Risk of Microbiological Contamination when Preparing Total Parenteral Nutrition for Pediatric Patients: A Pilot Study at a Regional Hospital in Southern Vietnam

Abstract

Hoang Thuy Linh, Trinh Xuan Tung, Trinh Huu Tung, Vo Quoc Bao, Le Thi Minh Hong, Pham Ngoc Thach, Nguyen Minh Ngoc, Luu Thanh Binh, Phan Trong Lan, Hoang Quoc Cuong, Nguyen Duc Hai, Nguyen Duy Long, Nguyen Thi Thu Phuong, Van Thi Thuy Linh, Pham Thi Mai Anh, Nguyen Thien Hai, Le Quan Nghiem, Nguyen Duc Tuan

Background: Total parenteral nutrition (TPN) presents a risk of contamination because it is a mixture of multiple additives and an excellent growth medium for microbes. In Vietnam, no official standard for TPN preparation has been established, thereby causing inconsistencies in implementation in healthcare facilities. We investigated the risk of microbiological contamination during the preparation of TPN for pediatric patients at a regional hospital in southern Vietnam.
Methods: This cross-sectional study was conducted from July to September 2019 at Children Hospital No. 2 in Ho Chi Minh City, southern Vietnam. Vaminolact 6.5% was the chosen TPN product for analysis. Collected bacterial samples were isolated in petri dishes containing nutrient agar as a solid growth medium. Each colony grown in the dish was subjected to Gram staining, after which species-specific identification was conducted on the basis of 16S ribosomal deoxyribonucleotide acid sequences.
Results: The results showed that after TPN preparation, ambient air in the laboratory contained contaminative agents. The bacteria isolated from medical devices and medical employees’ hands corresponded to colonies grown in two petri dishes. The bacterial species found included Moraxella osloensis, Micrococcus endophyticus, Micrococcus luteus, Macrococcus canis, Staphylococcus epidermidis, Brachybacterium muris, Micrococcus yunnanensis, Rothia amarae, Bacillus jeotgali, and Staphylococcus haemolyticus.
Conclusion: Disease-causing bacteria were found to proliferate during TPN preparation, highlighting the necessity of considering the risk of external contamination from sampling and testing.

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