Document Detail

Pathogenic colonization of the stomach in enterally fed elderly patients: Comparing percutaneous endoscopic gastrostomy with nasogastric tube.
MedLine Citation:
PMID:  17198497     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To compare the gastric juice microbiota of older people fed through a percutaneous endoscopic gastrostomy tube (PEG) with that of those fed through a nasogastric tube (NGT). DESIGN: Prospective comparative study. SETTING: Nursing and skilled nursing wards. PARTICIPANTS: Fifty-four elderly PEG-fed and 52 NGT-fed patients. MEASUREMENTS: Cultures from the oropharynx and the gastric juice. RESULTS: Pathogenic bacteria were isolated from the oropharynxes of 44% of the PEG-fed patients and 54% of the NGT-fed patients. The most frequent gram-negative bacilli isolated from the oropharynx were Proteus spp. (13-21%) and Pseudomonas aeruginosa (13-18%), with no significant difference between the groups. Isolation rates from the gastric juice were significantly more frequent in the NGT-fed patients than in the PEG-fed patients for Proteus spp. (4% vs 23%), Escherichia coli (6% vs 21%), and mixed flora (11% vs 27%). Significant correlation was found between high gastric pH and the isolation of bacteria in both groups (correlation coefficient = 0.58, P < .001). CONCLUSION: Gastric juice of PEG-fed patients harbors pathogenic bacteria in significant numbers. No significant difference was noted with respect to the rate of isolation of pathogenic bacteria from the oropharynx between the groups. Major bacterial pathogens, such as P. aeruginosa and Proteus spp., were isolated significantly more from the gastric juice of NGT-fed patients. These results support the view that a bidirectional spread pattern of pathogens may take place in NGT-fed patients.
Refael Segal; Michael Dan; Irena Pogoreliuk; Arthur Leibovitz
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of the American Geriatrics Society     Volume:  54     ISSN:  0002-8614     ISO Abbreviation:  J Am Geriatr Soc     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2007-01-02     Completed Date:  2007-01-30     Revised Date:  2008-03-10    
Medline Journal Info:
Nlm Unique ID:  7503062     Medline TA:  J Am Geriatr Soc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1905-8     Citation Subset:  IM    
Shmuel Harofeh Geriatric Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Beer-Yaakov, Israel.
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MeSH Terms
Aged, 80 and over
Enteral Nutrition / methods*
Gastric Juice / microbiology*
Gram-Negative Bacteria / isolation & purification*,  pathogenicity
Hydrogen-Ion Concentration
Intubation, Gastrointestinal*
Middle Aged
Prospective Studies

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