Prospective study of the incidence and complications of bacterial contamination of enteral feeding in neonates
Prospective study of the incidence and complications of bacterial contamination of enteral feeding in neonates
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DOI：
10.1053/jpsu.2002.34467
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发表时间：
2002-08-01
影响因子：
2.4
通讯作者：
Smith, SD
中科院分区：
文献类型：
--
作者：
Mehall, JR;Kite, CA;Smith, SD
目的：研究新生儿肠道喂养细菌污染的发生率和并发症。方法：对50例新生儿进行前瞻性研究。婴儿通过开放式重力排水系统进行团注喂养；收集了人口统计学和临床数据。7d后对管腔进行定量培养。结果：50例新生儿平均每例喂养17.6天，平均每例喂养125个病人周(每个病人每周1管)。125根试管中共有71根“受到污染”(1,000个菌落形成单位[CFU]/毫升)，平均菌落数为908,173个菌落单位和3种不同的细菌类型。在配方奶喂养的婴儿中，有污染管子的32周中有24周出现喂养不耐受，而无污染管子的44周中没有出现喂养不耐受(P<；0.05)。服用H2拮抗剂的患者48周中有41周出现污染，而胃酸正常的患者在66周中有32周发生污染(P<；0.05)。有7名患者发生坏死性小肠结肠炎；所有患者都喂食了污染超过10万cfu/m l革兰氏阴性细菌的配方奶粉。4例需手术；术中培养发现4例患儿管内细菌培养与以前培养的细菌相同。结论：肠道喂养细菌污染频繁，导致明显的喂养不耐受，可能与NEC的发生有关。版权所有2002，《爱思唯尔科学》(美国)。版权所有。
Purpose: The goal of this study was to determine incidence of, and complications resulting from, bacterial contamination of enteral feedings in neonates.Methods: A prospective study of 50 tube-fed neonates was conducted. Infants were bolus fed via an open gravity drained system; demographic and clinical data were gathered. The lumen of the tube was cultured quantitatively after 7 days. All organisms were isolated, identified, frozen, and stored to correlate with clinical cultures.Results: The 50 neonates were fed for a mean of 17.6 days each and represent 125 patient weeks (1 tube per patient per week). A total of 71 of 125 tubes were "contaminated" (>1,000 colony forming units [CFU]/mL), with a mean 908,173 CFU and 3 different bacteria types. Among formula-fed infants, feeding intolerance occurred in 24 of 32 weeks with contaminated tubes versus 0 of 44 weeks with noncontaminated tubes (P < .05). Contamination occurred in 41 of 48 weeks in patients on H2 antagonists versus 32 of 66 weeks in patients with normal gastric acidity (P < .05). Necrotizing enterocolitis developed in 7 patients; all were fed formula contaminated with greater than 100,000 CFU/mL of Gram-negative bacteria. Four required operation; intraoperative cultures found the same organism as cultured previously in the tube in all 4 infants.Conclusion: Bacterial contamination of enteral feeding occurs frequently, causes significant feeding intolerance, and may contribute to NEC. Copyright 2002, Elsevier Science (USA). All rights reserved.