Microbiological contamination of enteral feeding solutions used in Costa Rican Hospitals

Enteral feeding is the most common and preferred modality for providing nut ritional support to hospital patients with a functional gastrointestinal tr act that can not satisfy their nutritional requirements. Nevertheless, ente ral feeding may be an important cause of bacterial infection. The aim of th is study was to evaluate the microbial contamination level of enteral feedi ngs distributed in Costa Rican hospitals. A total of 124 samples of enteral feeding, coming from five different hospitals from San Jose, Costa Rice, w ere evaluated during the second semester of 1997 and first of 1998 for the presence and identification of total and fecal coliforms, Pseudomonas sp. a nd Listeria sp. A subpopulation of the Pseudomonas isolated was analyzed fo r their antibiotic susceptibility patterns. The concentration of Gram negat ive rods in the samples of enteral feeding solutions ranged from 10(3) to 1 0(7) CFU/mL, markedly exceeding the permissible level (10(2) CFU/mL or less ). The coliforms most frequently isolated included Enterobacter cloacae, Es cherichia coil, Serratia sp. and Klebsiella pneumoniae. Pseudomonas sp. was isolated in more than 70% of the samples made from commercial based soluti ons, fruits and vegetables. P. aeruginosa and P. fluorescens were the speci es most frequently isolated. Listeria sp. was not isolated from enteral sol utions samples. The results obtained demonstrate that it is urgent to assur e strict hygiene during the preparation and handling of all enteral feed in order to avoid bacterial growth. The implementation of HACCP (Hazard Analy sis and Critical Control Points) system will be required in a near future f or better quality control of enteral nutrition mixtures.