Hazard analysis and critical control point system approach in the evaluation of environmental and procedural sources of contamination of enteral feedings in three hospitals
Autor(a) principal: | |
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Data de Publicação: | 2000 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://repositorio.unifesp.br/11600/44532 http://dx.doi.org/10.1177/0148607100024005296 |
Resumo: | Background: The administration of contaminated diets may contribute to severe infections, mainly in immunosuppressed patients. To determine the microbiologic quality of enteral feedings and the critical control points involved in the processing of the formulas, a study was carried out in three hospitals in Sao Paulo, Brazil. Methods: One hundred sixteen diets were evaluated according to the system known as hazard analysis and critical control points (HACCP). The techniques included the monitoring of the cleaning and disinfection of utensils, surfaces, and equipment; time and temperature controls; and microbiologic analyses that comprised the enumeration of facultative aerobic mesophilic bacteria, yeasts and molds, coliforms, and Escherichia coli. The diets were assessed based on the British Dietetic Association and the Food and Drug Administration standards. Results: The hospital-formulated diets and the commercially made powdered feeds presented statistically significant higher counts of mesophilic bacteria and percentages of no compliance with the standards for coliforms when compared with the commercially prepared, ready-to-feed enteral formula supplied in cans. According to the British standards, 77% and 38% of the diets were inadequate for mesophilic and coliform bacteria, respectively, just after preparation. After 24-hour storage in refrigerators, the percentages rose to 83% and 45%, respectively; the mesophilic and coliforms counts were also significantly higher. The following critical control points (CCP) were identified: cleaning and disinfecting of surfaces, utensils, and equipment; the time spent in preparation; the water used for reconstitution; the final temperature of the diet; the exposure to room temperatures; the lack of a chilling step; the refrigeration temperature; the inadequate disinfecting of the handlers' hands; and the lack of external cleaning and disinfecting of the cans before opening. Conclusions: The results of this study are worrisome and show the need for implementation of good practices of hygiene and handling of the diets, and the regular monitoring of their preparation. The microbiologic quality of the enteral diets was compromised according to international standards, representing a potential risk of infection to the patients who require enteral nutrition. |
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Carvalho, Maria Lucia RochaMorais, Tania BeningaAmara, Daniela FerrazSigulem, Dirce MariaUniv Fed Mato GrossoUniversidade Federal de São Paulo (UNIFESP)2018-06-15T18:07:31Z2018-06-15T18:07:31Z2000-09-01Journal Of Parenteral And Enteral Nutrition. Silver Spring: Amer Soc Parenteral & Enteral Nutrition, v. 24, n. 5, p. 296-303, 2000.0148-6071http://repositorio.unifesp.br/11600/44532http://dx.doi.org/10.1177/014860710002400529610.1177/0148607100024005296WOS:000089389700011Background: The administration of contaminated diets may contribute to severe infections, mainly in immunosuppressed patients. To determine the microbiologic quality of enteral feedings and the critical control points involved in the processing of the formulas, a study was carried out in three hospitals in Sao Paulo, Brazil. Methods: One hundred sixteen diets were evaluated according to the system known as hazard analysis and critical control points (HACCP). The techniques included the monitoring of the cleaning and disinfection of utensils, surfaces, and equipment; time and temperature controls; and microbiologic analyses that comprised the enumeration of facultative aerobic mesophilic bacteria, yeasts and molds, coliforms, and Escherichia coli. The diets were assessed based on the British Dietetic Association and the Food and Drug Administration standards. Results: The hospital-formulated diets and the commercially made powdered feeds presented statistically significant higher counts of mesophilic bacteria and percentages of no compliance with the standards for coliforms when compared with the commercially prepared, ready-to-feed enteral formula supplied in cans. According to the British standards, 77% and 38% of the diets were inadequate for mesophilic and coliform bacteria, respectively, just after preparation. After 24-hour storage in refrigerators, the percentages rose to 83% and 45%, respectively; the mesophilic and coliforms counts were also significantly higher. The following critical control points (CCP) were identified: cleaning and disinfecting of surfaces, utensils, and equipment; the time spent in preparation; the water used for reconstitution; the final temperature of the diet; the exposure to room temperatures; the lack of a chilling step; the refrigeration temperature; the inadequate disinfecting of the handlers' hands; and the lack of external cleaning and disinfecting of the cans before opening. Conclusions: The results of this study are worrisome and show the need for implementation of good practices of hygiene and handling of the diets, and the regular monitoring of their preparation. The microbiologic quality of the enteral diets was compromised according to international standards, representing a potential risk of infection to the patients who require enteral nutrition.Univ Fed Mato Grosso, Dept Nutr & Dietet, Sao Paulo, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Food Qual Control Lab, Sao Paulo, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Postgrad Program Nutr, Sao Paulo, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Food Qual Control Lab, Sao Paulo, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Postgrad Program Nutr, Sao Paulo, BrazilWeb of Science296-303engAmer Soc Parenteral & Enteral NutritionJournal Of Parenteral And Enteral NutritionHazard analysis and critical control point system approach in the evaluation of environmental and procedural sources of contamination of enteral feedings in three hospitalsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP11600/445322021-10-05 22:05:35.23metadata only accessoai:repositorio.unifesp.br:11600/44532Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652023-05-25T12:12:21.054747Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.en.fl_str_mv |
Hazard analysis and critical control point system approach in the evaluation of environmental and procedural sources of contamination of enteral feedings in three hospitals |
title |
Hazard analysis and critical control point system approach in the evaluation of environmental and procedural sources of contamination of enteral feedings in three hospitals |
spellingShingle |
Hazard analysis and critical control point system approach in the evaluation of environmental and procedural sources of contamination of enteral feedings in three hospitals Carvalho, Maria Lucia Rocha |
title_short |
Hazard analysis and critical control point system approach in the evaluation of environmental and procedural sources of contamination of enteral feedings in three hospitals |
title_full |
Hazard analysis and critical control point system approach in the evaluation of environmental and procedural sources of contamination of enteral feedings in three hospitals |
title_fullStr |
Hazard analysis and critical control point system approach in the evaluation of environmental and procedural sources of contamination of enteral feedings in three hospitals |
title_full_unstemmed |
Hazard analysis and critical control point system approach in the evaluation of environmental and procedural sources of contamination of enteral feedings in three hospitals |
title_sort |
Hazard analysis and critical control point system approach in the evaluation of environmental and procedural sources of contamination of enteral feedings in three hospitals |
author |
Carvalho, Maria Lucia Rocha |
author_facet |
Carvalho, Maria Lucia Rocha Morais, Tania Beninga Amara, Daniela Ferraz Sigulem, Dirce Maria |
author_role |
author |
author2 |
Morais, Tania Beninga Amara, Daniela Ferraz Sigulem, Dirce Maria |
author2_role |
author author author |
dc.contributor.institution.none.fl_str_mv |
Univ Fed Mato Grosso Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.author.fl_str_mv |
Carvalho, Maria Lucia Rocha Morais, Tania Beninga Amara, Daniela Ferraz Sigulem, Dirce Maria |
description |
Background: The administration of contaminated diets may contribute to severe infections, mainly in immunosuppressed patients. To determine the microbiologic quality of enteral feedings and the critical control points involved in the processing of the formulas, a study was carried out in three hospitals in Sao Paulo, Brazil. Methods: One hundred sixteen diets were evaluated according to the system known as hazard analysis and critical control points (HACCP). The techniques included the monitoring of the cleaning and disinfection of utensils, surfaces, and equipment; time and temperature controls; and microbiologic analyses that comprised the enumeration of facultative aerobic mesophilic bacteria, yeasts and molds, coliforms, and Escherichia coli. The diets were assessed based on the British Dietetic Association and the Food and Drug Administration standards. Results: The hospital-formulated diets and the commercially made powdered feeds presented statistically significant higher counts of mesophilic bacteria and percentages of no compliance with the standards for coliforms when compared with the commercially prepared, ready-to-feed enteral formula supplied in cans. According to the British standards, 77% and 38% of the diets were inadequate for mesophilic and coliform bacteria, respectively, just after preparation. After 24-hour storage in refrigerators, the percentages rose to 83% and 45%, respectively; the mesophilic and coliforms counts were also significantly higher. The following critical control points (CCP) were identified: cleaning and disinfecting of surfaces, utensils, and equipment; the time spent in preparation; the water used for reconstitution; the final temperature of the diet; the exposure to room temperatures; the lack of a chilling step; the refrigeration temperature; the inadequate disinfecting of the handlers' hands; and the lack of external cleaning and disinfecting of the cans before opening. Conclusions: The results of this study are worrisome and show the need for implementation of good practices of hygiene and handling of the diets, and the regular monitoring of their preparation. The microbiologic quality of the enteral diets was compromised according to international standards, representing a potential risk of infection to the patients who require enteral nutrition. |
publishDate |
2000 |
dc.date.issued.fl_str_mv |
2000-09-01 |
dc.date.accessioned.fl_str_mv |
2018-06-15T18:07:31Z |
dc.date.available.fl_str_mv |
2018-06-15T18:07:31Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
Journal Of Parenteral And Enteral Nutrition. Silver Spring: Amer Soc Parenteral & Enteral Nutrition, v. 24, n. 5, p. 296-303, 2000. |
dc.identifier.uri.fl_str_mv |
http://repositorio.unifesp.br/11600/44532 http://dx.doi.org/10.1177/0148607100024005296 |
dc.identifier.issn.none.fl_str_mv |
0148-6071 |
dc.identifier.doi.none.fl_str_mv |
10.1177/0148607100024005296 |
dc.identifier.wos.none.fl_str_mv |
WOS:000089389700011 |
identifier_str_mv |
Journal Of Parenteral And Enteral Nutrition. Silver Spring: Amer Soc Parenteral & Enteral Nutrition, v. 24, n. 5, p. 296-303, 2000. 0148-6071 10.1177/0148607100024005296 WOS:000089389700011 |
url |
http://repositorio.unifesp.br/11600/44532 http://dx.doi.org/10.1177/0148607100024005296 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.ispartof.none.fl_str_mv |
Journal Of Parenteral And Enteral Nutrition |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
296-303 |
dc.publisher.none.fl_str_mv |
Amer Soc Parenteral & Enteral Nutrition |
publisher.none.fl_str_mv |
Amer Soc Parenteral & Enteral Nutrition |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
collection |
Repositório Institucional da UNIFESP |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
|
_version_ |
1783460262579273728 |