Milton, Debra L.

Abstract Background The number of patients requiring home enteral nutrition (HEN) continues to increase. Many of these patients are interested in using blended food instead of, or in addition to, commercial enteral formula (CEF). Increased risk of food‐borne illness is a concern of blenderized tube‐feeding (BTF). This project assessed a standard procedure for minimizing bacterial growth of BTF prepared in the home setting. Methods Fifty participants prepared BTF in their kitchens using a standard preparation procedure to minimize bacterial contamination. BTF was assessed for growth of aerobic microorganisms, Escherichia coli, Staphylococcus aureus , and coliforms at baseline, 24‐hour, and 48‐hour intervals after preparation for a total of 150 colony forming units (CFU) counts performed. Results No sample had zero aerobic microbial counts; yet no substantial increase in microbial counts was observed during the 48 hours. At baseline and 24 hours, 5/50 (10%) had a CFU count of >10 4 , and at 48 hours, 6/50 (12%) exceeded 10 4 CFUs. Out of 150 CFU counts, 2 (1.3%) were just over 10 5 CFU/mL. Samples exceeding 10 4 CFU/mL were likely contaminated by common endospore‐forming bacteria found in soil or by bacteria in milk that was close to its expiration date. Conclusion In this study, 88% of the samples met the US Food Code criteria for safe food consumption; 10.7% met guidelines for marginal safety by other standards; and 1.3% slightly exceeded 10 5 CFUs. Established safe food‐handling procedures can minimize bacterial contamination of BTF and consequently reduce risk of food‐borne infection in HEN patients.

AbstractBackgroundMany healthcare facilities and providers prohibit blenderized tube feeding (BTF) for patients who request it due to concerns of high microbial load. The current project compared microbial loads of a standard ready‐to‐feed polymeric commercial formula (CF), a BTF made using baby food (BTF‐BF), and a BTF prepared from blending whole food (BTF‐WF), following food safety standards expected of U.S. hospitals.MethodsThree tube‐feeding formulas (CF, BTF‐BF, BTF‐WF) were prepared in a U.S. hospital and delivered in vitro to an unoccupied patient room. Samples were collected at zero hour, 2 hours, and 4 hours and compared for growth of aerobic microorganisms, Staphylococus aureus, coliforms, and Escherichia coli. The experiment was conducted in triplicate, 1 week apart.ResultsNo S. aureus or coliform/E. coli were detected at any time point following preparation, and total bacterial count was well below acceptable limits. All 3 feeding formulas at zero hour, 2 hours, and 4 hours for each of the 3 sampling dates were acceptable for human consumption.ConclusionJudicious BTF recipe selection and adherence to safe food handling provide a safe feeding substrate equivalent to CF in the hospital setting. Due to increased use and interest in BTF by patients and their caregivers, healthcare facilities may need to reexamine their policies prohibiting BTF use.