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Enteral Nutrition Contamination as a Risk Factor for Ventilator-Associated Pneumonia in ICU Patients: A Study from Northeast Iran
Baranoush Noufel , Elnaz Harifi Mood , Kiarash Ghazvini *
Department of Medical Microbiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Abstract:   (7 Views)
Introduction: Ventilator-associated pneumonia (VAP) is a critical complication in hospitalized patients, particularly in intensive care units (ICUs). Evidence indicates an association between enteral nutrition (EN) contamination and nosocomial pneumonia, primarily through microbial colonization and aspiration. Accurate data on causative agents are vital for effective infection control. This 10‑month study at Ghaem Hospital, Mashhad, Iran, assessed the incidence of VAP in ICU patients and evaluated the microbiological contamination levels of enteral nutrition and its association with VAP development. Methods: This prospective cohort study in an ICU evaluated 51 patients receiving EN via nasogastric tubes. Microbial contamination was assessed at four stages (preparation, ICU delivery, administration, and post-administration residual) (threshold ≥10³ CFU/mL). Univariate and multivariable logistic regression analyses were employed to determine the independent association between enteral contamination and the development of VAP. Results: Out of 51 patients, VAP incidence was 60.8% (n=31). Significant contamination (≥10³ CFU/mL), dominated by Gram-negative bacilli, occurred predominantly at the bedside (Stages 3 and 4). Significant enteral contamination (≥ 10³ CFU/mL) was universally identified in all patients who developed VAP, underscoring its critical role as a primary reservoir and a key factor in the development of nosocomial pneumonia in this cohort. Conclusion: Contamination of enteral feeding solutions frequently exceeds safe microbiological thresholds and serves as a significant independent risk factor for VAP in ICU patients. Our findings underscore the critical importance of implementing rigorous aseptic protocols during the preparation and administration of enteral nutrition at the bedside. Adopting these measures is essential to mitigate infection risks and improve clinical outcomes in critically ill patients.
Keywords: Hospital-acquired pneumonia, Enteral nutrition, Intensive care units, Ventilator-associated pneumonia, Microbial contamination, Iran
     
Type of Study: Short communication | Subject: Diagnostic/screening methods and protocols
Received: 2025/10/21 | Accepted: 2026/02/21
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Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.