Thirty-six intensive care unit patients, receiving aseptic or manually (routine) reconstituted enteral feeding formulas, were evaluated prospectively for the relationship of microbial involvement, gastric pH, and antimicrobial therapy to diarrhea. The routine protocol group had a significantly higher incidence of bacterial contamination than the aseptic protocol group (Fisher's exact test, p < 0.05). There were no significant direct associations between isolate category (Gram-negative bacilli, Gram-positive cocci, Gram-negative cocci, yeast), gastric pH, or antimicrobials and diarrhea. However, two organisms (Group D Enterococci and yeast) were indirectly implicated in some cases of diarrhea. (Journal of Parenteral and Enteral Nutrition 14:622-628, 1990)
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