Pneumonia associated with a dental unit waterline

Ricci, Maria Luisa; Fontana, Stefano; Pinci, Federica; Fiumana, Emanuela; Pedna, Maria Federica; Farolfi, Paolo; Sabattini, Maria Antonietta Bucci; Scaturro, Maria

doi:10.1016/s0140-6736(12)60074-9

Cited by 151 publications

(110 citation statements)

References 2 publications

Supporting

Mentioning

107

Contrasting

Unclassified

Order By: Relevance

“…This study set out to characterise a risk factor associated with pathogenic bacteria commonly found in DUWL systems alongside free living amoebae that graze on these bacteria. In some instances, ingested pathogenic bacteria manipulate the amoebal host for their own survival and multiplication, potentially leading to the death of their infected human host [43]. Lawsuits can be brought against the dental practitioner if causal links between an infection and the dental treatment water are confirmed [8].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, non-tuberculosis Mycobacterium species [41,47], Klebsiella pneumoniae [37,57], P. aeruginosa [16,26] and S. marcescens [30,44,57] have also been identified. Despite tight controls to make sure the treatment water is safe, an elderly patient died from legionellosis following dental treatment in which L. pneumophila serogroup I was identified using molecular profiling from isolates taken both from the patient and from the clinical environment of the dental practice where treatment was performed, confirming the source of infection [43]. Circumstantial evidence also surrounds the death of a dental practitioner due to the same cause in the early nineties [5].…”

mentioning

confidence: 99%

“…In the context of healthcare, the greatest challenge to overcome is when pathogenic nosocomial bacteria use free living amoebae to support their growth [7,8,31,37,43]. Lawsuits can be brought against the dental practitioner if causal links are confirmed between an infection and the use of dental treatment water [8].…”

mentioning

confidence: 99%

See 2 more Smart Citations

Risk Assessment for the Spread of Serratia marcescens Within Dental-Unit Waterline Systems Using Vermamoeba vermiformis

et al. 2015

View full text Add to dashboard Cite

(2015) Risk assessment for the spread of Serratia marcescens within dental unit waterline systems using Vermamoeba vermiformis. Current Microbiology, 71 (4). pp. 434 442.It is advisable to refer to the publisher's version if you intend to cite from the work.http://dx.doi.org/10.1007/s00284-015-0872-0For more information about UCLan's research in this area go to http://www.uclan.ac.uk/researchgroups/ and search for . Conflict of interest disclosure statementAll named authors declare that there is no conflict of interest.2 Title: Risk assessment for the spread of Serratia marcescens within dental-unit waterline systems using Vermamoeba vermiformis Abstract:Vermamoeba vermiformis is associated with the biofilm ecology of dental-unit waterlines (DUWLs). This study investigated whether V. vermiformis is able to act as a vector for potentially pathogenic bacteria and so aid their dispersal within DUWL systems. Clinical dental water was initially examined for Legionella species by inoculating it onto Legionella selective-medium plates. The molecular identity/profile of the glassy colonies obtained indicated none of these isolates were Legionella species. During this work bacterial colonies were identified as a non-pigmented Serratia marcescens. As the water was from a clinical DUWL which had been treated with Alpron™ this prompted the question as to whether S. marcescens had developed resistance to the biocide. Exposure to Alpron™ indicated that this dental biocide was effective, under laboratory conditions, against S. marcescens at up to 1x10 8 colony forming units/millilitre (cfu/ml). V. vermiformis was cultured for eight weeks on cells of S. marcescens and Escherichia coli. Subsequent electron microscopy showed that V.vermiformis grew equally well on S. marcescens and E. coli (p = 0.0001). Failure to detect the presence of S.marcescens within the encysted amoebae suggests that V. vermiformis is unlikely to act as a vector supporting the growth of this newly isolated, nosocomial bacterium.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Risk Assessment for the Spread of Serratia marcescens Within Dental-Unit Waterline Systems Using Vermamoeba vermiformis

et al. 2015

View full text Add to dashboard Cite

show abstract

“…In order to confirm this claim, tap water samples were taken from the sink of the dental surgery, and from the high-speed turbine of the dental-unit waterlines, as well as water from the deceased patient's home (tap and shower) for laboratory analysis for the presence of L. pneumophila. Subsequently, the same strain of L. pneumophila as the one isolated from the patient, was found in tap water and the dental-unit waterlines output water in the dental practice (Ricci et al 2012).…”

Section: Introductionmentioning

confidence: 77%

“…Comprehensive lists of contaminating microorganisms isolated from dental-unit waterlines are described elsewhere (Pankhurst et al 1998;Szymanska et al 2008;Kumar et al 2010) and although the majority of waterborne bacteria pose no risk of infection, opportunistic nosocomial pathogens from dental waterlines have been associated with human cases of infection including L. pneumophila, non-tuberculosis Mycobacterium spp., Klebsiella pneumoniae and Pseudomonas aeruginosa (Martin 1987;Pankhurst et al 1998;D'Ovidio et al 2011;Ricci et al 2012). …”

Section: Introductionmentioning

confidence: 99%

Developing an ecologically relevant heterogeneous biofilm model for dental-unit waterlines

et al. 2016

View full text Add to dashboard Cite

This study monitored the biodiversity of microbes cultured from a heterogeneous biofilm which had formed on the lumen of a section of dental waterline tubing over a period of 910 days. By day two bacterial counts on the outlet-water showed that contamination of the system had occurred. After 14 days, a biofilm comparable to that of clinical waterlines, consisting of bacteria, fungi and amoebae had formed. This showed that the proprietary silver coating applied to the lumenal surface of the commercial waterline tubing failed to prevent biofilm formation. Molecular barcoding of isolated culturable microorganisms showed some degree of the diversity of taxa in the biofilm, including the opportunistic pathogen Legionella pneumophila. Whilst the system used for isolation and identification of contaminating microorganisms may underestimate the diversity of organisms in the biofilm, their similarity to those found in the clinical environment makes this a promising test-bed for future biocide testing.

show abstract

Demystifying the mist: Sources of microbial bioload in dental aerosols

Kumar

Subramanian

2020

Journal of Periodontology

View full text Add to dashboard Cite

The risk of transmitting airborne pathogens is an important consideration in dentistry and has acquired special significance in the context of recent respiratory disease epidemics. The purpose of this review, therefore, is to examine (1) what is currently known regarding the physics of aerosol creation, (2) the types of environmental contaminants generated by dental procedures, (3) the nature, quantity, and sources of microbiota in these contaminants and (4) the risk of disease transmission from patients to dental healthcare workers. Most dental procedures that use ultrasonics, handpieces, air‐water syringes, and lasers generate sprays, a fraction of which are aerosolized. The vast heterogeneity in the types of airborne samples collected (spatter, settled aerosol, or harvested air), the presence and type of at‐source aerosol reduction methods (high‐volume evacuators, low volume suction, or none), the methods of microbial sampling (petri dishes with solid media, filter paper discs, air harvesters, and liquid transport media) and assessment of microbial bioload (growth conditions, time of growth, specificity of microbial characterization) are barriers to drawing robust conclusions. For example, although several studies have reported the presence of microorganisms in aerosols generated by ultrasonic scalers and high‐speed turbines, the specific types of organisms or their source is not as well studied. This paucity of data does not allow for definitive conclusions to be drawn regarding saliva as a major source of airborne microorganisms during aerosol generating dental procedures. Well‐controlled, large‐scale, multi center studies using atraumatic air harvesters, open‐ended methods for microbial characterization and integrated data modeling are urgently needed to characterize the microbial constituents of aerosols created during dental procedures and to estimate time and extent of spread of these infectious agents.

show abstract

Pneumonia associated with a dental unit waterline

Cited by 151 publications

References 2 publications

Risk Assessment for the Spread of Serratia marcescens Within Dental-Unit Waterline Systems Using Vermamoeba vermiformis

Risk Assessment for the Spread of Serratia marcescens Within Dental-Unit Waterline Systems Using Vermamoeba vermiformis

Developing an ecologically relevant heterogeneous biofilm model for dental-unit waterlines

Demystifying the mist: Sources of microbial bioload in dental aerosols

Contact Info

Product

Resources

About