Microbiological quality of reconstituted enteral formulations used in hospitals

Contamination of enteral feeds may occur during preparation, storage, decanting, and administration to patients. The aim of this study was to investigate the microbiological quality of reconstituted enteral feeds, residual feeds from feed delivery systems, and the water used to reconstitute powdered feeds in hospital. Hazard Analysis Critical Control Points (HACCP) system was implemented to control microbiological contamination of the enteral feeding formulations. Before the implementation of the HACCP system microbiological analyses of feeds showed the presence of indicator organisms such as coliforms and Enterococcus spp. and unacceptably high levels of mesophilic aerobic microorganisms (>104 cfu/mL). After the implementation of the HACCP, the microbial quality of the feeds improved significantly, with counts of <101 cfu/mL. Blenders used in reconstituting feeds were found to be the main source of bacterial contamination.