Schulze-Röbbecke R, Feldmann C, Fischeder R, Janning B, Exner M, Wahl G
Hygiene-Institut der Universität Bonn, Germany.
Tuber Lung Dis. 1995 Aug;76(4):318-23. doi: 10.1016/s0962-8479(05)80030-9.
Infections caused by non-tuberculous mycobacteria (NTM) are generally thought to be acquired from environmental sources. However, little is known about the situations in which transmission occurs.
In an attempt to identify situations of relevant contact with NTM we investigated the water to which patients are exposed during dental treatment.
The concentration and species of NTM were determined in 43 cooling and spray water samples from 21 dental units in ten offices. In addition, mycobacterial colonization of 16 biofilm samples from the waterlines of two dental units was investigated.
The mean NTM concentration in the water samples was 365 colony-forming units (cfu) per mL, exceeding the mean drinking water concentration by a factor of almost 400. In the biofilm samples the mean NTM density amounted to 1165 cfu/cm2. The species identified included Mycobacterium gordonae, M. flavescens, M. chelonae, 'M. chelonae-like organism' and M. simiae.
High numbers of NTM may be swallowed, inhaled or inoculated into oral wounds during dental treatment, possibly resulting in colonization, sensitization or infection. Mycobacterial proliferation in biofilms forming within dental units may explain the extent of NTM contamination of dental spray and cooling water.
非结核分枝杆菌（NTM）引起的感染通常被认为是从环境中获得的。然而，对于其传播发生的情况知之甚少。
为了确定与NTM相关的接触情况，我们调查了牙科治疗期间患者接触的水。
对来自十个诊所21个牙科单元的43份冷却和喷雾水样中的NTM浓度和种类进行了测定。此外，还调查了两个牙科单元水线中16个生物膜样本的分枝杆菌定植情况。
水样中NTM的平均浓度为每毫升365个菌落形成单位（cfu），比饮用水的平均浓度高出近400倍。生物膜样本中NTM的平均密度为每平方厘米1165 cfu。鉴定出的菌种包括戈登分枝杆菌、微黄分枝杆菌、龟分枝杆菌、“类龟分枝杆菌”和猿分枝杆菌。
在牙科治疗过程中，大量的NTM可能会被吞咽、吸入或接种到口腔伤口中，可能导致定植、致敏或感染。牙科单元内形成的生物膜中的分枝杆菌增殖可能解释了牙科喷雾和冷却水NTM污染的程度。
