Institute of Hygiene, University Hospital Münster, Robert Koch-Straße 41, 48149, Münster, Germany.
Eur J Clin Microbiol Infect Dis. 2023 Oct;42(10):1235-1244. doi: 10.1007/s10096-023-04659-w. Epub 2023 Sep 12.
Water-bearing instruments and treatments in dental units produce aerosols originating from the dental unit waterlines (DUWLs), which are often microbially contaminated. Particularly, the presence of Legionella mainly realized as aerosols leads to a risk of infection in patients and dental staff.
Here, we record the general bacteriological status of DUWLs in Germany and investigated the prevalence of Legionella spp., with a focus on identification and occurrence of distinct species considering the various aspects of dental practice such as dental chair equipment, disinfection methods, and temperatures.
Out of 3789 water samples of 459 dental practices, collected in the years 2019 and 2020, 36.4% were Legionella positive with predominance of L. anisa (97.89%) identified by MALDI-TOF biotyping. L. pneumophila was detected very rarely. Risk factor analysis revealed that temperatures >20°C are a significant factor for increased Legionella colonization.
In order to minimize the risk of infection, routine monitoring of the water quality in dental chair units is recommended with regard to general microbiological loads and to the presence of Legionella as opportunistic pathogen as well as the regular application of routine disinfection procedures.
牙科器械和治疗用水会产生源自牙科用水管路（DUWL）的气溶胶，这些气溶胶通常受到微生物污染。特别是，由于气溶胶的存在，军团菌主要导致患者和牙科医护人员感染的风险。
本研究记录了德国 DUWL 的一般细菌学状况，并调查了军团菌属的流行情况，重点关注不同牙科实践方面（如牙科椅设备、消毒方法和温度）的鉴定和特定物种的发生。
在 2019 年和 2020 年收集的 459 家牙科诊所的 3789 份水样中，36.4%为军团菌阳性，优势种为 MALDI-TOF 生物分型鉴定的嗜肺军团菌（97.89%）。很少检测到嗜肺军团菌。风险因素分析表明，温度 >20°C 是军团菌定植增加的一个重要因素。
为了最大限度地降低感染风险，建议对牙科椅单元的水质进行常规监测，以监测一般微生物负荷和机会性病原体军团菌的存在情况，并定期应用常规消毒程序。
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