Home Print this page Email this page Small font size Default font size Increase font size
Users Online: 621
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Contacts Login 


 
 Table of Contents  
LETTER TO THE EDITOR
Year : 2020  |  Volume : 9  |  Issue : 1  |  Page : 60

The necessity of an aseptic environment for the preparation of enteral feeding solutions in iranian hospitals


Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran

Date of Submission06-Jan-2020
Date of Acceptance22-Jan-2020
Date of Web Publication28-Mar-2020

Correspondence Address:
Dr. Ali Rismanbaf
Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan
Iran
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jrpp.JRPP_20_1

Rights and Permissions

How to cite this article:
Rismanbaf A. The necessity of an aseptic environment for the preparation of enteral feeding solutions in iranian hospitals. J Res Pharm Pract 2020;9:60

How to cite this URL:
Rismanbaf A. The necessity of an aseptic environment for the preparation of enteral feeding solutions in iranian hospitals. J Res Pharm Pract [serial online] 2020 [cited 2020 Jun 3];9:60. Available from: http://www.jrpp.net/text.asp?2020/9/1/60/281551

Dear Editor,

Enteral feeding (EF) was first introduced in the early twentieth century and is nowadays one of the most common nutritional supportive measures for hospital-admitted patients who are unable to eat orally, but their digestive system still can digest and absorb food. In general, EF nutrition solutions are prepared either by commercial formulas or by manually mixing the necessary nutrients. One of the most critical concerns regarding EF solutions is the possibility of microbial contamination that can occur due to high nutrient richness and risk factors that exist for microbial contamination in all stages of preparation, storage, and consumption of these solutions. On the other hand, reports show that microbial contamination of EF solutions can slow down the recovery process of patients, decrease solutions expected nutritional value, and create dangerous conditions for patients, such as pneumonia, sepsis, and nosocomial infections. Accordingly, standards are developed to evaluate the microbial load of EF solutions, and the US Food and Drug Administration standards are the most valid of them.

Studies on microbial contamination of EF solutions in Iran in two intensive care units (ICUs) of university hospitals in Isfahan (the second-largest city of Iran) showed that microbial contamination of handmade solutions prepared in hospital catering was significantly above the acceptable standard levels even immediately after preparation and also after 18 h of their normal storage. These microbial contaminations increased dramatically in proportionate to the time elapsed from the preparation time.[1] However, it is reported that microbial contamination of handmade solutions prepared in the ICUs of Imam Reza and Shohada hospitals in Tabriz (northwest of Iran) comply with the standards, both at the time of preparation and 18 h after storage.[2] In Tabriz hospitals, solutions are prepared in a cleanroom, while in hospitals of Isfahan, the preparation is done in hospital catering which can show the significant role of aseptic environment in preventing contamination of EF solutions.[1],[2] Further, studies in the ICUs of Imam Reza and Shohada hospitals in Tabriz and a university hospital in Isfahan reported that commercial formulations also have microbial contamination beyond the standards and even more than handmade solutions immediately after preparation that should be doubted whether commercial products are manufactured and packaged in aseptic conditions.[2],[3] Consequently, according to the results of studies and the unreliability of commercial products, it can be hypothesized that preparing handmade solutions in an aseptic environment, preferably cleanroom, is the safest way to prepare solutions, and it can be a preventative factor for the spread of nosocomial infections and diseases with high mortality in hospitals.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Jalali M, Sabzghabaee AM, Badri SS, Soltani HA, Maracy MR. Bacterial contamination of hospital-prepared enteral tube feeding formulas in Isfahan, Iran. J Res Med Sci 2009;14:149-56.  Back to cited text no. 1
    
2.
Mahinkazemi M, Tarighat-Esfanjani A, Safaiyan A. Bacterial contamination and nutritional adequacy of enteral tube feedings in Iran. Progr Nutr 2017;19:283-90.  Back to cited text no. 2
    
3.
Baniardalan M, Sabzghabaee AM, Jalali M, Badri S. Bacterial safety of commercial and handmade enteral feeds in an Iranian teaching hospital. Int J Prev Med 2014;5:604-10.  Back to cited text no. 3
    




 

Top
 
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
References

 Article Access Statistics
    Viewed209    
    Printed8    
    Emailed0    
    PDF Downloaded28    
    Comments [Add]    

Recommend this journal