Microbial contamination of enteral feeding formulas and diarrhea

Okuma, Toshitada; Nakamura, Motokazu; Totake, Hideko; Fukunaga, Yoshitaka

doi:10.1016/s0899-9007(99)00229-4

Cited by 49 publications

(43 citation statements)

References 24 publications

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“…Okuma [21] found bacterial contamination in ready-made enteral diets; they examined 49 empty, unused bottles and found one contaminated unit. He did not report which microorganisms were found in the bottle.…”

Section: Discussionmentioning

confidence: 99%

Nosocomial diarrhea in the intensive care unit

Marcon¹,

Gamba²,

Vianna³

2006

Braz J Infect Dis

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We made an epidemiological case-control study to examine risk factors for the development of diarrhea in the intensive care unit (ICU) of a public hospital in Santo André, SP, from January to October 2002. Forty-nine patients with diarrhea (cases) and 49 patients without diarrhea (controls), matched for age and gender, were included in the study. A stool culture and enzyme immunoassays for Clostridium difficile toxins A and B were performed on fecal specimens from diarrhea patients.

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Section: Discussionmentioning

confidence: 99%

Nosocomial diarrhea in the intensive care unit

Marcon¹,

Gamba²,

Vianna³

2006

Braz J Infect Dis

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“…Many causes, presumably most of which deplete the numbers of normal intestinal flora, have been implicated in the pathogenesis of diarrhea related to enteral feeding, including antibiotic therapy, 30 various alterations in intestinal microbiota due to intragastric feeding, 31 infection by enteropathogens, 32 colonization with C difficile, 33 contaminated enteral feeding preparations and delivery systems, 33,34 route of enteral feeding, 33 osmotically active medications, 35 low serum levels of albumin, 36 and impairment of colonic secretion of water and electrolytes. 37 A recent study 32 indicated that great variability in intestinal flora occurs in patients who have diarrhea during enteral feeding.…”

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confidence: 99%

Decrease in Frequency of Liquid Stool in Enterally Fed Critically Ill Patients Given the Multispecies Probiotic VSL#3: A Pilot Trial

Frohmader¹,

Chaboyer²,

Robertson³

et al. 2010

American Journal of Critical Care

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Background Diarrhea has adverse consequences for critically ill patients, health care staff, and health care costs. Objective To evaluate the efficacy of the multispecies probiotic VSL#3 in reducing the mean number of episodes of liquid stool in enterally fed critically ill patients. Methods A single-center, double-blind, randomized, placebo-controlled pilot study was done in a 6-bed intensive care unit in a 330-bed public hospital in Australia. A total of 45 adults (20 intervention, 25 control) who required enteral nutrition for more than 72 hours were given VSL#3 or a placebo twice daily. The frequency (mean number of episodes per patient per day) and weight (grams per day) were determined for both liquid stool and liquid and loose (unformed) stool. Results The 2 groups of patients had no demographic or clinical differences. Patients received enteral nutrition for a mean of 8.5 days (SD, 5.4) and were studied for a mean of 11.9 days (SD, 5.6). Compared with the control group, the intervention group had a significant reduction in the frequency of liquid stools (incidence rate ratio, 0.50; 95% confidence interval, 0.27 to 0.93; P = .03). Smaller but still significant differences also occurred between the groups in both the frequency of episodes and the weight of liquid and loose (unformed) stool. Conclusion VSL#3 was effective in reducing the frequency of liquid stool in critically ill patients receiving enteral nutrition. Probiotics possibly can minimize diarrhea in critically ill tube-fed patients, but more controlled clinical trials are needed.

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“…Metabolic complications include fluid and electrolyte disorders, hyperglycemia, vitamin and trace element deficiencies and re-feeding syndrome [28,29]. Infectious complications can include aspiration pneumonia, bacterial contamination of enteral formulas and infection at jejunostomy site [30,31]. However, aspiration pneumonia is very rare in post-pyloric feeding and jejunostomy feeding is the route of choice in aspiration-risk patients [32].…”

Section: Introductionmentioning

confidence: 99%

Study of Feeding Jejunostomy as an Add on Procedure in Upper Gastrointestinal Surgeries

Shenoy

Adapala

2013

Indian J Surg

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Jejunostomy is usually indicated as an additional procedure during major surgery of upper digestive tract to administer enteral nutrition in post-operative period. Complications associated with it can be mechanical, infectious, gastrointestinal or metabolic. The aim of the study was to evaluate safety of post-operative feeding jejunostomy in different types of major upper gastrointestinal surgeries. It was a prospective study conducted during the period between August 2009 and September 2011. Post-operative cases of major upper gastrointestinal surgeries who receive jejunostomy feeds were included in the study. Sampling was done by convenient method with sample size of 50 cases. Post-operatively, patients were monitored according to standard orders of enteral nutrition. Total calorie and protein intake through feeding jejunostomy was calculated regularly, and complications were assessed in terms of frequency, type, duration, management, and final outcome in different types of upper gastro intestinal surgeries. Analysis was done using chi square test with the help of statistical package SPSS vers.13. P < 0.05 was considered as significant. Complications observed were gastrointestinal −8 (16 %), mechanical −6 (12 %), infectious −4 (8 %) and metabolic −4 (8 %). Duration of complications ranged from 1 to 7 days (mean, 4 days). All types of complications observed during study were less severe and could be managed by simple measurements. Haemoglobin, serum albumin and weight of the patient at the time of discharge were improved for all patients when compared to pre-operative values. All patients received target calories and proteins through feeding jejunostomy. Considering benefits of enteral feeding via jejunostomy tube with minor and acceptable complications, we conclude that feeding jejunostomy is a preferred route of nutritional administration in those who undergo major upper gastro intestinal surgeries.

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Microbial contamination of enteral feeding formulas and diarrhea

Cited by 49 publications

References 24 publications

Nosocomial diarrhea in the intensive care unit

Nosocomial diarrhea in the intensive care unit

Decrease in Frequency of Liquid Stool in Enterally Fed Critically Ill Patients Given the Multispecies Probiotic VSL#3: A Pilot Trial

Study of Feeding Jejunostomy as an Add on Procedure in Upper Gastrointestinal Surgeries

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