Microbial, nutritional and physical quality of commercial and hospital prepared tube feedings in Saudi Arabia.

OBJECTIVE Blenderized tube feedings (BTF) may present disadvantages over commercially prepared formulas (CPF). This study compares the microbial safety, nutritional content, and physical properties of BTF versus CPF. METHODS A total of 18 samples of BTF were collected from 3 hospitals in the Kingdom of Saudi Arabia from August 1999 through to November 1999. Samples of a CPF were collected for comparison. All samples were analyzed for nutritional content, microbial quality (aerobic plate counts, coliform counts, microorganism growth) and physical characteristics (viscosity, osmolality). RESULTS The nutrient content of BTF varied significantly within and between sites. The average intra site variability for all sites ranged from 16-50%. The average variability of the CPF was 4-7%. Between sites, the mean concentration of most nutrients varied by 2-3 fold. The BTF had considerable differences between actual and expected nutrient concentrations, reaching statistical significance in 12 nutrients. The measured concentration of most nutrients in the CPF was within 10% of expected values. The BTF samples had higher viscosity and osmolality than the CPF. All samples of BTF had detectable aerobic plate counts that increased significantly over 4 hours (p<0.0005). Coliform contamination varied between sites, with 100% contamination at one site. No aerobic plate counts or coliform counts were detected in the CPF samples. CONCLUSION There is a high degree of variability in nutrient content and physical properties with BTF. Furthermore, BTF are highly contaminated, increasing the risk of nosocomial infections. For these reasons, CPF should replace BTF.