{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T23:39:09Z","timestamp":1792193949237,"version":"4.4.0"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2009,9,1]],"date-time":"2009-09-01T00:00:00Z","timestamp":1251763200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2009,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>The objective of this study was to determine whether neonatal nasogastric enteral feeding tubes are colonised by the opportunistic pathogen <jats:italic>Cronobacter<\/jats:italic> spp. (<jats:italic>Enterobacter sakazakii<\/jats:italic>) and other <jats:italic>Enterobacteriaceae<\/jats:italic>, and whether their presence was influenced by the feeding regime.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>One hundred and twenty-nine tubes were collected from two neonatal intensive care units (NICU). A questionnaire on feeding regime was completed with each sample. <jats:italic>Enterobacteriaceae<\/jats:italic> present in the tubes were identified using conventional and molecular methods, and their antibiograms determined.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The neonates were fed breast milk (16%), fortified breast milk (28%), ready to feed formula (20%), reconstituted powdered infant formula (PIF, 6%), or a mixture of these (21%). Eight percent of tubes were received from neonates who were 'nil by mouth'. Organisms were isolated from 76% of enteral feeding tubes as a biofilm (up to 10<jats:sup>7<\/jats:sup> cfu\/tube from neonates fed fortified breast milk and reconstituted PIF) and in the residual lumen liquid (up to 10<jats:sup>7<\/jats:sup>\n              <jats:italic>Enterobacteriaceae<\/jats:italic> cfu\/ml, average volume 250 \u03bcl). The most common isolates were <jats:italic>Enterobacter cancerogenus<\/jats:italic> (41%), <jats:italic>Serratia marcescens<\/jats:italic> (36%), <jats:italic>E. hormaechei<\/jats:italic> (33%), <jats:italic>Escherichia coli<\/jats:italic> (29%), <jats:italic>Klebsiella pneumoniae<\/jats:italic> (25%), <jats:italic>Raoultella terrigena<\/jats:italic> (10%), and <jats:italic>S. liquefaciens<\/jats:italic> (12%). Other organisms isolated included <jats:italic>C. sakazakii<\/jats:italic> (2%),<jats:italic>Yersinia enterocolitica<\/jats:italic> (1%),<jats:italic>Citrobacter freundii<\/jats:italic> (1%), <jats:italic>E. vulneris<\/jats:italic> (1%), <jats:italic>Pseudomonas fluorescens<\/jats:italic> (1%), and <jats:italic>P. luteola<\/jats:italic> (1%). The enteral feeding tubes were in place between &lt; 6 h (22%) to &gt; 48 h (13%). All the <jats:italic>S. marcescens<\/jats:italic> isolates from the enteral feeding tubes were resistant to amoxicillin and co-amoxiclav. Of additional importance was that a quarter of <jats:italic>E. hormaechei<\/jats:italic> isolates were resistant to the 3<jats:sup>rd<\/jats:sup> generation cephalosporins ceftazidime and cefotaxime. During the period of the study, <jats:italic>K. pneumoniae<\/jats:italic> and <jats:italic>S. marcescens<\/jats:italic> caused infections in the two NICUs.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>This study shows that neonatal enteral feeding tubes, irrespective of feeding regime, act as loci for the bacterial attachment and multiplication of numerous opportunistic pathogens within the <jats:italic>Enterobacteriaceae<\/jats:italic> family. Subsequently, these organisms will enter the stomach as a bolus with each feed. Therefore, enteral feeding tubes are an important risk factor to consider with respect to neonatal infections.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1471-2334-9-146","type":"journal-article","created":{"date-parts":[[2009,9,1]],"date-time":"2009-09-01T18:14:28Z","timestamp":1251828868000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":111,"title":["Neonatal enteral feeding tubes as loci for colonisation by members of the Enterobacteriaceae"],"prefix":"10.1186","volume":"9","author":[{"given":"Edward","family":"Hurrell","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Kucerova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Loughlin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juncal","family":"Caubilla-Barron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Hilton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Armstrong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Grant","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiu","family":"Shoo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Forsythe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2009,9,1]]},"reference":[{"key":"911_CR1","volume-title":"Meeting report, MRA series 6","author":"Food and Agriculture Organization\/World Health Organization (FAO\/WHO)","year":"2004","unstructured":"Food and Agriculture Organization\/World Health Organization (FAO\/WHO): Enterobacter sakazakii and other microorganisms in powdered infant formula. 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