high calorie infusion fluid, microbial contamination was detected based on the color of the inline filter.…”

Promoting the reuse of enteral feeding equipment in ambulatory patients: Where do we stand?

“…Another source of contamination is through retrograde bacterial growth. The patient's own intestinal bacteria can colonise the distal end of the feeding tube and over time migrate into the delivery set, and potentially to the reservoir of feed product if 24‐hour maximum hang times are exceeded 2,4 …”

“…It has been routine practice in Australia and internationally to reuse enteral feeding equipment (gravity and pump administration sets, irrigation syringes and feed reservoir bags) designed for single or single‐patient use 1–4 . In Australia, this is particularly so with ambulatory patients requiring enteral feeding.…”

A qualidade do ar de interiores e a química

“…O atrito entre partes que se movimentam ou pedaços de móveis produzirão partículas sólidas; varrer, tirar a poeira, ou limpar utilizando aspiração à vácuo facilita a reentrada de partí-culas sólidas no ar; umidificadores e vários tipos de "sprays" produzem partículas líquidas 28 . O ato de fumar, ou mesmo cozinhar, produz a condensação de aerossóis, tanto sólidos, como líquidos, bem como o simples acionar da descarga de banheiros.…”