Prevalence of bacterial contamination of powdered infant feeds in a hospital environment
Background The study arose as part of a nutrition model regarding the introduction of ready-to-use (RTU) infant feeds in place of powdered infant feeds (PIFs) as a standard formula for infants under the age of 1 year who are unable to be breastfed. Internationally and locally there is grave concern regarding the safety and efficacy of PIFs, especially in a hospital setting, and the resultant bacterial contamination causing enteric infections, in premature, immunocompromised and sick infants.
Objective. To evaluate the of bacterial contamination of PIPs given to infants at Red Cross War Memorial Children's Hospital, Cape Town.
Methods. Quantitative levels of bacterial contamination were determined and were expressed as colony-forming units (CFUs) per millilitre of sample. Aliquots of milk were inoculated onto agar, and the milk samples were then incubated at 25°C overnight (N = 10), 30°C overnight (N = 48) and 30°C for 6 hours (N 34). Post-incubation milk samples were cultured again Contamination was defined as any positive culture administration (i.e. pre incubation) or> 102 CFU/ ml after administration (i.e. post incubation).
Results. Fifty samples of PIFs (N 82) were contaminated pre incubation, with (30.4%) being heavily contaminated(> 104 CFU /ml). Post incubation, 43/92 samples (46.7%) were contaminated with> 102 CFU /mi. The acidified PIFs appeared to have some bactericidal effect against some of the organisms, but not all.
Conclusions. RTU infant feeds are sterile and are recommended for use in all hospitalised infants. The results of this study indicate that even when milk is prepared in a controlled environment there is bacterial contarnination of PIFs post production. As feeds are now readily available in South Africa every attempt should be made to use a sterile RTU system for hospitalised infants.
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