Assessment of the risk of contamination of enteral nutrition bottles based on the simulation of home use conditions and hygiene procedures.

BACKGROUND: Home-prepared enteral formulations are supplied to patients through enteral nutrition bottles, via a gravity bag or other container, which may be inadequately sanitized and reused more times than recommended by the manufacturer. Such procedures increase the risk of contamination and can compromise the patient's clinical outcome. In light of this, the present study aimed to assess the risk of contamination of enteral nutrition bottles by simulating home use conditions and hygiene procedures. METHODS: A simulation of bottle usage was conducted across the three categories of enteral nutrition (homemade enteral preparations, blended enteral preparations, and commercial enteral formulas) for 3 days, using three hygiene procedures reported by caregivers: use of detergent (DET); use of detergent and boiling water (DET+BW); and use of detergent and bleach (DET+BL). The microbiological contamination was determined by the analysis of aerobic mesophilic microorganisms. RESULTS: The bottles that were used for 3 days, regardless of the enteral nutrition category, were within the acceptable limit for aerobic mesophilic microorganisms (between <4 and 8.0 colony-forming units [CFU]/cm2) when sanitized using the DET+BW and DET+BL procedures. The enteral nutrition bottles, when cleaned using the DET procedure during the 3 days of usage, showed low microbial contamination (between <4 and 3.0 CFU/cm2) in blended preparation and commercial formula only. CONCLUSION: Thus, regardless of the enteral nutrition category, we found that the bottles can be used for 3 days, as long as the DET+BW or DET+BL hygiene procedure is applied and safe food handling measures are adopted.

Perspectives from individuals with low education and interviewers using the GloboDiet 24 h recall: a qualitative study.

The perception of individuals with low education about dietary assessments is not well explored and studying this may be beneficial to improve data collection. The study builds on previous quantitative studies by providing explanations for the observed lower performance of the 24-h recall method among low-educated individuals. A qualitative study was carried out in Brazil. First, trained interviewers attended a focus group via video conference. Next, individuals with low education, defined as less than 9 years of study, participated in semi-structured face-to-face interviews. Three main themes emerged from the focus groups and were contrasted with the interviews. Summarising, the establishment of adequate communication during the interview is of utmost importance among the low-educated population. Besides, the familiarity of individuals with food and nutrition favours the report of information. Lastly, the use of photographs for food portion quantification helps the dietary assessment although further investigations to improve their use are also needed.