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Krishnan CS, Tompkins GR, Lyons KM, Cannon RD. Electrolysed oxidising water as a multi-purpose biocide in dental healthcare-A scoping review. Gerodontology 2023; 40:422-462. [PMID: 37694292 DOI: 10.1111/ger.12712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVES The objective of this scoping review was to map evidence of electrolysed oxidising water (EOW) as a biocide for dental applications of relevance to older people and identify research gaps. BACKGROUND EOW is an emerging, "green," and cost-effective biocide. There are no reviews on the landscape of EOW research as either an antiseptic or disinfectant in dental healthcare or its suitability for the oral healthcare of older people. MATERIALS AND METHODS The review follows the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines. Database searches (Google Scholar, PubMed, Web of Science, Ovid, Scopus and Science Direct) were undertaken using MESH terms and Boolean operators with no date restrictions, to identify full-text, original reports published in English-language peer-reviewed journals. RESULTS The search yielded 114 papers that met the inclusion/exclusion criteria. Dental applications of EOW include its use as an endodontic irrigant (39%); mouth rinse/surgical irrigant (21%); disinfectant for dental unit water lines (19%) and dental biomaterials (17%); and for antimicrobial efficacy, effects on oral tissues and on dental material properties. Most studies (83%) evaluated a single EOW formulation (acidic, moderately acidic or neutral) that was either generated at 'point-of-use' (POU; 72%), bottled ('ready-to-use', RTU; 24%) or from unspecified (3%) sources. Six reports evaluated storage-related parameters and 25 evaluated clinical applications; 89 were in vitro studies and one investigated the cost-effectiveness of POU EOW. CONCLUSIONS Neutral-pH, EOW is effective as an antimicrobial agent without deleterious effects on oral tissues. However, research on the impact of storage conditions, anti-Candida biofilm efficacy and mechanism of action against yeasts, long-term effects on denture materials and cost-effectiveness is required to establish the suitability of EOW as a multipurpose biocide for dental healthcare, including infection-control requirements relating to older people.
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Affiliation(s)
- Chitra S Krishnan
- Department of Oral Sciences, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Geoffrey R Tompkins
- Department of Oral Sciences, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Karl M Lyons
- Department of Oral Rehabilitation, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Richard D Cannon
- Department of Oral Sciences, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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Hoogenkamp MA, Mazurel D, Deutekom-Mulder E, de Soet JJ. The consistent application of hydrogen peroxide controls biofilm growth and removes Vermamoeba vermiformis from multi-kingdom in-vitro dental unit water biofilms. Biofilm 2023; 5:100132. [PMID: 37346320 PMCID: PMC10279787 DOI: 10.1016/j.bioflm.2023.100132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 05/24/2023] [Accepted: 05/24/2023] [Indexed: 06/23/2023] Open
Abstract
The water systems inside a dental unit are known to be contaminated with a multi-kingdom biofilm encompassing bacteria, fungi, viruses and protozoa. Aerosolization of these micro-organisms can potentially create a health hazard for both dental staff and the patient. Very little is known on the efficacy of dental unit disinfection products against amoeba. In this study we have examined the effect of four different treatment regimens, with the hydrogen peroxide (H2O2) containing product Oxygenal, on an in-vitro multi-kingdom dental unit water system (DUWS) biofilm. The treatment efficacy was assessed in time using heterotrophic plate counts, the bacterial 16S rDNA, fungal 18S rDNA gene load and the number of genomic units for Legionella spp. the amoeba Vermamoeba vermiformis. The results indicated that a daily treatment of the DUWS with a low dose H2O2 (0.02% for 5 h), combined with a weekly shock dose (0.25% H2O2, 30 min) is necessary to reduce the heterotrophic plate count of a severely contaminated DUWS (>106 CFU.mL-1) to below 100 CFU.mL-1. A daily treatment with a low dose hydrogen peroxide alone, is sufficient for the statistically significant reduction of the total amount of bacterial 16S rDNA gene, Legionella spp. and Vermamoeba vermiformis load (p < 0.005). Also shown is that even though hydrogen peroxide does not kill the trophozoite nor the cysts of V. vermiformis, it does however result in the detachment of the trophozoite form of this amoeba from the DUWS biofilm and hereby ultimately removing the amoeba from the system.
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Affiliation(s)
- Michel A. Hoogenkamp
- Corresponding author. Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, the Netherlands.
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3
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Buitrago JM, Kolbe RJ, Siqueira MF. Dental unit waterline testing practices: an 11-Year retrospective study. BMC Oral Health 2023; 23:867. [PMID: 37968643 PMCID: PMC10652605 DOI: 10.1186/s12903-023-03590-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/27/2023] [Indexed: 11/17/2023] Open
Abstract
OBJECTIVES This retrospective study examined the dental unit waterline (DUWL) testing practices of Saskatchewan dental clinics over a period of 11 years, with an emphasis on their responses after identification of high microbial levels. MATERIALS AND METHODS Dental clinics (n = 137) aseptically collected samples of output water from their air/water syringes, handpieces, and ultrasonic scaler lines using Sigma-Aldrich® waterline test kits and delivered them to a quality assurance laboratory. Tests were incubated for seven days at room temperature, and those with heterotrophic plate counts > 500 CFU/mL were reported as failures. Statistical analyses were performed on a database containing 4,093 test results. RESULTS Participating clinics submitted an average of 11 DUWL tests per year. Overall, 21% of tests failed, and a moderate positive association (rs=.52, p < 0.001) was found between clinics' DUWL testing frequency and failure rate. Only 7% of failed DUWL tests were followed up by collection of a subsequent test within two weeks, of which 47% still exceeded the 500 CFU/mL threshold. CONCLUSIONS Our findings demonstrate an association between DUWL testing frequency and detection of unacceptable microbial levels, along with infrequent retesting and often-inadequate intervention after a failed test. This suggests the need for further efforts at the regulatory and educational levels to maintain adequate water quality during dental treatment. CLINICAL RELEVANCE Procedural water can become contaminated in DUWLs and endanger patients. Regular DUWL monitoring and evidence-based interventions to treat contaminated systems are necessary to safeguard patient health.
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Affiliation(s)
- Juan M Buitrago
- College of Dentistry, University of Saskatchewan, Saskatoon, SK, Canada
| | - Rob J Kolbe
- College of Dentistry, University of Saskatchewan, Saskatoon, SK, Canada
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El Meligy OA, Elemam NM, Talaat IM. Ozone Therapy in Medicine and Dentistry: A Review of the Literature. Dent J (Basel) 2023; 11:187. [PMID: 37623283 PMCID: PMC10453584 DOI: 10.3390/dj11080187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/23/2023] [Accepted: 08/02/2023] [Indexed: 08/26/2023] Open
Abstract
Ozone has been successfully used in medicine for over 100 years due to its microbiological qualities. Its powerful oxidation impact, which results in the production of free radicals, and its ability to cause the direct death of nearly all microorganisms is the basis for its bactericide, virucide, and fungicide properties. Ozone also has a medicinal impact that speeds up blood flow and aids wound healing. Ozone may be applied as a gas or dissolved in water for medical purposes. Despite the benefits of using ozone therapeutically, concerns about its use in dentistry still exist. We aimed to provide a summary of the current uses of ozone in medicine and dentistry. An electronic search was performed for all English scientific papers published between 2012 and 2023 using PubMed, Cochrane, and Google Scholar search engines. Ozone, clinical applications, medicine, and dentistry were the search terms used. Seventy full-text articles describing the use of ozone therapy in medicine and dentistry were included in the present review. Ozone has shown several beneficial effects in the medical field. However, despite the encouraging in vitro evidence, the clinical use of ozone in dentistry has not yet been demonstrated as highly effective.
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Affiliation(s)
- Omar A. El Meligy
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
- Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Alexandria University, Alexandria 21131, Egypt
| | - Noha M. Elemam
- Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates
- Research Institute of Medical & Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Iman M. Talaat
- Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates
- Research Institute of Medical & Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
- Pathology Department, Faculty of Medicine, Alexandria University, Alexandria 21131, Egypt
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Marino F, Mazzotta M, Pascale MR, Derelitto C, Girolamini L, Cristino S. First water safety plan approach applied to a Dental Clinic complex: identification of new risk factors associated with Legionella and P. aeruginosa contamination, using a novel sampling, maintenance and management program. J Oral Microbiol 2023; 15:2223477. [PMID: 37346998 PMCID: PMC10281406 DOI: 10.1080/20002297.2023.2223477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/18/2023] [Accepted: 06/06/2023] [Indexed: 06/23/2023] Open
Abstract
Dental unit waterlines (DUWLs) represent a complex environment able to promote microbial contamination, due to functional, mechanical and practical risk factors. According to a water safety plan approach, the main goal is to preserve the health of dentists, dental staff and patients. The aim of this study is to develop a DUWLs water safety plan that is able to support correct and effective maintenance and disinfection procedures. Three different water systems serve 60 dental chairs: (i) water that comes directly from municipal water (Type A), (ii) water supplied by municipal water and water bottles (Type B) and (iii) water supplied only via water bottles (Type C). For each type, Legionella and Pseudomonas aeruginosa contamination was studied, by applying a new sampling scheme, based on separate sampling from water bottles, cup filler and handpieces. Type B DUWL is the only type of DUWL contaminated by L. pneumophila (ST 59) and L. anisa (mean contamination: 608.33 ± 253.33 cfu/L) detected in cup filler and handpieces, as well as the high presence of P. aeruginosa (44.42 ± 13.25 cfu/100 mL). Two subsequent shock treatments and resampling procedures were performed by increasing disinfectant dosage and contact time and removing some DUWL components linked to biofilm growth in DUWLs. A significant reduction of contamination was obtained for both microorganisms (Legionella spp.: -100%, p < 0.001 and P. aeruginosa: -99.86%, p = 0.006). The sampling strategy proposed allows us to identify the source of contamination and better focus on the maintenance and disinfection procedures. DUWLs represent an environment that requires a multidisciplinary approach, combining the knowledge of all DUWL components to correct procedures that are able to preserve the health of personnel and patients, as well as guaranteeing DUWLs' safe functionality.
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Affiliation(s)
- Federica Marino
- Department of Biological, Geological, and Environmental Sciences, University of Bologna, Bologna, Italy
| | - Marta Mazzotta
- Department of Biological, Geological, and Environmental Sciences, University of Bologna, Bologna, Italy
| | - Maria Rosaria Pascale
- Department of Biological, Geological, and Environmental Sciences, University of Bologna, Bologna, Italy
- Department of Civil, Chemical, Environmental and Materials Engineering, University of Bologna, Bologna, Italy
| | - Carlo Derelitto
- Department of Biological, Geological, and Environmental Sciences, University of Bologna, Bologna, Italy
| | - Luna Girolamini
- Department of Biological, Geological, and Environmental Sciences, University of Bologna, Bologna, Italy
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Legionella Infections (ESGLI), Basel, Switzerland
| | - Sandra Cristino
- Department of Biological, Geological, and Environmental Sciences, University of Bologna, Bologna, Italy
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Legionella Infections (ESGLI), Basel, Switzerland
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Combined Use of Antimicrobial Peptides with Antiseptics against Multidrug-Resistant Bacteria: Pros and Cons. Pharmaceutics 2023; 15:pharmaceutics15010291. [PMID: 36678918 PMCID: PMC9863607 DOI: 10.3390/pharmaceutics15010291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 01/18/2023] Open
Abstract
Antimicrobial peptides (AMPs) are acknowledged as a promising template for designing new antimicrobials. At the same time, existing toxicity issues and limitations in their pharmacokinetics make topical application one of the less complicated routes to put AMPs-based therapeutics into actual medical practice. Antiseptics are one of the common components for topical treatment potent against antibiotic-resistant pathogens but often with toxicity limitations of their own. Thus, the interaction of AMPs and antiseptics is an interesting topic that is also less explored than combined action of AMPs and antibiotics. Herein, we analyzed antibacterial, antibiofilm, and cytotoxic activity of combinations of both membranolytic and non-membranolytic AMPs with a number of antiseptic agents. Fractional concentration indices were used as a measure of possible effective concentration reduction achievable due to combined application. Cases of both synergistic and antagonistic interaction with certain antiseptics and surfactants were identified, and trends in the occurrence of these types of interaction were discussed. The data may be of use for AMP-based drug development and suggest that the topic requires further attention for successfully integrating AMPs-based products in the context of complex treatment. AMP/antiseptic combinations show promise for creating topical formulations with improved activity, lowered toxicity, and, presumably, decreased chances of inducing bacterial resistance. However, careful assessment is required to avoid AMP neutralization by certain antiseptic classes in either complex drug design or AMP application alongside other therapeutics/care products.
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Khajezadeh M, Mohseni F, Khaledi A, Firoozeh A. Contamination of dental unit water lines (DUWL) with Legionella pneumophila and Pseudomonas aeruginosa; A Middle East systematic review and meta-analysis. Eur J Microbiol Immunol (Bp) 2023; 12:93-99. [PMID: 36626121 PMCID: PMC9869867 DOI: 10.1556/1886.2022.00023] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 12/12/2022] [Indexed: 01/11/2023] Open
Abstract
This review aimed to evaluate the contamination rate of dental unit waterlines (DUWL) with Pseudomonas aeruginosa and Legionella pneumophila in several countries in the Middle East.Literature search was conducted in databases such as PubMed, Scopus, Web of Science, and Google Scholar to gather studies published from the beginning of 2000 to 30th April 2020. Medical Subject Headings (MeSH) terms were; "Legionellosis"; "Legionnaire", "Legionellosis", "L. pneumophila", "dent", "dental", "dentistry", "Dental Unit Waterlines", "dental water", "DUWL", "Middle East", "P. aeruginosa", "Iran", "Turkey", "Iraq", and "Jordan". The search was independently conducted by two of the authors. Data was analyzed using Comprehensive Meta-Analysis software.Almost all studies included in this review reported a high rate of bacterial contamination of DUWL, which exceeded the current standard bacterial contamination level of <200 (CFU) mL-1 recommended by the American Dental Association (ADA). The combined prevalence of L. pneumophila from four countries (Iran, Jordan, Turkey, and Iraq) was 23.5% (95% Cl: 6.5-57.7), and the combined prevalence of P. aeruginosa was reported 21.7% (95% Cl: 7.1-50.1%).This study showed a high bacterial contamination rate of DUWL with opportunistic pathogens. So, it is recommended to prevent biofilm formation in DUWL, some measures should be extended by practical approaches allowing for water quality control and improvement on-site in the dental practices such as mobile filtration units, chlorination and disinfection chemicals.
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Affiliation(s)
- Masoud Khajezadeh
- Cellular and Molecular Gerash Research Center, Gerash University of Medical Sciences, Gerash, Iran
| | - Fatemeh Mohseni
- Department of Anesthesiology, Nursing School, Gerash University of Medical Sciences, Gerash, Iran,Department of Medical Education, Medical School, Tehran University of Medical Sciences, Tehran, Iran
| | - Azad Khaledi
- Infectious Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran,Department of Microbiology and Immunology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Arezoo Firoozeh
- Department of Microbiology, Mashhad University of Medical Sciences, Mashhad, Iran,Corresponding author. Tel.: +989304347901. E-mail:
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Cárdenas AM, Campos-Bijit V, Di Francesco F, Schwarz F, Cafferata EA, Vernal R. Electrolyzed water for the microbiologic control in the pandemic dental setting: a systematic review. BMC Oral Health 2022; 22:579. [PMID: 36494635 PMCID: PMC9733258 DOI: 10.1186/s12903-022-02528-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 10/21/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Electrolyzed water has brought recent attention due to its antimicrobial properties. Indeed, electrolyzed water has been proposed to sterilize dental materials and instruments without compromising their structural integrity. In addition, electrolyzed water has been proposed as a mouthwash to control bacterial and viral oral infections without detrimental effects on the oral mucosa. However, no current consensus or evidence synthesis could indicate its potentially favorable use in the dental setting, particularly during the COVID-19 context. Therefore, this systematic review aimed to elucidate whether electrolyzed water could improve microbiologic control in the COVID-19 pandemic dental setting. METHODS MEDLINE via Pubmed, EMBASE, Cochrane's CENTRAL, Scopus, LILACS, and Web of Science databases were searched up to September 2021 to identify experimental studies utilizing electrolyzed water for eliminating microorganisms in a dental setting. Besides, a manual and a grey literature search were performed. The data selection and extraction were performed individually and in duplicate. The Risk of Bias (RoB) was assessed with the Nature Publication Quality Improvement Project (NPQIP) score sheet. The study protocol was registered at PROSPERO CRD42020206986. RESULTS From a total of 299 articles, 63 studies met the inclusion criteria. The included studies assessed several types of electrolyzed waters, which showed a high disinfection potential when used to deal with different oral conditions. Electrolyzed water demonstrated a broad antimicrobial spectrum and was highly efficient in the dental office disinfection against viruses, fungi, and bacteria, being compatible with most dental materials. In addition, electrolyzed water could protect against SARS-CoV-2 infection and contamination in the dental office. Regarding the RoB, only 35.18% of entries were answered as 'Yes', thus achieving less than half of the reporting sheet. CONCLUSION Electrolyzed water effectively disinfects contaminated surfaces, dental materials, and equipment. Therefore, their use is recommendable in the SARS-CoV-2 pandemic dental setting.
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Affiliation(s)
- Angélica M. Cárdenas
- grid.443909.30000 0004 0385 4466Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Sergio Livingstone Pohlhammer 943, 8380492 Santiago, Independencia Chile ,grid.442190.a0000 0001 1503 9395Faculty of Dentistry, Universidad Santo Tomás, Bucaramanga, Colombia ,Department of Science and Innovation, BIOMEP Research Group, Bucaramanga, Colombia
| | - Vanessa Campos-Bijit
- grid.443909.30000 0004 0385 4466Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Sergio Livingstone Pohlhammer 943, 8380492 Santiago, Independencia Chile
| | - Fabrizio Di Francesco
- grid.9841.40000 0001 2200 8888Multidisciplinary Department of Medical, Surgical and Dental Sciences, Campania University Luigi Vanvitelli, Naples, Italy
| | - Frank Schwarz
- grid.7839.50000 0004 1936 9721Department of Oral Surgery and Implantology, Carolinum, Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany
| | - Emilio A. Cafferata
- grid.7839.50000 0004 1936 9721Department of Oral Surgery and Implantology, Carolinum, Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany ,grid.430666.10000 0000 9972 9272Department of Periodontology, School of Dentistry, Universidad Científica del Sur, Av. Paseo de la República 5544, 15074 Lima, Miraflores Peru
| | - Rolando Vernal
- grid.443909.30000 0004 0385 4466Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Sergio Livingstone Pohlhammer 943, 8380492 Santiago, Independencia Chile
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Hata Y, Bouda Y, Hiruma S, Miyazaki H, Nakamura S. Biofilm Degradation by Seashell-Derived Calcium Hydroxide and Hydrogen Peroxide. NANOMATERIALS (BASEL, SWITZERLAND) 2022; 12:3681. [PMID: 36296871 PMCID: PMC9609215 DOI: 10.3390/nano12203681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/04/2022] [Accepted: 10/14/2022] [Indexed: 06/16/2023]
Abstract
Microbial cells and self-produced extracellular polymeric substances assembled to form biofilms that are difficult to remove from surfaces, causing problems in various fields. Seashell-derived calcium hydroxide, a sustainable inorganic material, has shown high bactericidal activity even for biofilms due to its alkalinity. However, its biofilm removal efficacy is relatively low. Herein, we report a biofilm degradation strategy that includes two environmentally friendly reagents: seashell-derived calcium hydroxide and hydrogen peroxide. A biofilm model of Escherichia coli was prepared in vitro, treated with calcium hydroxide-hydrogen peroxide solutions, and semi-quantified by the crystal violet stain method. The treatment significantly improved biofilm removal efficacy compared with treatments by calcium hydroxide alone and hydrogen peroxide alone. The mechanism was elucidated from calcium hydroxide-hydrogen peroxide solutions, which suggested that perhydroxyl anion and hydroxyl radical generated from hydrogen peroxide, as well as the alkalinity of calcium hydroxide, enhanced biofilm degradation. This study showed that concurrent use of other reagents, such as hydrogen peroxide, is a promising strategy for improving the biofilm degradation activity of seashell-derived calcium hydroxide and will contribute to developing efficient biofilm removal methods.
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Affiliation(s)
- Yuuki Hata
- Correspondence: (Y.H.); (S.N.); Tel.: +81-4-2995-1211 (Y.H. & S.N.)
| | | | | | | | - Shingo Nakamura
- Correspondence: (Y.H.); (S.N.); Tel.: +81-4-2995-1211 (Y.H. & S.N.)
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Totaro M, Badalucco F, Papini F, Grassi N, Mannocci M, Baggiani M, Tuvo B, Casini B, Menchini Fabris GB, Baggiani A. Effectiveness of a Water Disinfection Method Based on Osmosis and Chlorine Dioxide for the Prevention of Microbial Contamination in Dental Practices. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10562. [PMID: 36078275 PMCID: PMC9518534 DOI: 10.3390/ijerph191710562] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/17/2022] [Accepted: 08/23/2022] [Indexed: 06/15/2023]
Abstract
In dental clinics, the infections may be acquired through contaminated devices, air, and water. Aerosolized water may contain bacteria, grown into the biofilm of dental unit waterlines (DUWLs). We evaluated a disinfection method based on water osmosis and chlorination with chlorine dioxide (O-CD), applied to DUWL of five dental clinics. Municipal water was chlorinated with O-CD device before feeding all DUWLs. Samplings were performed on water/air samples in order to research total microbial counts at 22-37 °C, Pseudomonas aeruginosa, Legionella spp., and chlorine values. Water was collected from the taps, spittoons, and air/water syringes. Air was sampled before, during, and after 15 min of aerosolizing procedure. Legionella and P. aeruginosa resulted as absent in all water samples, which presented total microbial counts almost always at 0 CFU/mL. Mean values of total chlorine ranged from 0.18-0.23 mg/L. Air samples resulted as free from Legionella spp. and Pseudomonas aeruginosa. Total microbial counts decreased from the pre-aerosolizing (mean 2.1 × 102 CFU/m3) to the post-aerosolizing samples (mean 1.5 × 10 CFU/m3), while chlorine values increased from 0 to 0.06 mg/L. O-CD resulted as effective against the biofilm formation in DUWLs. The presence of residual activity of chlorine dioxide also allowed the bacteria reduction from air, at least at one meter from the aerosolizing source.
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Affiliation(s)
- Michele Totaro
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
| | - Federica Badalucco
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
| | - Francesca Papini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
| | - Niccolò Grassi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
| | - Marina Mannocci
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
| | | | - Benedetta Tuvo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
| | - Beatrice Casini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
| | | | - Angelo Baggiani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
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11
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Umer F, Khan M, Khan FR, Tejani K. Managing dental unit waterlines: a quality improvement programme. BMJ Open Qual 2022; 11:bmjoq-2021-001685. [PMID: 35667705 PMCID: PMC9171218 DOI: 10.1136/bmjoq-2021-001685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 05/17/2022] [Indexed: 11/25/2022] Open
Abstract
The presence of bacterial biofilms within dental unit waterlines (DUWLs) can cause secondary bacterial infections in immunocompromised patients. As a result, the management of biofilms within waterlines has always concerned medical and dental professionals. In February 2020, an internal audit identified the high bacterial counts within the DUWLs at the Aga Khan University Hospital, Karachi and this paper discusses a pragmatic approach to improving the water quality of DUWLs. A three-person committee was developed and the area for improvement was identified as the contaminated DUWLs. Distilled water samples from two dental units were first assessed as baseline in July 2020. The process changes were then implemented which included daily flushing of the dental unit waterlines and ‘shock treatment’ using A-dec ICX capsules. Subsequently, the units were tested after intervention on 24 August 2020 and water from all 16 dental units assessed on 20 November 2020 and again on 22 April 2021. The samples from all the dental units assessed showed marked reduction in bacterial counts and compliance with the Centers for Disease Control guidelines after intervention. All the dental units showed minimal bacterial counts; however, a slightly low pH was noted in the final round of water testing. DUWLs are heavily contaminated with microbes and pose potential risk both to the patient as well as the DHCPs. This study suggests that chemical disinfection using A-dec ICX tablets and flushing as an effective method of reducing the bacterial load in DUWLs.
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Affiliation(s)
- Fahad Umer
- Surgery, Operative Dentistry, The Aga Khan University Hospital Main Campus Karachi, Karachi, Sindh, Pakistan
| | - Madiha Khan
- Surgery, The Aga Khan University Hospital Main Campus Karachi, Karachi, Pakistan
| | - Farhan Raza Khan
- Surgery, Operative Dentistry, The Aga Khan University Hospital Main Campus Karachi, Karachi, Sindh, Pakistan
| | - Karim Tejani
- Surgery, The Aga Khan University Hospital Main Campus Karachi, Karachi, Pakistan
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Li J, Zhang C, Hu X, Yoshida A, Osatomi K, Guo X, Yang JL, Liang X. Impact of different enzymes on biofilm formation and mussel settlement. Sci Rep 2022; 12:4685. [PMID: 35304533 PMCID: PMC8933495 DOI: 10.1038/s41598-022-08530-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 02/24/2022] [Indexed: 12/03/2022] Open
Abstract
Enzymes have been known to impact the biofilm forming capacity. However, how the enzymes mediate the biofilm formation and macrofouling remains little known. Here, we investigated the effects of the three kinds of proteases, four kinds of glycosidases and one kind of lipase on the detachment of biofilms of Shewanella marisflavi ECSMB14101, identified biofilm total proteins response to enzyme treatments, and then tested the effects of biofilms treated with enzymes on the settlement of the mussel Mytilus coruscus plantigrades. The results showed that the cell density of bacteria in biofilms formed at different initial bacterial density were noticeably reduced after treating with all tested enzymes, and Neutrase and α-Amylase exhibited best removing efficiency of > 90%. Bacterial total proteins in S. marisflavi biofilm noticeably reduced or disappeared after treated by Alcalase. For the settlements of the mussel M. coruscus plantigrades, inducing capacities of S. marisflavi biofilm were noticeably suppressed and downregulation was > 75% at the initial density of 5 × 106 cells/cm2. Thus, the tested enzymes could effectively remove the adhered bacterial cell, inhibit the biofilm formation and finally suppress the mussel settlement. Our findings extend novel knowledge to developing eco-friendly approach to control micro- and macro-fouling.
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Affiliation(s)
- Jiazheng Li
- International Research Center for Marine Biosciences, Ministry of Science and Technology, Shanghai Ocean University, Shanghai, China.,Shanghai Collaborative Innovation Center for Cultivating Elite Breeds and Green-Culture of Aquaculture Animals, Shanghai, China.,Southern Marine Science and Engineering Guangdong Laboratory, Guangzhou, China
| | - Chi Zhang
- International Research Center for Marine Biosciences, Ministry of Science and Technology, Shanghai Ocean University, Shanghai, China.,Shanghai Collaborative Innovation Center for Cultivating Elite Breeds and Green-Culture of Aquaculture Animals, Shanghai, China
| | - Xiaomeng Hu
- International Research Center for Marine Biosciences, Ministry of Science and Technology, Shanghai Ocean University, Shanghai, China.,Shanghai Collaborative Innovation Center for Cultivating Elite Breeds and Green-Culture of Aquaculture Animals, Shanghai, China.,Southern Marine Science and Engineering Guangdong Laboratory, Guangzhou, China
| | - Asami Yoshida
- Graduate School of Fisheries and Environmental Sciences, Nagasaki University, Nagasaki, Japan
| | - Kiyoshi Osatomi
- Graduate School of Fisheries and Environmental Sciences, Nagasaki University, Nagasaki, Japan
| | - Xingpan Guo
- International Research Center for Marine Biosciences, Ministry of Science and Technology, Shanghai Ocean University, Shanghai, China. .,Shanghai Collaborative Innovation Center for Cultivating Elite Breeds and Green-Culture of Aquaculture Animals, Shanghai, China.
| | - Jin-Long Yang
- International Research Center for Marine Biosciences, Ministry of Science and Technology, Shanghai Ocean University, Shanghai, China.,Shanghai Collaborative Innovation Center for Cultivating Elite Breeds and Green-Culture of Aquaculture Animals, Shanghai, China.,Southern Marine Science and Engineering Guangdong Laboratory, Guangzhou, China
| | - Xiao Liang
- International Research Center for Marine Biosciences, Ministry of Science and Technology, Shanghai Ocean University, Shanghai, China. .,Shanghai Collaborative Innovation Center for Cultivating Elite Breeds and Green-Culture of Aquaculture Animals, Shanghai, China. .,Southern Marine Science and Engineering Guangdong Laboratory, Guangzhou, China.
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13
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Fan C, Gu H, Liu L, Zhu H, Yan J, Huo Y. Distinct Microbial Community of Accumulated Biofilm in Dental Unit Waterlines of Different Specialties. Front Cell Infect Microbiol 2021; 11:670211. [PMID: 34222041 PMCID: PMC8248794 DOI: 10.3389/fcimb.2021.670211] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 05/31/2021] [Indexed: 12/26/2022] Open
Abstract
The contamination of dental unit waterlines (DUWLs) is a serious problem and directly affects the dental care. This study aims to explore the microbial community of biofilm in DUWL from different specialties and investigate the associated factors. A total of 36 biofilm samples from 18 DUWL of six specialties (i.e., prosthodontics, orthodontics, pediatrics, endodontics, oral surgery, and periodontics) at two time points (i.e., before and after daily dental practice) were collected with a novel method. Genomic DNA of samples was extracted, and then 16S ribosomal DNA (rDNA) (V3–V4 regions) and ITS2 gene were amplified and sequenced. Kruskal–Wallis and Wilcoxon rank test were adopted for statistical analysis. Microbial community with high diversity of bacteria (631 genera), fungi (193 genera), and viridiplantae was detected in the biofilm samples. Proteobacteria was the dominant bacteria (representing over 65.74–95.98% of the total sequences), and the dominant fungi was Ascomycota (93.9–99.3%). Microorganisms belonging to multiple genera involved in human diseases were detected including 25 genera of bacteria and eight genera of fungi, with relative abundance of six genera over 1% (i.e., Acinetobacter, Pseudomonas, Enterobacter, Aspergillus, Candida, and Penicillium). The biofilm microbiome may be influenced by the characteristics of dental specialty and routine work to some extent. The age of dental chair unit and overall number of patients had the strongest impact on the overall bacteria composition, and the effect of daily dental practices (associated with number of patients and dental specialty) on the fungi composition was the greatest. For the first time, biofilm in DUWL related to dental specialty was comprehensively evaluated, with more abundance of bacterial and fungal communities than in water samples. Biofilm accumulation with daily work and multiple kinds of opportunistic pathogen emphasized the infectious risk with dental care and the importance of biofilm control.
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Affiliation(s)
- Cancan Fan
- Zhujiang New Town Clinic, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Haijing Gu
- Zhujiang New Town Clinic, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Limin Liu
- Zhujiang New Town Clinic, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Haiwei Zhu
- Zhujiang New Town Clinic, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Juan Yan
- Zhujiang New Town Clinic, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Yongbiao Huo
- Zhujiang New Town Clinic, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
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14
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Zemouri C, de Soet JJ, Volgenant CMC, Crielaard W, Laheij AMGA. Heterogeneity in the efficacy of dental chemical disinfectants on water-derived biofilms in vitro. BIOFOULING 2020; 36:587-596. [PMID: 32580580 DOI: 10.1080/08927014.2020.1782894] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 05/29/2020] [Accepted: 06/08/2020] [Indexed: 06/11/2023]
Abstract
Conditions in dental unit waterlines are favourable for biofilm growth and contamination of dental unit water. The aim of this study was to assess the effect of several chemical disinfectants on bacteria in a biofilm model. Water-derived biofilms were grown in a static biofilm model (Amsterdam Active Attachment model), using two growth media. Biofilms were challenged with Alpron/Bilpron, Anoxyl, Citrisil, Dentosept, Green & Clean, ICX and Oxygenal in shock dose and maintenance doses. The concentration and the composition of the chemical disinfectants influenced the number of culturable bacteria in the biofilms. The application of a single shock dose followed by a low dose of the same chemical disinfectants resulted in the greatest suppression of viable bacteria in the biofilms. Exposure to Citrisil and ICX consistently resulted in failure to control the biofilms, while Alpron/Bilpron had a substantial and relevant effect on the number of bacteria in the biofilms.
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Affiliation(s)
- C Zemouri
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - J J de Soet
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - C M C Volgenant
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - W Crielaard
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - A M G A Laheij
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
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15
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Cheng L, Naibijiang N, Hasenbai A, Dong H, He H. Bacteriostatic effects of nanometer silver disinfectant on the biofilms in dental unit water lines. J Dent Sci 2020; 16:327-332. [PMID: 33384816 PMCID: PMC7770243 DOI: 10.1016/j.jds.2020.03.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/30/2020] [Indexed: 01/10/2023] Open
Abstract
Background/purpose Dental unit water lines (DUWLs) may be contaminated by aerobic bacteria in clinical settings and comprehensive disinfecting methods should be considered without delay. Herein, this study aims to investigate the timeliness and dynamic bacteriostatic effects of different forms of nanometer silver (NMS) disinfectant on bio-film in DUWLs. Materials and methods Bacterial DUWLs samples were respectively treated with different NMS forms, including liquid phase and solid phase at the concentrations of 0.25%, 0.5%, 1% and 2% and their bacteriostatic effects were observed at the 1st, 4th, 7th, 14th, 28th day. Results The bacteriostatic effects of liquid phase NMS at all concentrations were unsatisfactory and the bacteriostatic rate was only 20% at the 1st day. However, there appeared massive bacteria growth at the 4th, 7th, 14th, 28th day. Comparatively, no bacteria growth was found at the 1st, 4th, 7th, 14th, 28th day after sterilizing with different concentrations of solid phase NMS and the bacteriostatic rate was 100%. Conclusion Microbial contamination in DUWLs can be disinfected by different NMS forms, among which solid phase NMS is more bactericidal against bacteria bio-films, demonstrating significant roles of solid phase NMS in preventing DUWL contamination.
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Affiliation(s)
- Lujin Cheng
- Department of Stomatology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uyghur Autonomous Region, People's Republic of China
| | - Nijiatijiang Naibijiang
- Urumqi Stomatology Hospital, Urumqi, Xinjiang Uyghur Autonomous Region, People's Republic of China
| | - Aletengguli Hasenbai
- Department of Stomatology, The People's Hospital of Guoerguosi, Guoerguosi, Xinjiang Uyghur Autonomous Region, People's Republic of China
| | - Hongbin Dong
- Department of Stomatology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uyghur Autonomous Region, People's Republic of China
| | - Huiyu He
- Department of Stomatology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uyghur Autonomous Region, People's Republic of China
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Efficacy of BRS ® and Alpron ®/Bilpron ® Disinfectants for Dental Unit Waterlines: A Six-Year Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082634. [PMID: 32290533 PMCID: PMC7215904 DOI: 10.3390/ijerph17082634] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 04/07/2020] [Accepted: 04/10/2020] [Indexed: 01/26/2023]
Abstract
Biofilms in dental unit waterlines (DUWL) are a potentially significant source of contamination posing a significant health risk as these may come into contact with patients and dental staff during treatment. The aim of this study was to evaluate the microbiological quality of DUWL water treated by Biofilm-Removing-System® (BRS®) and Alpron®/Bilpron® disinfectant solutions for six years in a French university hospital. The microbiological quality of water supplied by 68 dental units—initially shock treated with BRS®, then continuously treated by Alpron® with sterile water during working days and Bilpron® during inactivity period, and combined with purging every morning and after each patient—was assessed biannually during six years for total culturable aerobic bacteria at 22 °C and 36 °C, Legionella sp., Pseudomonas aeruginosa, and total coliforms. A total of 628 samples were analyzed, 99.8% were compliant with extended microbiological levels, and we never detected pathogen bacteria like Legionella sp. and P. aeruginosa. Only one sample (0.2%) was noncompliant with the level of total culturable aerobic bacteria at 36 °C, which exceeded 140 colony forming units per mL. The protocol implemented in our university hospital gives excellent results and enables control of the microbiological quality of DUWL water in the long term.
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17
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Hoogenkamp MA, Brandt BW, de Soet JJ, Crielaard W. An in-vitro dynamic flow model for translational research into dental unit water system biofilms. J Microbiol Methods 2020; 171:105879. [DOI: 10.1016/j.mimet.2020.105879] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 02/14/2020] [Accepted: 02/22/2020] [Indexed: 12/18/2022]
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18
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Cicciù M. Water Contamination Risks at the Dental Clinic. BIOLOGY 2020; 9:E43. [PMID: 32120909 PMCID: PMC7150821 DOI: 10.3390/biology9030043] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 02/23/2020] [Accepted: 02/24/2020] [Indexed: 01/14/2023]
Abstract
Dental clinics, furnished with an array of specialized equipment, are commonplace, particularly in industrialized countries. Minimizing the risk of infection at the dental practice requires the formulation and implementation of strict protocols. These protocols must address the real risk posed by water contamination, particularly given that water is both integral to the function of some dental equipment, and is typically administered directly to the patient. The water in the dental clinic may be of local origin or from a water main, this can be problematic since the clinician often has little assurance regarding the quality of water reaching the dental chair. Though most modern dental equipment includes self-sterilization protocols, care must be taken that water does not stagnate anywhere in the dental equipment or clinic. The management of water quality at the dental clinic is an important part of respecting the protocols needed to manage the risk of patient infections.
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Affiliation(s)
- Marco Cicciù
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, Policlinico G. Martino, Via Consolare Valeria, 98100 Messina, Italy
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19
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Britton HC, Draper M, Talmadge JE. Antimicrobial efficacy of aqueous ozone in combination with short chain fatty acid buffers. Infect Prev Pract 2019; 2:100032. [PMID: 34368688 PMCID: PMC8336142 DOI: 10.1016/j.infpip.2019.100032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 12/09/2019] [Indexed: 12/26/2022] Open
Abstract
Background Mitigating surface contamination by microbes such as S. aureus, Salmonella enterica, or Klebsiella pneumoniae, is an ongoing problem in hospital and food production environments. Aim To determine whether addition of buffering solution to source water used for manufacture of aqueous ozone increases ozone efficacy against ozone-resistant bacterial species. Methods Antimicrobial effects of aqueous ozone were studied in combination with acetate, propionate, or butyrate short chain fatty acids (SCFA) as well as citrate or oxalate buffer formulations against Staphylococcus aureus on glass coupons. Aqueous ozone combined with an acetate buffer was also evaluated against Salmonella enterica and Klebsiella pneumoniae. Findings The acetate, propionate, and butyrate buffered aqueous ozone combinations had a significant 3-4 log reduction of S. aureus (P<0.05) colony forming unit (CFU), while citrate or oxalate buffered aqueous ozone, although statistically significant versus buffer alone, had less activity. Treatment of S. aureus, S. enterica, or K. pneumoniae with acetate buffered aqueous ozone also resulted in a 4 log or greater reduction in CFUs post-treatment for all three species, versus treatment with water alone. Conclusions All buffer systems tested had a significantly greater reduction in CFUs following treatment with the combination of buffer and ozone, compared to treatment with buffer or ozone individually, which has not been previously reported for hard surfaces. These results suggest that SCFA buffered ozone has greater anti-bacterial activity relative to either agent alone, and the activity is independent of the buffering activity. Thus, these formulations have potential to sanitize without residues, using an environmentally conscious formulation.
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Affiliation(s)
- Holly C Britton
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | | | - James E Talmadge
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska, USA
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20
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Okubo K, Ito T, Shiota Y, Kawata Y, Yamamoto T, Takashiba S. Effectiveness and safety of low-concentrated ozonized water for the reduction of contamination in dental unit water lines. Heliyon 2019; 5:e02306. [PMID: 31463403 PMCID: PMC6710486 DOI: 10.1016/j.heliyon.2019.e02306] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 05/09/2019] [Accepted: 08/09/2019] [Indexed: 11/30/2022] Open
Abstract
Contamination of dental unit waterlines (DUWL) with heterotrophic bacteria can cause problems in immune compromised patients (aged, tumor and organ transplantation-patients). We focused on the use of low-concentrated ozonized water (OZW) as the biofilm formation restraint system for DUWL. Here, we examined the effects of low-concentrated OZW on the growth of bacteria and related biofilm formation and harmfulness to dental unit components (DUCs) in vitro. OBJECTIVES To evaluate the bactericidal effects of OZW on biofilms in DUWL and DUC in vitro. METHODS Low-concentrated OZW (0.4 mg/L) was generated using an OZS-PTDX generator. Heterotrophic bacterial biofilms in old DUWL tubes and Candia albicans solution (control microbe) were treated with OZW for 1 h with gentle agitation before static culturing for 96 h in Reasoner's 2A liquid media. The control solutions were 0.1% cetylpyridinium chloride (CPC), chlorinated tap water (TW), and phosphate-buffered saline (PBS). Adenosine triphosphate (ATP) amounts of the microbes were measured and the biofilms of these microbes were observed using scanning electron microscopy (SEM). Moreover, surfaces of DUC soaked in OZW and TW were observed by SEM. RESULTS The OZW reduced ATP levels in microbes to 50% compared to TW and PBS treatment, although CPC reduced it below detection limits. SEM observation revealed deformation of microbes cultured with OZW, whereas no changes were seen on DUC surfaces. CONCLUSIONS Low-concentrated OZW is bactericidal against heterotrophic bacteria biofilms and it is not harmful to DUC, suggesting that it might be useful in preventing DUWL contamination.
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Affiliation(s)
- Keisuke Okubo
- Department of Pathophysiology - Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8525, Japan
- Division of Dentistry, Tottori Municipal Hospital, 1-1 Matoba, Tottori, 680-8501, Japan
| | - Takashi Ito
- Center for Innovative Clinical Medicine, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8525, Japan
| | - Yasuyoshi Shiota
- Department of Pathophysiology - Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8525, Japan
- Division of Dentistry, National Hospital Organization Shikoku Cancer Center, 160 Minamiumemoto-cho-ko, Matuyama, 791-0280, Japan
| | - Yusuke Kawata
- Department of Pathophysiology - Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8525, Japan
| | - Tadashi Yamamoto
- Department of Pathophysiology - Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8525, Japan
| | - Shogo Takashiba
- Department of Pathophysiology - Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8525, Japan
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Amin M, Ardaneh M, Hashemzadeh M, Asarehzadegan Dezfuli A, JafarZadeh E. In vitro antibacterial effect of deconex and sodium hypochlorite against bacterial taxa isolated from dental units. Infect Drug Resist 2019; 12:805-814. [PMID: 31114262 PMCID: PMC6489653 DOI: 10.2147/idr.s197988] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 02/18/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose: Dental unit's environment and relevant instruments are a major source of infectious diseases caused by a variety of microorganisms. The application of various disinfectants is one of the most effective methods for reducing or eliminating microbial contamination. The objective of this study was to evaluate the antibacterial effects of deconex and sodium hypochlorite against bacterial taxa isolated from dental unit's environment of Ahvaz Jundishapur University of Medical Sciences, southwest of Iran. Methods: In order to evaluate the quality of disinfection, sampling was performed from different parts of 100 clinical units. For bacterial recovery and isolation, samples were enriched and cultured onto different microbiological culture media. Species identification was carried out using phenotypic and molecular methods (16S rDNA sequence analysis). In vitro activity of sodium hypochlorite and deconex were determined by the broth micro-dilution method. Results: According to conventional techniques, Bacillus spp (48%) was the most frequently encountered isolates, followed by staphylococcus spp (26%). By using both techniques, Bacillus subtilis was the most frequently encountered species (n=23, 21%), followed by Bacillus licheniformis (n=8, 7.4%), Streptococcus pneumonia (n=8, 7.4%), Staphylococcus epidermidis (n=8, 7.4%), Staphylococcus saprophyticus (n=8, 7.4%) and Staphylococcus warneri. The highest levels of contamination were observed in oral medications. The deconex had lower minimum inhibitory concentration (MIC) concentration in comparasion to sodium hypochlorite, which showed that deconex was a much more potent disinfectant. Conclusion: In conclusion, the results of the present in vitro study showed that deconex had promising results for decontamination of the tested microorganism, and it is recommended for disinfecting of dental units and environment. In this study, the high percentage of dental unit's contamination showed the need to improve disinfection procedures, sterilization systems, and the use of an appropriate concentration of deconex and sodium hypochlorite for dental units decontamination .
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Affiliation(s)
- Mansour Amin
- Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Marieh Ardaneh
- Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Hashemzadeh
- Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Aram Asarehzadegan Dezfuli
- Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Elham JafarZadeh
- Laboratory of Taleqhani Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Uraz A, Karaduman B, Isler SÇ, Gönen S, Çetiner D. Ozone application as adjunctive therapy in chronic periodontitis: Clinical, microbiological and biochemical aspects. J Dent Sci 2018; 14:27-37. [PMID: 30988877 PMCID: PMC6445981 DOI: 10.1016/j.jds.2018.06.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 05/30/2018] [Indexed: 12/01/2022] Open
Abstract
Background/purpose The application of ozone as an adjunctive treatment represents a new approach in the management of chronic periodontitis. The purpose of this study was to evaluate the clinical, biochemical and microbiological efficacy of ozone treatment as an adjunct to scaling and root planing (SRP) in generalized chronic periodontitis (GCP) patients. Materials and methods Eighteen patients (9 males and 9 females; aged from 28 to 47 years, mean age of 40 ± 6.51 years) with GCP were recruited in the study. In a split mouth design, two quadrants in each patient were randomly allocated to SRP-alone or SRP-ozone therapy (SRP + OT) groups by coin toss method. Subgingival plaque and gingival crevicular fluid (GCF) samples were collected at baseline, following 1st and 3rd months. The clinical parameters were monitored at baseline and after 3 months. Microbiological parameters were analyzed by quantitative-PCR and GCF biomarkers were determined by ELISA. Results were analyzed statistically. Results Statistically significant improvements in all clinical parameters were accompanied by a reduction in microbiological and biochemical parameters in both treatment groups. SRP treatment resulted in a significant reduction of Porphyromonas gingivalis (Pg) at 1st month and Tannerella forsythia (Tf) and Prevotella intermedia (Pi) at 3 months. Following SRP treatment the interleukin (IL)-8 levels were significantly reduced at month 1. There were no significant differences between two treatments for any of the parameters. Conclusion Within the limitations of this study, adjunctive ozone therapy did not provide additional benefits to clinical, microbiological and biochemical parameters over SRP in chronic periodontitis patients.
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Affiliation(s)
- Ahu Uraz
- Department of Periodontology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Burcu Karaduman
- Department of Periodontology, Faculty of Dentistry, Biruni University, İstanbul, Turkey
| | - Sila Çagri Isler
- Department of Periodontology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Sevim Gönen
- Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Deniz Çetiner
- Department of Periodontology, Faculty of Dentistry, Gazi University, Ankara, Turkey
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Yoon HY, Lee SY. Susceptibility of bacteria isolated from dental unit waterlines to disinfecting chemical agents. J GEN APPL MICROBIOL 2018; 64:269-275. [DOI: 10.2323/jgam.2018.02.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Hye Young Yoon
- Department of Oral Microbiology, College of Dentistry, Research Institute of Oral Science, Gangneung-Wonju National University
| | - Si Young Lee
- Department of Oral Microbiology, College of Dentistry, Research Institute of Oral Science, Gangneung-Wonju National University
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24
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Current and Emerging Topical Antibacterials and Antiseptics: Agents, Action, and Resistance Patterns. Clin Microbiol Rev 2017; 30:827-860. [PMID: 28592405 DOI: 10.1128/cmr.00112-16] [Citation(s) in RCA: 188] [Impact Index Per Article: 26.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Bacterial skin infections represent some of the most common infectious diseases globally. Prevention and treatment of skin infections can involve application of a topical antimicrobial, which may be an antibiotic (such as mupirocin or fusidic acid) or an antiseptic (such as chlorhexidine or alcohol). However, there is limited evidence to support the widespread prophylactic or therapeutic use of topical agents. Challenges involved in the use of topical antimicrobials include increasing rates of bacterial resistance, local hypersensitivity reactions (particularly to older agents, such as bacitracin), and concerns about the indiscriminate use of antiseptics potentially coselecting for antibiotic resistance. We review the evidence for the major clinical uses of topical antibiotics and antiseptics. In addition, we review the mechanisms of action of common topical agents and define the clinical and molecular epidemiology of antimicrobial resistance in these agents. Moreover, we review the potential use of newer and emerging agents, such as retapamulin and ebselen, and discuss the role of antiseptic agents in preventing bacterial skin infections. A comprehensive understanding of the clinical efficacy and drivers of resistance to topical agents will inform the optimal use of these agents to preserve their activity in the future.
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Yoon HY, Lee SY. Establishing a laboratory model of dental unit waterlines bacterial biofilms using a CDC biofilm reactor. BIOFOULING 2017; 33:917-926. [PMID: 29160100 DOI: 10.1080/08927014.2017.1391950] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 10/06/2017] [Indexed: 06/07/2023]
Abstract
In this study, a laboratory model to reproduce dental unit waterline (DUWL) biofilms was developed using a CDC biofilm reactor (CBR). Bacteria obtained from DUWLs were filtered and cultured in Reasoner's 2A (R2A) for 10 days, and were subsequently stored at -70°C. This stock was cultivated on R2A in batch mode. After culturing for five days, the bacteria were inoculated into the CBR. Biofilms were grown on polyurethane tubing for four days. Biofilm accumulation and thickness was 1.3 × 105 CFU cm-2 and 10-14 μm respectively, after four days. Bacteria in the biofilms included cocci and rods of short and medium lengths. In addition, 38 bacterial genera were detected in biofilms. In this study, the suitability and reproducibility of the CBR model for DUWL biofilm formation were demonstrated. The model provides a foundation for the development of bacterial control methods for DUWLs.
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Affiliation(s)
- Hye Young Yoon
- a Department of Oral Microbiology, College of Dentistry, Research Institute of Oral Science , Gangneung-Wonju National University , Gangneung , Korea
| | - Si Young Lee
- a Department of Oral Microbiology, College of Dentistry, Research Institute of Oral Science , Gangneung-Wonju National University , Gangneung , Korea
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Liu J, Yu S, Han B, Chen J. Effects of benzalkonium chloride and ethanol on dual-species biofilms of Serratia liquefaciens S1 and Shewanella putrefaciens S4. Food Control 2017. [DOI: 10.1016/j.foodcont.2017.02.063] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Gitipour A, Al-Abed SR, Thiel SW, Scheckel KG, Tolaymat T. Nanosilver as a disinfectant in dental unit waterlines: Assessment of the physicochemical transformations of the AgNPs. CHEMOSPHERE 2017; 173:245-252. [PMID: 28110014 PMCID: PMC6143180 DOI: 10.1016/j.chemosphere.2017.01.050] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 01/06/2017] [Accepted: 01/08/2017] [Indexed: 05/29/2023]
Abstract
Dental unit water lines (DUWL) are susceptible to biofilm development and bacterial growth leading to water contamination, causing health and ecological effects. This study monitors the interactions between a commonly used nanosilver disinfectant (ASAP-AGX-32, an antimicrobial cleaner for dental units, 0.0032% Ag) and biofilm development in DUWL. To simulate the disinfection scenario, an in-house DUWL model was assembled and biofilm accumulation was allowed. Subsequent to biofilm development, the disinfection process was performed according to the manufacturer's instructions. The pristine nanosilver particles in the cleaner measured between 3 and 5 nm in diameter and were surrounded by a stabilizing polymer. However, the polymeric stabilizing agent diminished over the disinfection process, initiating partial AgNPs aggregation. Furthermore, surface speciation of the pristine AgNPs were identified as primarily AgO, and after the disinfection process, transformations to AgCl were observed. The physicochemical characteristics of AgNPs are known to govern their fate, transport and environmental implications. Hence, knowledge of the AgNPs characteristics after the disinfection process (usage scenario) is of significance. This study demonstrates the adsorption of AgNPs onto biofilm surfaces and, therefore, will assist in illustration of the toxicity mechanisms of AgNPs to bacteria and biofilms. This work can be an initial step in better understanding how AgNPs transform depending on the conditions they are exposed to during their lifetime. Until this date, most research has been focused on assessing the impacts of pristine (lab synthesized) nanomaterials on various systems. However, it is our belief that nanoparticles may undergo transformations during usage, which must be taken into consideration. Furthermore, this experiment is unique as it was conducted with a commonly used, commercially available nanosilver suspension leading to more realistic and applicable findings.
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Affiliation(s)
- Alireza Gitipour
- Biomedical, Chemical, and Environmental Engineering, University of Cincinnati, Cincinnati, OH, USA
| | - Souhail R Al-Abed
- US EPA, Office of Research and Development, National Risk Management Laboratory, Cincinnati, OH, USA.
| | - Stephen W Thiel
- Biomedical, Chemical, and Environmental Engineering, University of Cincinnati, Cincinnati, OH, USA
| | - Kirk G Scheckel
- US EPA, Office of Research and Development, National Risk Management Laboratory, Cincinnati, OH, USA
| | - Thabet Tolaymat
- US EPA, Office of Research and Development, National Risk Management Laboratory, Cincinnati, OH, USA
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Costa D, Mercier A, Gravouil K, Lesobre J, Verdon J, Imbert C. Occurrence and diversity of both bacterial and fungal communities in dental unit waterlines subjected to disinfectants. Pathog Dis 2016; 74:ftw094. [PMID: 27630186 DOI: 10.1093/femspd/ftw094] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2016] [Indexed: 11/13/2022] Open
Abstract
Chemical disinfectants are widely advocated to reduce the microbial contamination in dental unit waterlines (DUWL). However, until now their efficacy has been poorly examined after long-term application. In this study, through quantitative PCR and high-throughput sequencing, both bacterial and fungal communities were profiled from 8- to 12-year-old DUWL treated with disinfectants commonly used by European dentists. Water was collected from the tap water supplying units to the output exposure point of the turbine handpiece following a stagnation period and dental care activity. Results showed that (i) the unit itself is the principal source of microbial contamination and (ii) water stagnation, DU maintenance practices and quality of water supplying DU appeared as parameters driving the water quality. Despite disinfecting treatment combined to flushing process, the microbial contamination remained relevant in the studied output water, in association with a high bacterial and fungal diversity. The occurrence of potentially pathogenic microorganisms in these treated DUWL demonstrated a potential infectious risk for both patients and dental staff. A disinfectant shock before a prolonged stagnation period could limit the microbial proliferation inside DUWL. Necessity to proceed to regular water quality control of DUWL was highlighted.
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Affiliation(s)
- Damien Costa
- Team Water Microbiology, Ecology and Biology of Interactions, CNRS, University of Poitiers, 86073 Poitiers Cedex, France Bacteriology and Hospital Hygiene Laboratory, University Hospital of Poitiers 86021 Poitiers Cedex, France
| | - Anne Mercier
- Team Water Microbiology, Ecology and Biology of Interactions, CNRS, University of Poitiers, 86073 Poitiers Cedex, France Cooperative Laboratory Thanaplast SP-EBI-Carbios Bioplastics, Ecology and Biology of interactions, CNRS UMR 7267, University of Poitiers 86073 Poitiers Cedex, France
| | - Kevin Gravouil
- Cooperative Laboratory Thanaplast SP-EBI-Carbios Bioplastics, Ecology and Biology of interactions, CNRS UMR 7267, University of Poitiers 86073 Poitiers Cedex, France
| | - Jérôme Lesobre
- Microorganisms laboratory: Genome and environment, UMR CNRS 6023, University Blaise Pascal 63177 Aubière Cedex, France
| | - Julien Verdon
- Team Water Microbiology, Ecology and Biology of Interactions, CNRS, University of Poitiers, 86073 Poitiers Cedex, France
| | - Christine Imbert
- Team Water Microbiology, Ecology and Biology of Interactions, CNRS, University of Poitiers, 86073 Poitiers Cedex, France University of Medicine Pharmacy of Poitiers 86073 Poitiers Cedex, France
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Pawar A, Garg S, Mehta S, Dang R. Breaking the Chain of Infection: Dental Unit Water Quality Control. J Clin Diagn Res 2016; 10:ZC80-4. [PMID: 27630960 DOI: 10.7860/jcdr/2016/19070.8196] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 05/26/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The air-water syringes, ultrasonic scalers, high speed air turbine handpieces are connected to dental units by a network of small-bore plastic tubes through which water and air travel to activate or cool the instruments and it had been shown that this system is extensively contaminated with microbial biofilms and pose a potential risk of infection for patients as well as dental professionals. AIM To evaluate and compare the efficacy of various disinfectants in reducing the microbial colony count in water derived from Dental Unit Waterlines. MATERIALS AND METHODS Five random dental units were selected and samples were collected before and after intervention with 5 disinfectants (0.02% H2O2 continuously, 0.02% H2O2 continuously with shock treatment with 0.25% H2O2 weekly, 0.12% Chlorohexidine and 12% Ethanol overnight, 1:50 Original Listerine overnight, 2% Sodium Perborate and 2% EDTA 5 minutes in morning) using different disinfection methods for 4 weeks. Samples were cultured on Reasoner's 2A (R2A) agar for microbial counting. RESULTS Results were recorded as Colony forming units/ml (cfu/ml) and were evaluated statistically. Results showed that all the dental unit waterlines were heavily contaminated with microbes before any intervention. After 1 day of disinfection regime the counts reduced significantly and showed progressive reduction in consecutive weeks. Goals set by ADA & CDC were ultimately achieved at the end of 4 weeks. CONCLUSION All the disinfectants were equally effective in reducing the microbial colony count of DUWLs, irrespective of their concentration and method of disinfection.
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Affiliation(s)
- Amrita Pawar
- Senior Lecturer, Department of Prosthodontics, ITS College of Dental Sciences & Research , Muradnagar, Ghaziabad, UP, India
| | - Sandeep Garg
- Professor and Head, Department of Prosthodontics, MM College of Dental Sciences & Research , Mullana, Ambala, Haryana, India
| | - Sonia Mehta
- Associate Professor, Department of Microbiology, MM College of Medical Sciences & Research , Mullana, Ambala, Haryana, India
| | - Rajat Dang
- Professor, Department of Prosthodontics, MM College of Dental Sciences & Research , Mullana, Ambala, Haryana, India
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Leow-Dyke SF, Rooney P, Kearney JN. Evaluation of Copper and Hydrogen Peroxide Treatments on the Biology, Biomechanics, and Cytotoxicity of Decellularized Dermal Allografts. Tissue Eng Part C Methods 2016; 22:290-300. [PMID: 26701226 DOI: 10.1089/ten.tec.2015.0271] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Decellularized tissue allografts are paving the way as an alternative to cellular tissue transplantation. Effective sterilization or decontamination of tissue allografts is paramount for the safety of the allograft; however, some of the current sterilization procedures have a detrimental effect on the tissue scaffold. The bactericidal and virucidal activity of copper (II) ions and hydrogen peroxide (H2O2) have been widely reported, however, their effect on the biology, biochemistry, and biocompatibility of decellularized tissue have yet to be elucidated. In this study, decellularized human dermis (dCELL human dermis) was treated with copper (II) chloride (CuCl2) and H2O2; both singly and in combination, and parameters, including concentration, pH, and synergy between CuCl2 and H2O2, were evaluated to identify conditions where any detrimental effects on the tissue scaffold were observed. Skin from 13 human donors was retrieved with appropriate consent and processed into dCELL human dermis. The dCELL human dermis was then treated for 3 h with 0.1 mg/L-1 g/L (w/v) CuCl2 and 0.01-7.5% (v/v) H2O2 and combinations of both of these in the same concentration range. dCELL human dermis treated with solutions of 0.1 mg/L-1 g/L CuCl2 or 0.01-7.5% H2O2 caused no detrimental effects on gross histology, collagen denaturation, collagen orientation, and biomechanical properties of the tissue or cytotoxicity. The highest combined concentration of CuCl2 and H2O2 demonstrated an increase in ultimate tensile strength, loss of collagen type IV immunostaining at the dermal-epidermal junction, and in vitro cytotoxicity. Combinations within the range of up to 10 mg/L CuCl2 with up to 0.5% H2O2 had no effect. The data identify the concentrations of CuCl2 and H2O2 solutions that have no effect on the biological, biomechanical, and biochemical properties of dCELL human dermis, while retaining biocompatibility. These treatments may be suitable for use as sterilization/decontamination agents on human decellularized tissues.
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Affiliation(s)
- Sophie F Leow-Dyke
- NHS Blood and Transplant, Tissue Services R&D , Liverpool, United Kingdom
| | - Paul Rooney
- NHS Blood and Transplant, Tissue Services R&D , Liverpool, United Kingdom
| | - John N Kearney
- NHS Blood and Transplant, Tissue Services R&D , Liverpool, United Kingdom
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Fujita M, Mashima I, Nakazawa F. Monitoring the decontamination efficacy of the novel Poseidon-S disinfectant system in dental unit water lines. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2015; 50:270-276. [PMID: 26066542 DOI: 10.1016/j.jmii.2015.05.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 04/10/2015] [Accepted: 05/05/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Contaminated dental unit waterlines (DUWLs) are a known source of specific health care-acquired infections because of the difficulty in keeping them clean during routine dental practice. Recently, an electrolysis apparatus that uses only the chlorine normally present in municipal water, the Poseidon-S system, was developed as a novel additive-free disinfectant system to control microbial contamination in DUWLs. METHODS The microbiological quality of water samples collected from DUWLs was assessed before and after installation of the Poseidon-S system in terms of the total viable counts (TVCs) of microorganisms. The microbicidal effects of the electrolyzed water against oral organisms and its cytotoxicity against human oral-derived cell lines were also examined. RESULTS Water samples from the DUWLs initially had average microbial TVCs of 103-106 colony-forming units (CFU)/mL. After installation of the Poseidon-S system, the number of microorganisms in the water samples decreased to less than 1 × 102 CFU/mL. The electrolyzed water also exhibited remarkable microbicidal effects on the microorganisms present in the DUWLs as well as microorganisms commonly isolated from human oral cavities, but showed low cytotoxicity towards human oral-derived cells. CONCLUSION This study demonstrated that routine use of the Poseidon-S system can effectively maintain low microbial levels in DUWLs.
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Affiliation(s)
- Mari Fujita
- Department of Oral Microbiology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - Izumi Mashima
- Department of Oral Microbiology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - Futoshi Nakazawa
- Department of Oral Microbiology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan.
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Leoni E, Dallolio L, Stagni F, Sanna T, D'Alessandro G, Piana G. Impact of a risk management plan on Legionella contamination of dental unit water. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:2344-58. [PMID: 25711357 PMCID: PMC4377905 DOI: 10.3390/ijerph120302344] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 02/13/2015] [Indexed: 11/23/2022]
Abstract
The study aimed to assess the prevalence of Legionella spp. in dental unit waterlines of a dental clinic and to verify whether the microbiological parameters used as indicators of water quality were correlated with Legionella contamination. A risk management plan was subsequently implemented in the dental health care setting, in order to verify whether the adopted disinfection protocols were effective in preventing Legionella colonization. The water delivered from syringes and turbines of 63 dental units operating in a dental clinic, was monitored for counts of the heterotrophic bacteria P. aeruginosa and Legionella spp. (22 °C and 37 °C). At baseline, output water from dental units continuously treated with disinfection products was more compliant with the recommended standards than untreated and periodically treated water. However, continuous disinfection was still not able to prevent contamination by Legionella and P. aeruginosa. Legionella was isolated from 36.4%, 24.3% and 53.3% of samples from untreated, periodically and continuously treated waterlines, respectively. The standard microbiological parameters used as indicators of water quality proved to be unreliable as predictors of the presence of Legionella, whose source was identified as the tap water used to supply the dental units. The adoption of control measures, including the use of deionized water in supplying the dental unit waterlines and the application of a combined protocol of continuous and periodic disinfection, with different active products for the different devices, resulted in good control of Legionella contamination. The efficacy of the measures adopted was mainly linked to the strict adherence to the planned protocols, which placed particular stress on staff training and ongoing environmental monitoring.
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Affiliation(s)
- Erica Leoni
- Department of Biomedical and Neuromotor Sciences, Unit of Hygiene, Public Health and Medical Statistics, University of Bologna, via San Giacomo 12, 40126, Bologna, Italy.
| | - Laura Dallolio
- Department of Biomedical and Neuromotor Sciences, Unit of Hygiene, Public Health and Medical Statistics, University of Bologna, via San Giacomo 12, 40126, Bologna, Italy.
| | - Francesca Stagni
- Department of Biomedical and Neuromotor Sciences, Unit of Odontostomatological Sciences, University of Bologna, via San Vitale 59, 40125, Bologna, Italy.
| | - Tiziana Sanna
- Department of Biomedical and Neuromotor Sciences, School of Hygiene and Preventive Medicine, University of Bologna, via San Giacomo 12, 40126, Bologna, Italy.
| | - Giovanni D'Alessandro
- Department of Biomedical and Neuromotor Sciences, Unit of Odontostomatological Sciences, University of Bologna, via San Vitale 59, 40125, Bologna, Italy.
| | - Gabriela Piana
- Department of Biomedical and Neuromotor Sciences, Unit of Odontostomatological Sciences, University of Bologna, via San Vitale 59, 40125, Bologna, Italy.
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Gao S, Hemar Y, Ashokkumar M, Paturel S, Lewis GD. Inactivation of bacteria and yeast using high-frequency ultrasound treatment. WATER RESEARCH 2014; 60:93-104. [PMID: 24835956 DOI: 10.1016/j.watres.2014.04.038] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 04/11/2014] [Accepted: 04/19/2014] [Indexed: 06/03/2023]
Abstract
High-frequency (850 kHz) ultrasound was used to inactivate bacteria and yeast at different growth phases under controlled temperature conditions. Three species of bacteria, Enterobacter aerogenes, Bacillus subtilis and Staphylococcus epidermidis as well as a yeast, Aureobasidium pullulans were considered. The study shows that high-frequency ultrasound is highly efficient in inactivating the bacteria in both their exponential and stationary growth phases, and inactivation rates of more than 99% were achieved. TEM observation suggests that the mechanism of bacteria inactivation is mainly due to acoustic cavitation generated free radicals and H2O2. The rod-shaped bacterium B. subtilis was also found to be sensitive to the mechanical effects of acoustic cavitation. The study showed that the inactivation process continued even after ultrasonic processing cessed due to the presence of H2O2, generated during acoustic cavitation. Compared to bacteria, the yeast A. pullulans was found to be more resistant to high-frequency ultrasound treatment.
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Affiliation(s)
- Shengpu Gao
- School of Chemical Sciences, The University of Auckland, Private Bag 92019, Auckland, New Zealand; School of Biological Sciences, The University of Auckland, Private Bag 92019, Auckland, New Zealand; Institute of Food and Agricultural Standardization, China National Institute of Standardization, Beijing 10088, China
| | - Yacine Hemar
- School of Chemical Sciences, The University of Auckland, Private Bag 92019, Auckland, New Zealand.
| | | | - Sara Paturel
- School of Chemical Sciences, The University of Auckland, Private Bag 92019, Auckland, New Zealand; School of Biological Sciences, The University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - Gillian D Lewis
- School of Biological Sciences, The University of Auckland, Private Bag 92019, Auckland, New Zealand
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Khan AY, Bandyopadhyaya R. Silver nanoparticle impregnated mesoporous silica as a non-enzymatic amperometric sensor for an aqueous solution of hydrogen peroxide. J Electroanal Chem (Lausanne) 2014. [DOI: 10.1016/j.jelechem.2014.05.027] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Lal S, Singhrao SK, Bricknell M, Pearce M, Morton LHG, Ahmed W, Crean SJ. Monitoring Dental-Unit-Water-Line Output Water by Current In-office Test Kits. Curr Microbiol 2014; 69:135-42. [DOI: 10.1007/s00284-014-0569-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 02/04/2014] [Indexed: 10/25/2022]
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Effect of different disinfection protocols on microbial and biofilm contamination of dental unit waterlines in community dental practices. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:2064-76. [PMID: 24552789 PMCID: PMC3945585 DOI: 10.3390/ijerph110202064] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 01/20/2014] [Accepted: 01/28/2014] [Indexed: 11/17/2022]
Abstract
Output water from dental unit waterlines (DUWLs) may be a potential source of infection for both dental healthcare staff and patients. This study compared the efficacy of different disinfection methods with regard to the water quality and the presence of biofilm in DUWLs. Five dental units operating in a public dental health care setting were selected. The control dental unit had no disinfection system; two were disinfected intermittently with peracetic acid/hydrogen peroxide 0.26% and two underwent continuous disinfection with hydrogen peroxide/silver ions (0.02%) and stabilized chlorine dioxide (0.22%), respectively. After three months of applying the disinfection protocols, continuous disinfection systems were more effective than intermittent systems in reducing the microbial contamination of the water, allowing compliance with the CDC guidelines and the European Council regulatory thresholds for drinking water. P. aeruginosa, Legionella spp, sulphite-reducing Clostridium spores, S. aureus and β-haemolytic streptococci were also absent from units treated with continuous disinfection. The biofilm covering the DUWLs was more extensive, thicker and more friable in the intermittent disinfection dental units than in those with continuous disinfection. Overall, the findings showed that the products used for continuous disinfection of dental unit waterlines showed statistically better results than the intermittent treatment products under the study conditions.
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Kadaifciler DG, Ökten S, Sen B. Mycological contamination in dental unit waterlines in Istanbul, Turkey. Braz J Microbiol 2014; 44:977-81. [PMID: 24516467 PMCID: PMC3910220 DOI: 10.1590/s1517-83822013000300049] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Accepted: 11/13/2012] [Indexed: 11/22/2022] Open
Abstract
Studies on dental units (DUs) are conducted either for the prevention or the reduction of the density of bacterial contamination in dental unit waterlines (DUWLs). However, the existence of fungi in the these systems requires more attention. During dental treatment, direct contact with water contaminated with fungi such as Candida, Aspergillus, or inhalation of aerosols from high-speed drill may cause various respiratory infections, such as asthma, allergies, and wounds on mucose membranes, especially on immunocompromised patients and dentists. The aims of this study are to investigate the number and colonization of fungi in DUWLs in the city of Istanbul, Turkey. Water samples were collected from air-water syringes, high-speed drills, and inlet waters from 41 DUs. The aerobic mesophilic fungi count in high- speed drills was higher than inlet waters and air-water syringes. Non-sporulating fungi were found in 7 DUs. The isolated fungi were identified as Penicillium waksmanii, Cladosporium spp., Penicillium spp., Candida famata, Cryptococcus laurentii, Candida guilliermondii, Penicillium verrucosum, Aspergillus pseudoglaucus, Penicillium decumbens, and Acremonium sp. Some of these fungal genera are known as opportunistic pathogens that led to respiratory diseases such as allergic rhinits. This study shows the importance of regular control of mycological contamination on water at DUs.
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Affiliation(s)
| | - Suzan Ökten
- Department of Biology, Faculty of Science, Trakya University, Edirne, Turkey
| | - Burhan Sen
- Department of Biology, Faculty of Science, Trakya University, Edirne, Turkey
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Murphy J, Mahony J, Bonestroo M, Nauta A, van Sinderen D. Impact of thermal and biocidal treatments on lactococcal 936-type phages. Int Dairy J 2014. [DOI: 10.1016/j.idairyj.2013.06.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Effect of 0.2% chlorhexidine on microbial and fungal contamination of dental unit waterlines. Dent Res J (Isfahan) 2014; 11:351-6. [PMID: 25097645 PMCID: PMC4119368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND It is known that dental unit waterline can be a source of infection. The aim of this study was to evaluate the efficacy of a mouthwash, chlorhexidine, in controlling microbial and fungal contamination of dental unit waterlines. MATERIALS AND METHODS In the present experimental study, the water in high-speed handpieces and air/water syringes of 35 dental units in a dental school was investigated microbiologically. Five of the units and one tap water served as controls; 100-200-mL water samples were collected aseptically in sterile containers in the morning after a 2-min purge. Water reservoir bottles were emptied and 50 mL of 0.2% chlorhexidine mouthwash was introduced into the tank. Then the water syringe was used to flush the waterline until the pink-colored chlorhexidine was observed to flow from the water syringe. Before the next day's session and before the students used the unit, two water samples from the water syringe and water turbine was collected. The samples were transferred to the laboratory. After 48 h at 37°C, the microbial colonies were counted. The number of these colonies was evaluated using colony forming unit CFU. Data were analyzed with Mann - Whitney U test and SPSS 13.5 statistical program. The statistical significance was defined at P ≤ 0.05. RESULTS All 35 units were contaminated before chlorhexidine use; no contamination was detected after adding chlorhexidine to the waterlines of the units. After week 1, 28 of the 30 treated dental unit waterlines (DUWLs) had values of CFU/mL less than 200. CONCLUSION The present study showed that the use of chlorhexidine could reduce microbial counts in dental unit waterlines.
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Taylor M, Ross K, Bentham R. Spatial arrangement of legionella colonies in intact biofilms from a model cooling water system. Microbiol Insights 2013; 6:49-57. [PMID: 24826074 PMCID: PMC3987755 DOI: 10.4137/mbi.s12196] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
There is disagreement among microbiologists about whether Legionella requires a protozoan host in order to replicate. This research sought to determine where in biofilm Legionellae are found and whether all biofilm associated Legionella would be located within protozoan hosts. While it is accepted that Legionella colonizes biofilm, its life cycle and nutritional fastidiousness suggest that Legionella employs multiple survival strategies to persist within microbial systems. Fluorescent in situ hybridization (FISH) and confocal laser scanning microscopy (CLSM) demonstrated an undulating biofilm surface architecture and a roughly homogenous distribution of heterotrophic bacteria with clusters of protozoa. Legionella displayed 3 distinct spatial arrangements either contained within or directly associated with protozoa, or dispersed in loosely associated clusters or in tightly packed aggregations of cells forming dense colonial clusters. The formation of discreet clusters of tightly packed Legionella suggests that colony formation is influenced by specific environmental conditions allowing for limited extracellular replication. This work represents the first time that an environmentally representative, multispecies biofilm containing Legionella has been fluorescently tagged and Legionella colony morphology noted within a complex microbial system.
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Affiliation(s)
- Michael Taylor
- School of the Environment, Flinders University of South Australia, Adelaide, Australia
| | - Kirstin Ross
- School of the Environment, Flinders University of South Australia, Adelaide, Australia
| | - Richard Bentham
- School of the Environment, Flinders University of South Australia, Adelaide, Australia
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Yousefshahi F, Azimpour K, Boroumand MA, Najafi M, Barkhordari K, Vaezi M, Rouhipour N. Can a new antiseptic agent reduce the bacterial colonization rate of central venous lines in post-cardiac surgery patients? J Tehran Heart Cent 2013; 8:70-5. [PMID: 23967028 PMCID: PMC3740112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Accepted: 10/03/2012] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Central venous (CV) catheters play an essential role in the management of critically ill patients in the Intensive Care Unit (ICU). CV lines are, however, allied to catheter-associated blood stream infections. Bacterial colonization of CV lines is deemed the main cause of catheter-associated infection. The purpose of our study was to compare bacterial colony counts in the catheter site before CV line insertion in two groups of post-cardiac surgery patients: a group receiving Sanosil (an antiseptic agent composed of H2O2 and silver) and a control group. METHODS This interventional prospective double-blinded clinical trial recruited the patients in three post-cardiac surgery ICUs of a heart center. The participants were divided into interventional (113 patients) and control (136 patients) groups. Sanosil was added to the routine preparation procedure (Chlorhexidine bath one day before and scrub with Povidone-Iodine just before the CV line insertion). After the removal of the CV lines, the catheters tips were sent for culture and evaluation of colony counts. RESULTS Catheter colonization occurred in 55 (22.1%) patients: 26 (23%) patients in the Sanosil group and 29 (21.3%) in the control group; there was no significant statistical difference between the two groups (p value = 0.75, RR = 1.05, 95% CI: 0.76-1.45). The most common organism having colonized in the cultures of the catheter tips was staphylococcus epidermis: 20 cases in the control group and 16 cases in the intervention group. CONCLUSION Catheter colonization frequently occurs in post-cardiac surgery patients. However, our results did not indicate the effectiveness of adding Sanosil to the routine preparation procedure with respect to reducing catheter bacterial colonization.
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Affiliation(s)
- Fardin Yousefshahi
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Mahdi Najafi
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Khosro Barkhordari
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Vaezi
- Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Nahid Rouhipour
- Moayeri Hospital, Social Security Organization, Tehran, Iran.,Corresponding Author: Nahid Rouhipour, Moayeri Hospital, Social Security Organization, Mojahedin Islam Street, Baharestan Square, Tehran, Iran. 1154938861. Tel: +98 21 77535110. Fax: +98 21 77535116. E-mail:
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Gea-Izquierdo E, Loza-Murguia MG. Calidad del agua y Salud: Las biopelículas y Legionella. JOURNAL OF THE SELVA ANDINA RESEARCH SOCIETY 2013. [DOI: 10.36610/j.jsars.2012.030200112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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MENG L, CAI W, QU H, LIU J, LAN J, LU J, LAN T, LI J. Inhibition of Ethylenediaminetetraacetic acid (EDTA) on Biofilm Formation of Staphylococcus aureus. FOOD SCIENCE AND TECHNOLOGY RESEARCH 2013. [DOI: 10.3136/fstr.19.323] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Barbot V, Robert A, Rodier MH, Imbert C. Update on infectious risks associated with dental unit waterlines. ACTA ACUST UNITED AC 2012; 65:196-204. [PMID: 22469485 DOI: 10.1111/j.1574-695x.2012.00971.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Revised: 02/08/2012] [Accepted: 03/22/2012] [Indexed: 11/28/2022]
Abstract
Modern dental chair units consist of a network of interconnected narrow-bore plastic tubes called dental unit waterlines (DUWLs). The water delivered by these DUWLs acts as both a coolant for a range of instruments and an irrigant during dental treatments. The quality of water is of considerable importance because both patients and dental team are regularly exposed to water and aerosols generated by dental equipment. Studies have demonstrated that DUWLs provide a favourable environment for microbial proliferation and biofilm formation, and that water is consequently often contaminated with high densities of various microorganisms (bacteria, fungi, protozoa, viruses). The presence of high levels of microbial contamination may be a health problem for dentists and patients, especially those who are immunocompromised. The current status of knowledge on microbial contamination of DUWLs is presented, with an emphasis on the infectious risk associated with DUWLs and on the various approaches for disinfecting and protecting DUWLs.
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Affiliation(s)
- Vanessa Barbot
- Laboratoire de Chimie et Microbiologie de l'Eau, Université de Poitiers, Poitiers, France.
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Linley E, Denyer SP, McDonnell G, Simons C, Maillard JY. Use of hydrogen peroxide as a biocide: new consideration of its mechanisms of biocidal action. J Antimicrob Chemother 2012; 67:1589-96. [PMID: 22532463 DOI: 10.1093/jac/dks129] [Citation(s) in RCA: 277] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Hydrogen peroxide is extensively used as a biocide, particularly in applications where its decomposition into non-toxic by-products is important. Although increasing information on the biocidal efficacy of hydrogen peroxide is available, there is still little understanding of its biocidal mechanisms of action. This review aims to combine past and novel evidence of interactions between hydrogen peroxide and the microbial cell and its components, while reflecting on alternative applications that make use of gaseous hydrogen peroxide. It is currently believed that the Fenton reaction leading to the production of free hydroxyl radicals is the basis of hydrogen peroxide action and evidence exists for this reaction leading to oxidation of DNA, proteins and membrane lipids in vivo. Investigations of DNA oxidation suggest that the oxidizing radical is the ferryl radical formed from DNA-associated iron, not hydroxyl. Investigations of protein oxidation suggest that selective oxidation of certain proteins might occur, and that vapour-phase hydrogen peroxide is a more potent oxidizer of protein than liquid-phase hydrogen peroxide. Few studies have investigated membrane damage by hydrogen peroxide, though it is suggested that this is important for the biocidal mechanism. No studies have investigated damage to microbial cell components under conditions commonly used for sterilization. Despite extensive studies of hydrogen peroxide toxicity, the mechanism of its action as a biocide requires further investigation.
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Affiliation(s)
- Ezra Linley
- Cardiff School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
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O’Donnell MJ, Boyle MA, Russell RJ, Coleman DC. Management of dental unit waterline biofilms in the 21st century. Future Microbiol 2011; 6:1209-26. [DOI: 10.2217/fmb.11.104] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Dental chair units (DCUs) use water to cool and irrigate DCU-supplied instruments and tooth surfaces, and provide rinsewater during dental treatment. A complex network of interconnected plastic dental unit waterlines (DUWLs) supply water to these instruments. DUWLs are universally prone to microbial biofilm contamination seeded predominantly from microorganisms in supply water. Consequently, DUWL output water invariably becomes contaminated by high densities of microorganisms, principally Gram-negative environmental bacteria including Pseudomonas aeruginosa and Legionella species, but sometimes contain human-derived pathogens such as Staphylococcus aureus. Patients and staff are exposed to microorganisms from DUWL output water and to contaminated aerosols generated by DCU instruments. A wide variety of approaches, many unsuccessful, have been proposed to control DUWL biofilm. More recently, advances in biofilm science, chemical DUWL biofilm treatment agents, DCU design, supply water treatment and development of automated DUWL biofilm control systems have provided effective long-term solutions to DUWL biofilm control.
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Affiliation(s)
- Mary J O’Donnell
- Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental University Hospital, University of Dublin, Trinity College Dublin, Dublin 2, Republic of Ireland
| | - Maria A Boyle
- Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental University Hospital, University of Dublin, Trinity College Dublin, Dublin 2, Republic of Ireland
| | - Ronnie J Russell
- The Department of Microbiology, The Moyne Institute of Preventive Medicine, University of Dublin, Trinity College Dublin, Dublin 2, Republic of Ireland
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Thorn RMS, Lee SWH, Robinson GM, Greenman J, Reynolds DM. Electrochemically activated solutions: evidence for antimicrobial efficacy and applications in healthcare environments. Eur J Clin Microbiol Infect Dis 2011; 31:641-53. [DOI: 10.1007/s10096-011-1369-9] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2011] [Accepted: 07/15/2011] [Indexed: 10/17/2022]
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Garcia F, Murray PE, Garcia-Godoy F, Namerow KN. Effect of Aquatine Endodontic Cleanser on smear layer removal in the root canals of ex vivo human teeth. J Appl Oral Sci 2010; 18:403-8. [PMID: 20835577 PMCID: PMC5349080 DOI: 10.1590/s1678-77572010000400014] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2009] [Accepted: 03/14/2010] [Indexed: 11/22/2022] Open
Abstract
Objectives The purpose of this study was to measure and compare the root canal cleanliness
and smear layer removal effectiveness of Aquatine Endodontic Cleanser (Aquatine
EC) when used as an endodontic irrigating solution in comparison with 6% sodium
hypochlorite (NaOCl). Material and Methods Forty-five human teeth were randomly allocated to five treatment groups; the pulp
chamber was accessed, cleaned, and shaped by using ProTaper and ProFile rotary
instrumentation to an ISO size #40. The teeth were then processed for scanning
electron microscopy, and the root canal cleanliness and removal of smear layer
were examined. Results The most effective removal of smear layer occurred with Aquatine EC and NaOCl,
both with a rinse of EDTA. Conclusions Aquatine EC appears to be the first hypochlorous acid approved by the FDA to be a
possible alternative to the use of NaOCl as an intracanal irrigant. Further
research is needed to identify safer and more effective alternatives to the use of
NaOCl irrigation in endodontics.
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Affiliation(s)
- Faustino Garcia
- Department of Endodontics, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, Florida 33328-2018, USA
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Evaluation of Vashe Wound Therapy in the clinical management of patients with chronic wounds. Adv Skin Wound Care 2010; 23:352-7. [PMID: 20664326 DOI: 10.1097/01.asw.0000383198.35815.a2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To analyze if Vashe Wound Therapy (PuriCore, Malvern, Pennsylvania) is a valuable contribution to standard protocols of wound care. DESIGN Open, noncomparative study. SETTING Outpatient clinic. PATIENTS Thirty-one patients, primarily with venous or mixed venous/arterial leg ulcers. INTERVENTIONS Vashe Wound Therapy (hypochlorous acid, produced on site and on demand) was used as an adjunct to a standard wound care protocol. MAIN OUTCOME MEASURES Wound healing, reduction of pain, and odor. MAIN RESULTS At the end of the study, 86% of all lesions healed, and the average size of reduction in nonhealed wounds was 47%. Odor was present at the beginning of enrollment in 21 patients and was rated 4.58 on the visual analog scale. In all patients, the odor score at end of treatment was zero. Seventy-seven percent of all patients reported a positive pain score at the beginning of participation in the evaluation (average pain score, 4.7). At the end of the study, no patient experienced pain. CONCLUSION Vashe Wound Therapy is a valuable contribution to standard protocols of wound care.
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