When Is It Safe to Feed After Surgical Feeding Tube Placement? A Survey of EAST Members.

INTRODUCTION: Many critically ill trauma and surgical patients require nutritional support. Patients needing long-term enteral access often undergo placement of surgical feeding tubes, including percutaneous endoscopic gastrostomy tube, laparoscopic gastrostomy tube, and open gastrostomy tube. This study was performed to determine national practice patterns for feeding after feeding tube placement. METHODS: A 16-question online survey was administered to members of the Eastern Association for the Surgery of Trauma via Qualtrics about feeding practices after placement of the feeding tube. Questions included demographics, training, current practice, annual procedural volume, timing to resume feeds: <2, 6, 12, or 24 h, methods to advance feeds, and reasons behind management decisions. For comparison, responses were grouped into "early" (≤6 h) and "late" (18-24 h) groups. The chi-square test was used, and P < 0.05 was significant. RESULTS: Five hundred sixteen Eastern Association for the Surgery of Trauma members completed the survey. Most (95%) respondents worked at a level 1 or 2 trauma center, and 68% are in academic practice. The most common feeding tube placement was percutaneous endoscopic gastrostomy (median = 25/y, interquartile range = 15-40). Responses showed variability in timing of when feeds were resumed after procedure. Early feeding was not affected by age (≤42 y), trauma center designation, volume, or training programs at the respondent's hospital. Graduates of surgical critical care fellowship were less likely to feed early (P = 0.043). CONCLUSIONS: There is wide variability in feeding practices after surgical feeding tube placement. Given the large quantity of procedures performed, a randomized controlled trial should be performed to determine the optimal timing to resume feeds in critically ill patients.

Complete Genome Sequences of 18 Paenibacillus larvae Phages from the Western United States.

We present here the complete genomes of 18 phages that infect Paenibacillus larvae, the causative agent of American foulbrood in honeybees. The phages were isolated between 2014 and 2016 as part of an undergraduate phage discovery course at Brigham Young University. The phages were isolated primarily from bee debris and lysogens.

Complete Genome Sequences of Paenibacillus larvae Phages BN12, Dragolir, Kiel007, Leyra, Likha, Pagassa, PBL1c, and Tadhana.

We present here the complete genomes of eight phages that infect Paenibacillus larvae, the causative agent of American foulbrood in honeybees. Phage PBL1c was originally isolated in 1984 from a P. larvae lysogen, while the remaining phages were isolated in 2014 from bee debris, honeycomb, and lysogens from three states in the USA.