Fórmulas desidratadas para lactentes em ambientes hospitalares: Boas práticas de manipulação e qualidade microbiológica

Abstract

Formulas for infants may contain microbiological contaminants capable of causing infections, especially in more vulnerable infants. The preparation of infant formulas in hospital formula preparation rooms (FPR) must follow Good Hygiene Practices (GHP) to ensure food safety. The objective of this work was to elaborate an overview on the subject, and to evaluate the good handling practices and microbiological quality of reconstituted infant formulas in the hospital FPR of Espírito Santo, Brazil. The study was based on information from the health surveillance sector of the Espírito Santo Secretary of State for Health. Data were obtained by the health surveillance sector through inspection actions using a standardized checklist, consisting of 10 sections. The establishments were classified into groups according to the percentage of adequacy of the inspection checklist: Group 1 (≥76%), Group 2 (51-75.9%) and Group 3 (<51%). Sample collections for microbiological analysis were carried out through the food monitoring routine. The following assays were performed: Salmonella, B. cereus, E. coli, coagulase positive Staphylococcus, Enterobacteriaceae, total coliforms and mesophilic aerobic microorganisms. To analyze the GHP and microbiological quality data, a descriptive statistical analysis was performed. Pearson’s correlation test was performed between the section results. Data were obtained from 34 hospital FPR and reports from 69 samples of reconstituted formulas. The percentage of general adequacy of the evaluated FPR was 62.50%. With regard to the sections of cleaning materials, preparation process, labeling, conservation and transport, and quality assurance, most of the establishments (63.64%, 58.82%, 70.59% and 73.53%, respectively) were classified in Group 3 (<51% adequacy). The infrastructure section presented a very strong correlation with the personal hygiene section. Among the analyzed samples, 26.79%, 15.38% and 1.45% presented unsatisfactory results for total coliforms, Enterobacteriaceae and coagulase-positive Staphylococcus, respectively. The evaluation of the FPR revealed inadequate handling practices, contradicting recommendations for powdered formula preparation. The results of the microbiological analyses indicate the occurrence of failures. The current conditions for handling formulas in hospitals in Espírito Santo may pose a risk to the infant’s health.