Feeding tube practices and the colonisation of the preterm stomach in the first week of life

INTRODUCTION. We aimed to determine if changing nasogastric feeding tubes more often would impact colonisation of the upper gastrointestinal tract of the premature infant. METHODS. We included 22 neonates born < 32 weeks gestation within 48 hours after birth. The neonates were randomised to have their feeding tubes changed on day seven or daily during the first week of life. We determined the bacterial concentration by the culture method in maternal milk samples, gastric aspirates and feeding tube flushes. Bacteria were identified by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF). The primary outcome was the concentration of bacteria in the gastric aspirate from a freshly placed nasogastric tube on day seven of life. RESULTS. Data from only 11 neonates were eligible for primary outcome analysis. We found no difference in bacterial concentration between the two groups with a mean colony-forming unit count per ml aspirate of 4.62 log 10 (standard deviation (SD): +/- 3.43) in the intervention group and 2.76 log 10 (SD: +/- 3.13) in the control group. Data from 19 neonates were eligible for analysis of secondary outcome measures. We found no statistically significant differences in the composition of the bacterial load between the two groups. Infants with a lower gastric pH had lower gastric bacterial counts. CONCLUSION. Changing the feeding tube daily rather than weekly in the first week of life did not result in reduced bacterial concentration in gastric aspirates. The bacterial load from the feeding tubes was low suggesting that contamination of feeding tubes did not affect early colonisation of the upper gastrointestinal tract.