Rautemaa R, Nordberg A, Wuolijoki-Saaristo K, Meurman J H
Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki, Finland.
J Hosp Infect. 2006 Sep;64(1):76-81. doi: 10.1016/j.jhin.2006.04.011. Epub 2006 Jul 3.
Aerosols containing microbes from the oral cavity of the patient are created when using modern high-speed rotating instruments in restorative dentistry. How far these aerosols spread and what level of contamination they cause in the dental surgery has become a growing concern as the number of patients with oro-nasal meticillin-resistant Staphylococcus aureus colonization has increased. The present study aimed to determine how far airborne bacteria spread during dental treatment, and the level of contamination. Fall out samples were collected on blood agar plates placed in six different sectors, 0.5-2m from the patient. Restorative dentistry fallout samples (N=72) were collected from rooms (N=6) where high-speed rotating instruments were used, and control samples (N=24) were collected from rooms (N=4) used for periodontal and orthodontic treatment where rotating and ultrasonic instruments were not used. The collection times were 1.5 and 3 h. In addition, samples were taken from facial masks of personnel and from surfaces in the rooms before and after disinfection. After 48 h of incubation at 37 degrees C, colonies were counted and classified by Gram stain. The results showed significant contamination of the room at all distances sampled when high-speed instruments were used (mean 970 colony-forming units/m2/h). The bacterial density was found to be higher in the more remote sampling points. Gram-positive cocci, namely viridans streptococci and staphylococci, were the most common findings. The area that becomes contaminated during dental procedures is far larger than previously thought and practically encompasses the whole room. These results emphasize the need for developing new means for preventing microbial aerosols in dentistry and protection of all items stored temporarily on work surfaces. This is especially important when treating generally ill or immunocompromised patients at dental surgeries in hospital environments.
在修复牙科中使用现代高速旋转器械时，会产生含有患者口腔微生物的气溶胶。随着口腔鼻腔耐甲氧西林金黄色葡萄球菌定植患者数量的增加，这些气溶胶传播的距离以及它们在牙科手术中造成的污染程度日益受到关注。本研究旨在确定牙科治疗过程中空气传播细菌的扩散距离以及污染程度。在距离患者0.5 - 2米的六个不同区域放置血琼脂平板收集沉降样本。从使用高速旋转器械的6个房间收集修复牙科沉降样本（N = 72），并从4个用于牙周和正畸治疗且未使用旋转和超声器械的房间收集对照样本（N = 24）。收集时间为1.5小时和3小时。此外，在消毒前后从工作人员的面罩和房间表面采集样本。在37℃孵育48小时后，对菌落进行计数并通过革兰氏染色分类。结果显示，使用高速器械时，在所有采样距离处房间均受到显著污染（平均970菌落形成单位/平方米/小时）。在较远的采样点发现细菌密度更高。革兰氏阳性球菌，即草绿色链球菌和葡萄球菌，是最常见的发现。牙科手术过程中被污染的区域比之前认为的要大得多，实际上几乎涵盖了整个房间。这些结果强调了开发新方法以预防牙科中微生物气溶胶以及保护临时存放在工作表面的所有物品的必要性。在医院环境中的牙科手术中治疗一般患病或免疫功能低下的患者时，这一点尤为重要。
