Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310006, PR China.
J Med Microbiol. 2022 Jun;71(6). doi: 10.1099/jmm.0.001540.
Severe contamination of dental unit waterlines was found in healthcare settings. The benefits of decontamination methods are controversial. The aim of this review was to systematically evaluate disinfection methods in contamination control of dental unit waterlines. The terms 'dental unit waterline(s) or DUWL(s) or dental unit water line(s)' were searched through PubMed, Cochrane Library, Embase, Web of Science and Scopusup to 31 May 2021. The DUWLs' output water was incubated on R2A agar at 20-28 °C for 5-7 days to evaluate heterotrophic mesophilic bacteria. The risk of bias was evaluated by a modified Newcastle-Ottawa quality assessment scale. Eighteen papers from the literature were included. One study indicated that water supply played a crucial role in disinfecting DUWLs. Three studies indicated that flushing decreased bacteria counts but did not meet the American CDC standard (500 c.f.u. ml). All chlorine- and peroxide-containing disinfectants except sodium hypochlorite in one of 15 studies as well as three mouthrinses and citrus botanical extract achieved the standard (≤500 c.f.u. ml). The included studies were of low (1/18), moderate (6/18) and high (11/18) quality. Independent water reservoirs are recommended for disinfecting DUWLs using distilled water. Flushing DUWLs should be combined with disinfections. Nearly all the chlorine-, chlorhexidine- and peroxide-containing disinfectants, mouthrinses and citrus botanical extract meet the standard for disinfecting DUWLs. Alkaline peroxide would lead to tube blockage in the DUWLs. Regularly changing disinfectants can reduce the risk of occurrence of disinfectant-resistant strains of microbes.
在医疗机构中发现牙科手机内部水路受到严重污染。消毒方法的益处存在争议。本研究旨在系统评估消毒方法在控制牙科手机内部水路污染中的作用。通过 PubMed、Cochrane 图书馆、Embase、Web of Science 和 Scopus 数据库，检索了“牙科手机内部水路或 DUWL 或牙科手机内部水路”的相关文献，检索时限截至 2021 年 5 月 31 日。将牙科手机水路输出的水接种于 R2A 琼脂，在 20-28°C 下孵育 5-7 天，以评估异养需氧嗜中温菌。采用改良的 Newcastle-Ottawa 质量评估量表评估偏倚风险。纳入了 18 篇文献。有一项研究表明，供水对牙科手机水路消毒起着至关重要的作用。有三项研究表明，冲洗可降低细菌计数，但未达到美国疾病预防控制中心（CDC）标准（500 c.f.u. ml）。在 15 项研究中，除了一项研究中的次氯酸钠外，所有含氯和过氧化物的消毒剂以及三种漱口液和柑橘植物提取物都达到了标准（≤500 c.f.u. ml）。纳入的研究质量较低（1/18）、中等（6/18）和较高（11/18）。建议使用蒸馏水为牙科手机独立储水器消毒。冲洗牙科手机水路应与消毒相结合。几乎所有含氯、氯己定和过氧化物的消毒剂、漱口液和柑橘植物提取物都符合牙科手机水路消毒标准。碱性过氧化物会导致牙科手机内部水路堵塞。定期更换消毒剂可以降低微生物产生耐药菌株的风险。
