A prospective observational study on microbiological isolation in low-profile gastrostomy's feeding extension sets in children on long-term home enteral nutrition.

Background: Although reuse of enteral feeding equipment has been linked to risk of microbial contamination and risk of infection, there is a paucity of research in this area. Per the manufacturer's instructions low-profile gastrostomy feeding extension sets (LPG-FES) may be reusable for the same patient, but there are no recommendations on replacement intervals.

Methods: We conducted a prospective observational study to analyze and compare the contamination rate of LPG-FES after 15 (T1) and after 30 days (T2) of regular use. We included children 2-18 years of age exclusively receiving long-term home enteral nutrition (HEN) via LPG.

Results: We included 17 patients with a median age of 5 years (interquartile range: 3-8 years). We did not find statistically significant differences in microbial overgrowth comparing LPG-FES obtained after 15 or 30 days of use, although overgrowth was slightly higher in LPG-FES used for 30 days (64.7% and 70.6% vs 52.9% and 58.8%). Every patient presented at least one positive culture, either in T1 or T2. Candida parapsilosis was globally the most frequent microbiological finding. We found no relation between duration of HEN and type of feeding and positive culture at T1 and T2. We found no symptoms of local nor systemic infection during the study period.

Conclusion: Despite the high rate of microbial overgrowth in the LPG-FES, no patient had clinical symptoms of infection secondary to this finding. Microbiological isolation in FES may represent only a form of contamination without clinical implications, which raises doubts on possible LPG-FES dwell times.