Abstract

Nasogastric tube feeding is the most common and oldest form of interventional feeding. The oropharynx of nasogastric tube fed elderly patients provides an ecosystem that promotes the colonization of Pseudomonas aeruginosa. The study was conducted to determine the incidence of P. aeruginosa isolation from the oropharynx of nasogastric tube fed elderly patients and explore its antibiotic sensitivity. The work was carried on 60 geriatric patients who were admitted in the surgical and medical ICUs of El-Demerdash Hospital. The patients were suffering from an active disease and require close medical supervision, 30 control subjects matched orally fed who resident in the same wards were included. Sterile cotton swab was applied to the dorsum of the tongue rubbing buccal mucosa and the oropharyngeal region, for microbiological culture and DNA extraction of P. aeruginosa for real time polymerase reaction. Incidence of P. aeruginosa isolation in the nasogastric tube fed patients was 43.3% in comparison to 3.3% in the control orally fed group. 57% of these patient sample were reported negative by both culture and real time polymerase chain reaction (PCR), 40% were positive by both methods, none was positive only by culture whereas 3% were positive only by real time PCR. The only single positive case in the control group was positive by both methods. The antibiotic sensitivity of the isolated P. aeruginosa in the patient group was detected according to the Clinical laboratory standard institute guidelines (CLSI, 2007) and reported multidrug resistant P. aeruginosa as 15% whereas the single positive control case was sensitive to all tested antibiotics. There is an urgent need to develop and investigate new effective antiseptic compounds and adopt oral health care techniques for elderly patients with nasogastric tube feeding.

Key words: Pseudomonas aeruginosa, nasogastric tube (NGT), clinical laboratory standard institute (CLSI).