Determination of Specific Critical Control Points in Orogastric Tube (OGT) Feeding Associated with Transmission of Nosocomial Pathogens at the Neonatal Intensive Care Unit (NICU) of a Tertiary Government Hospital

Abstract

This pilot study was conducted to determine whether two of the commonly isolated pathogens in the Neonatal Intensive Care Unit (NICU) of a tertiary government hospital, Candida spp. and Burkholderi mallei, can be transmitted through OGT feeding of the neonates. Using two asymptomatic neonates with 28-32 weeks of gestation as subjects, samples were collected from possible critical control points - the pasteurized breast milk, syringe, OGT, syringe stand, air, and hands of the attending nurses, as well as from thefr stools. The target microbes were detected using selective culture media. The results of the study showed the presence of Candida spp. on the stands, syringes and OGT as well as the stools of the subject neonates. Analysis of the results suggests that contamination of Candida in OGT and syringe is most likely to be of endogenous origin. No B.mallei were observed on any of the possible critical control points suggesting that OGT feeding may not be associated with its transmission among the two subjects.. Antimicrobial susceptibility testing showed that the Candida isolates were all susceptible to fluconazole while one was intermediately susceptible to ketoconazole. Despite the finding that contaminations are of endogenous origins, Candida overgrowth on the OGT may possibly aggravate fungal colonization on the neonates.