The enteral feeding tube of a neonate may become colonized by Gram-negative bacteria. The presence of biofilms allows Enterobacteriaceae to survive and thrive in the environment.
Risk factors for problems:
(1) use of infant formula contaminated with Enterobacter sakazakii or other bacteria
(2) not handling the prepared formula properly, allowing it to sit at room temperature for some time
(3) failing to completely flush the tube after use, leaving formula or fluids within the tube
(4) keeping the same enteral feeding tube for a long period of time
(5) failure to the wash hands before and after an enteral feeding
(6) frequent reflux of gastrointestinal fluids into the lower opening of the tube
Colonization of a feeding tube by bacteria that are antibiotic resistant allows these organisms to persist and spread at the location. Feeding tubes should be included in any investigation of a bacterial outbreak in a neonatal intensive care unit.
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