BACTERIAL-CONTAMINATION OF ENTERAL FEEDING SYSTEMS DUE TO FAULTY HANDLING PROCEDURES - A COMPARISON OF A NEW SYSTEM WITH 2 ESTABLISHED SYSTEMS

Background: The purpose of this study was to compare the risks of intr oducing microbial contamination when assembling and running two common ly used, ready-to-hang, enteral feeding systems (Nutrison glass bottle s and Steriflo) with a newly introduced system (Nutrison pack). Method s: The nutrient container tops of all systems were deliberately touche d during assembly by a researcher wearing gloves contaminated with Kle bsiella aerogenes. After touching, half the containers were immediatel y connected to giving sets, the other half were disinfected using alco hol wipes before connection to the giving sets. Systems were run for 2 4 h, with a change of nutrient container at 12 h for the Steriflo (2 x 1000 mi), Nutrison pack (2 x 1000 mi) and Nutrison glass bottles (2 x 500 mi), and at 6 h for the Nutrison glass bottles (4 x 500 mi). Feed samples for microbiological analysis were taken from feed in the syst ems at the Oh assembly, and from residual feed in all discarded nutrie nt containers. Each protocol was repeated five times. Results: The per centage of feed samples in which K. aerogenes was detected reduced sig nificantly from 68% for non-disinfected Nutrison glass bottles changed every 6 h, to 59% after disinfection, and from 51% to 0% after disinf ection of Steriflo systems (Mann-Whitney, P < 0.05). For Nutrison glas s bottles changed every 12 h the fall from 51% with no disinfection to 49% after disinfection was not significant (Mann-Whitney, P < 0.05). Nutrison packs were not disinfected and yet K, aerogenes was only dete cted in 2% of feed samples. This rate of contamination was significant ly less than that for all the other non-disinfected systems (Mann-Whit ney, P < 0.05). Conclusion: The results show a reduction in the incide nce of bacterial contamination of the feed samples when systems were d isinfected subsequent to being exposed to faulty handling procedures, thus supporting manufacturers recommendations to disinfect systems dur ing assembly. The results particularly highlight the important role pl ayed by system design in reducing the levels and incidence of bacteria l contamination of enteral tube feeds.