Neonatal Feeding Tube Colonization and the Potential Effect on Infant Health: A Review.
Neonatal Feeding Tube Colonization and the Potential Effect on Infant Health: A Review.
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DOI：
10.3389/fnut.2022.775014
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发表时间：
2022
影响因子：
5
通讯作者：
Neu J
中科院分区：
文献类型：
--
作者：
Parker LA;Magalhães M;Desorcy-Scherer K;Torrez Lamberti M;Lorca GL;Neu J
新生儿重症监护病房 (NICU) 中的婴儿通常需要使用饲管 (FT) 数周至数月。由于 FT 几乎持续接触母乳和/或配方奶粉，因此细菌可能快速而广泛地生长。由于婴儿的免疫和胃肠 (GI) 系统不成熟，FT 定植可能导致婴儿面临重大健康风险。在成人中，FT 保留在原位的时间长度（停留时间）会影响定植程度和生物膜形成，这对于输卵管保留在原位长达 30 天的婴儿来说非常重要。本综述的目的是描述和总结有关婴儿 FT 细菌定植的证据，并找出需要进一步研究的差距。在 Medline、CINAHL 和 Embase 数据库中检索了基于临床和/或实验室的观察性和随机对照研究，调查了新生儿 FT 中细菌的存在。对 10 项研究的回顾发现，有证据表明新生儿 FT 可能含有大量潜在致病性和抗生素耐药性细菌，较长的停留时间可能会增加细菌负荷。此外，有证据表明 FT 定植可能起源于医院，并导致婴儿健康不良。饲管是细菌定植的一个未被识别的来源，可能会增加早产儿的发病率，因此 FT 中细菌的存在是 NICU 中脆弱婴儿营养护理的一个重要研究领域。为了提出临床建议，需要进一步进行基于临床、使用适当分析并控制潜在协变量的适当动力研究。
Infants in the neonatal intensive care unit (NICU) often require feeding tubes (FT) for weeks to months. Because FTs are in near constant contact with human milk and/or formula, rapid and extensive bacterial growth is possible. Due to their immature immunologic and gastrointestinal (GI) systems, infants may be at significant health risk due to FT colonization. In adults, length of time FTs remain in place (dwell time) affects the degree of colonization and biofilm formation which is important in infants whose tubes remain in place up to 30 days. The purpose of this review was to describe and summarize the evidence regarding FT bacterial colonization in infants and identify gaps needing further investigation. Medline, CINAHL, and Embase databases were searched for clinical and/or laboratory-based observational and randomized controlled studies investigating the presence of bacteria in neonatal FTs. This review of 10 studies found evidence that neonatal FTs may contain high quantities of potentially pathogenic and antibiotic resistant bacteria and longer dwell times may increase the bacterial load. Furthermore, evidence suggests FT colonization may be nosocomial in origin and contribute to adverse infant health. Feeding tubes are an unrecognized source of bacterial colonization which may increase morbidity in premature infants and thus the presence of bacteria in FTs is an important area of investigation in the nutritional care of vulnerable infants in the NICU. Further appropriately powered studies which are clinically based, use appropriate analyses, and control for potential covariates are necessary to make clinical recommendations.
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