Tehran University of Medical Sciences Iranian Journal of Microbiology 2008-3289 17 4 2025 07 29 606 612 EN Mohammad Yousefi Food and Beverages Safety Research Center, Urmia University of Medical Sciences, Urmia, Iran Kave Koorehpaz Department of Theriogenology, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran Morteza Bagheri Cellular and Molecular Research Center, Cellular and Molecular Medicine Research Institute, Urmia University of Medical Sciences, Urmia, Iran Yaghob Sharifi Department of Microbiology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran Amir Rahimirad Food and Drug Administration, Urmia University of Medical Sciences, Urmia, Iran Yousef Roosta Department of Internal Medicine, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran 2025 03 07 2025 07 02 Background and Objectives: Enteral feeding solutions (gavage) play a vital role in supporting ICU patients who cannot eat by mouth. However, their preparation is vulnerable to microbial contamination, posing serious health risks. This study aimed to assess and improve the microbial safety of enteral feeding solutions prepared at Imam Khomeini Hospital in Urmia, Iran. Materials and Methods: A three-phase intervention was conducted involving microbial and PCR analyses, source identification, and corrective measures. Initial testing revealed high contamination levels: coliform bacteria (>5×10³ CFU/mL), fungi (>3×10³ CFU/mL), and total mesophilic bacteria (>10⁴ CFU/mL). PCR analysis confirmed the absence of Escherichia coli and Klebsiella spp. Corrective actions—such as installing UV lighting, implementing enhanced cleaning protocols, and replacing the mixing device—were introduced. Results: Post-intervention analyses showed complete elimination of detectable microbial contamination in the gavage solutions. Conclusion: This study demonstrates that implementing a HACCP-based approach can effectively eliminate microbial contamination in enteral feeding solutions. The findings support the development of national guidelines and highlight the importance of standardized safety practices to improve patient care in hospital settings. https://ijm.tums.ac.ir/index.php/ijm/article/view/5336 https://ijm.tums.ac.ir/index.php/ijm/article/download/5336/1804