Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025;81(3):150-159.
doi: 10.1159/000543972. Epub 2025 Feb 5.

Microbial Contamination of Percutaneous Endoscopic Gastrostomy Tube and Nasogastric Tube with Drug-Resistant Bacteria

Shota Kanamori  1   2 , Hiroaki Koya  2 , Naomi Kurata  3   4 , Keiko Ishino  1
Affiliations

Microbial Contamination of Percutaneous Endoscopic Gastrostomy Tube and Nasogastric Tube with Drug-Resistant Bacteria

Shota Kanamori et al. Ann Nutr Metab. 2025.

Abstract

Introduction: Enteral nutrition is used in patients with stroke, head-and-neck or esophageal cancer surgery, or repeated aspiration pneumonia. Japanese enteral nutrition guidelines recommend percutaneous endoscopic gastrostomy tube (PEG) for long-term use of >4 weeks and nasogastric tube (NGT) for short-term use of <4 weeks. Catheters may be contaminated with microorganisms because enteral feeding products passed through them daily, but there are few reports on catheter contamination in Japan and no reports on the duration of catheter use. There are also reports that enteral feeding is a risk factor for the appearance of drug-resistant bacteria. Therefore, this study aimed to determine whether microorganisms could be isolated from enteral feeding catheters and determine the percentage of drug-resistant bacteria.

Methods: Forty-six PEGs and 59 NGTs were collected at Showa University Hospital and Showa University Fujigaoka Rehabilitation Hospital from May 2019 to March 2020. Microorganisms were cultured by incubating 20 mL pass/wash solution of sterile purified water on BHI agar medium (37°C) for 24-72 h. The strains were isolated and cultured, then frozen (80°C) and stored. Antimicrobial susceptibility was determined by broth microdilution method.

Results: Microorganisms were detected in 37 PEGs and 57 NGTs (p = 0.007). Bacteria were detected in 27 PEGs and 53 NGTs (p < 0.001), and yeasts were detected in 29 PEGs and 28 NGTs (p = 0.112). Drug-resistant bacteria were isolated from 19.6% (9 of 46) in PEGs and 23.7% (14 of 59) in NGTs.

Conclusions: PEGs and NGTs were contaminated with microorganisms, and drug-resistant bacteria were isolated. This study provides a rationale for future appropriate use in enteral feeding catheters.

Keywords: Bacteria; Drug-resistant bacteria; Enteral feeding; Nasogastric tube; Percutaneous endoscopic gastrostomy.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1.
Fig. 1.
CFU concentrations for PEGs and NGTs.
Fig. 2.
Fig. 2.
CFU concentrations and duration of catheter use for PEGs.
Fig. 3.
Fig. 3.
CFU concentrations and duration of catheter use for NGTs.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. JASPEN , Guidelines for venous enteral nutrition. 3rd ed. Tokyo: Shorinsha; 2016. Available from: https://minds.jcqhc.or.jp/common/wp-content/plugins/pdfjs-viewer-shortco...
    1. Okuma T, Nakamura M, Totake H, Fukunaga Y. Microbial contamination of enteral feeding formulas and diarrhea. Nutrition. 2000;16(9):719–22. - PubMed
    1. Casewell MW, Cooper JE, Webster M. Enteral feeds contaminated with Enterobacter cloacae as a cause of septicaemia. Br Med J Clin Res Ed. 1981;282(6268):973. - PMC - PubMed
    1. Sano M, Shindo Y, Takahashi K, Okumura J, Sakakibara T, Murakami Y, et al. . Risk factors for antibiotic resistance in hospital-acquired and ventilator-associated pneumonia. J Infect Chemother. 2022;28(6):745–52. - PubMed
    1. Koya H, Ishino K, Kishimoto M, Kurata N. Comparison of methods for cleaning enteral feeding tube junctions of the new international standard (ISO 80369-3). Ann Nutr Metab. 2022;78(4):207–12. - PMC - PubMed

MeSH terms