Prevalence of Legionella-specific IgG and IgM Antibody in a Dental Clinic Population

Abstract

This study was undertaken to determine the frequency of Legionella infection in a dental clinic setting. Serum samples from 270 dental clinic personnel were evaluated using an enzyme-linked immunosorbent assay to detect Legionella-specific IgM and IgG antibodies. The pooled-species whole-cell-antigen preparation used in these assays was derived from six Legionella pneumophila strains and one strain each from Legionella bozemanii and Legionella micdadei. Significant levels of IgG and IgM antibodies were found in 20% and 16%, respectively, of the samples. This compares with 8% and 10%, respectively, for a randomly selected non-clinical group from the region (P less than 0.005). Samples from clinic personnel with significant IgG titers (greater than 1:128) were also evaluated for activity to each of the eight single-species antigens, with the following results: L. pneumophila, 45% (combined six strains); L. micdadei, 37%; and L. bozemanii, 18%. Comparing individuals' "years spent in the clinic environment" with the incidence of significant antibody levels strongly suggests that the risk of Legionella infection increases proportionately with increased clinic exposure time (P less than 0.05). Analysis of these data implies that Legionella may be present in the dental clinic environment, thus creating an increased risk for clinical personnel or patients.

Prevalence of legionella waterline contamination and Legionella pneumophila antibodies in general dental practitioners in London and rural Northern Ireland

“…11 Similar results were found in dental personnel working in a dental hospital in the USA. 12 No cases of Legionnaires' disease or Pontiac fever were reported amongst the study volunteers but unfortunately the DUWL were not tested for the presence of Legionellae. Presumably one would have expected to see heavy contamination of the system.…”

“…10 It has been suggested that legionellae within DUWL may contribute to respiratory illness amongst the dental team. 11,12 The reported prevalence of legionellae in DUWL varies widely from 0-68% depending, in part, on the isolation procedures. [13][14][15] Variations in recovery rates are seen with different geographic locations, presence of large cold-water tanks and complex plumbing systems, 7 thermal conditions and the type of dental equipment.…”

Electro-chemically activated water in dental unit water lines

“…28 Dentists' health would also seem to be directly at risk. [29][30][31] The American Dental Association (ADA) is concerned about these problems and adopted a statement on December 13, 1995, identifying it as one of the critical research areas in dentistry today. 25 The ADA set a number of less than 200 colony forming units per millilitre as the goal to be reached by all members by the year 2000.…”

Evaluation of Bacterial Contamination in Dental Unit Waterlines of Qazvin’ Dental School ,Iran

“…In similar studies carried out in the USA, 20% of West Virginia students and staff of dentistry department were found to be positive in terms of antibodies in their serum (7). These studies indicate the increased risk of exposure of dentistry personnel to pathogenic gram positive and negative bacteria and that the dental unit waterlines can be the source of infection.…”