Re-use of enteral feeding tubes--a potential hazard to the patient? A study of the efficiency of a representative range of cleaning and disinfection procedures.

ABSTRACT

Some hospitals and manufacturers are now recommending that patients (particularly those on home enteral feeding) remove and re-insert their tubes on a daily basis. This study was carried out to evaluate the effectiveness of a representative range of currently used cleaning procedures in removing bacteria from the lumina of these tubes. One thousand-ml portions of feed experimentally contaminated with 10(2)-10(3) Klebsiella aerogenes ml(-1) were perfused through three types of commonly used polyurethane enteral feeding tubes for 15 h. The tubes were then cleaned by a range of methods including rinsing them with sterile water, sterile water and detergent and/or disinfection with hypochlorite solution. A further 1000-ml sterile feed was then perfused through the tubes for 15 h and it was found that residual organisms in the tubes multiplied to yield levels of 10(6)-10(9) colony-forming units (cfu) ml(-1) in the feed collected from the distal ends of the tubes after 15 h. It is concluded that none of the cleaning methods tested can be recommended as being totally effective in removing bacteria from the lumina of contaminated tubes.