Microbiological Evaluation of Water Used in Dental Units
Abstract
:1. Introduction
2. Materials and Methods
2.1. Sample Collection
2.2. Analysis
3. Results
4. Discussion
4.1. International Dental Water Guidelines and Our Research Result
4.2. Comparison to the Results of Research by Other Authors
4.3. Methods for Improving the Quality of Dental Water
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Microorganisms | Presence in Dental Units | Proportion [%] | Pathogenicity |
---|---|---|---|
Gram-positive bacteria | |||
A. dentalis | 1 | 2.9 | periodontitis [23] |
A. oris | 1 | 2.9 | oral microbiota [23] |
B. casei | 2 | 5.9 | opportunistic pathogen that causes peritonitis in immunocompromised patients [24] |
B. celere | 1 | 2.9 | no literature data available |
C. avidum | 1 | 2.9 | opportunistic pathogen that is present primarily in immunocompromised patients receiving chemotherapy and radiotherapy (cutaneous abscesses, infective endocarditis), deep tissue infections [25]; potential aetiological agent of periprosthetic joint infection [26] |
K. palustris | 3 | 8.8 | bacteraemia, endocarditis, peritonitis, cholecystitis, urinary tract infections, brain abscesses, and keratitis [27] |
K. kristinae | 1 | 2.9 | bacteraemia associated with the use of central venous catheter, infective endocarditis, acute peritonitis, abdominal abscesses, umbilical sepsis, acute cholecystitis, and urinary tract infection [28] |
L. shinshuensis | 13 | 38.2 | Combined with other bacterial species, they cause infections associated with the use of central venous catheters used as vascular access to haemodialysis [29]. |
M. phyllosphaerae | 2 | 5.9 | plant pathogen; a case of prosthetic hip infection has been described [30] |
M. ginsengisoli | 5 | 14.7 | no literature data available |
M. testaceum | 3 | 8.8 | blood poisonings, urinary tract infections [30] |
M. esteraromaticum | 2 | 5.9 | blood poisonings [30] |
R. dentocariosa | 1 | 2.9 | caries, infections of paradental tissues and opportunistic infections: endocarditis, peritonitis, sepsis, lung abscesses, pneumonia in patients with immune deficiencies, neoplasms [31] |
R. amarae | 4 | 11.76 | bloodstream infections in haematological patients with comorbidities [31] |
Gram-negative bacteria | |||
A. ursingii | 3 | 8.8 | bacteraemia in patients with haematological neoplasms and neutropenia [32] |
A. lwoffii | 1 | 2.9 | microbiota of the oropharynx, skin, and perineum in approx. 25% of healthy individuals; opportunistic pathogen in immunocompromised patients and nosocomial infections: sepsis, pneumonia, meningitis, and wound infections [33,34] |
A. citratiphilum | 1 | 2.9 | occurs in water systems [35]; no reports concerning pathogenicity |
B. fragilis | 1 | 2.9 | peritonitis; soft tissue infections; pelvic, lung, and brain abscesses [36] |
B. cepacia | 9 | 26.47 | opportunistic pathogen in patients with cystic fibrosis [37], involved in nosocomial infections |
B. pyrrocinia | 1 | 2.9 | no literature data available |
C. metallidurans | 8 | 25.53 | catheter-related infections [38] |
C. pauculus | 2 | 5.9 | bacteraemia in haematological, oncologic, and diabetic patients and those with chronic heart failure [38] |
E. coli | 1 | 2.9 | pathogenic serotypes may cause bloody diarrhoea, hemolytic uremic syndrome, acute renal failure, and sepsis [39] |
M. morganii | 1 | 2.9 | infections in immunocompromised patients; nosocomial infections [40] |
N. resinovorum | 1 | 2.9 | They are found in lake, soil, and water [41]. |
P. septica | 1 | 2.9 | bacteraemia in immunocompromised patients, those with comorbidities and with vascular catheters [42] |
P. fungorum | 1 | 2.9 | opportunistic bacterium [43] |
P. putida | 2 | 5.9 | opportunistic pathogen causing nosocomial infections mainly in neutropenic patients, cancer patients, neonatal patients, and those with cystic fibrosis [44] |
P. xantuomarina | 1 | 2.9 | no literature data available |
R. pickettii | 7 | 20.5 | Waterborne opportunistic pathogen [45]. Transmission may occur due to contaminated medical devices or solutions typical of health care facilities (post-dialysis sepsis) [46,47]. The source may be a contaminated, intravascular solution intended for haematological patients [45]. This causes diseases in patients with compromised immunity, respiratory infections—especially in patients with cystic fibrosis, meningitis, peritonitis, and sepsis. |
S. maltophilia | 7 | 20.5 | It mainly causes nosocomial infections (bacteraemia, biliary tract infections, urinary tract infections, respiratory infections, skin and soft tissue infections, endocarditis) [48,49]. Nosocomial infections, usually in those with comorbidities (e.g., malignancy, HIV) and with chronic lung diseases or lung cancer. This species was classified as an ESKAPE pathogen due to its high level of drug resistance [48]. |
A. russicus | 1 | 2.9 | no literature data available |
Gram-positive granulomas | |||
E. faecalis | 1 | 2.9 | dental root canal infections [50]; aetiologic agent of endocarditis; bacteraemia in patients with comorbidities [51] |
M. luteus | 8 | 25.53 | opportunistic pathogen that causes infections such as endocarditis or bacteraemia in cancer patients [52] |
P. polychromogenes | 2 | 5.9 | no literature data available |
P. oxydans | 1 | 2.9 | no literature data available |
S. cohnii | 3 | 8.8 | catherer-related infections, meningitis, urinary tract infections, and cholecystitis [53,54]; valve endocarditis in immunocompetent patients [55] |
S. haemolyticus | 10 | 29.41 | opportunistic nosocomial pathogen—bacteraemia, meningitis, skin infections, prosthetic joint infections, and endocarditis [56] |
S. capitis | 7 | 20.5 | opportunistic nosocomial pathogen that causes bloodstream infections, joint and valve prosthesis infections, bacterial endocarditis with subsequent osteomyelitis [57] |
S. epidermidis | 23 | 67.65 | skin microbiota; an important opportunistic pathogen that causes bloodstream infections, endocarditis, osteomyelitis, and abscesses in immunocompromised patients; these infections are associated with the use of intravascular catheters, valves, prosthetic heart valves, artificial lenses, and orthopaedic implants [58]. |
S. hominis | 5 | 14.7 | potentially opportunistic and nosocomial pathogen that causes infections in patients with compromised immune systems (infective endocarditis) [59] |
S. pasteuri | 5 | 14.7 | opportunistic pathogen in immunocompromised patients—bacteraemia in patients with leukemia [60]; urinary tract infection associated with the use of a urinary catheter in a patient receiving chemotherapy; endocarditis [61]; osteomyelitis [62] |
S. warneri | 20 | 58.82 | infections in immunocompromised patients (endocarditis, sepsis, septic arthritis, meningitis, cutaneous botryomycosis) [63]; however, there are cases of endocarditis in an immunocompetent patient (early and late endocarditis) after tooth extraction or mammoplasty [64]. |
S. aureus | 5 | 14.7 | causes pneumonia, endocarditis, osteomyelitis, and sepsis in hospitalised and immunocompromised patients [58] |
S. xylosus | 2 | 5.9 | Late knee joint infection in a patient who underwent total knee alloplasty 18 years earlier; commensal bacterium associated with skin and mucous membranes, rarely involved in infections [65] |
S. succinus | 1 | 2.9 | no literature data available |
S. parasanquinis | 1 | 2.9 | It causes endocarditis. It causes infections in 10% of oncological patients; peritonitis was found [66]. |
S. sanguinis | 2 | 5.9 | subacute infective endocarditis; septic arthritis; in patients with periodontal disease, endocarditis, or valvular heart disease [58] |
S. oralis | 2 | 5.9 | low pathogenicity; in rare cases it may cause meningitis in patients after dental procedures and with poor oral hygiene [24]; rare cases of peritonitis associated with peritoneal dialysis [67] |
S. salivarius | 1 | 2.9 | exogenous and endogenous intraocular inflammation in patients with comorbidities [68] |
Gram-positive bacilli (red, spore-forming) | |||
B. pumilus | 6 | 17.6 | septic arthritis in healthy individuals [69] and skin infections [70]; sepsis in a newborn was described in the literature [71]. |
B. mycoides | 3 | 8.8 | blood poisoning described in the literature [72] |
B. weihenstephanensis | 3 | 8.8 | non-pathogenic, dairy contamination [73] |
B. cereus | 3 | 8.8 | Bacteraemia in immunocompromised patients and haematological malignancies [71] |
B. simplex | 4 | 11.76 | no literature data available |
B. muralis | 3 | 8.8 | no literature data available |
B. megaterium | 2 | 5.9 | considered non-pathogenic or at least of very low malignity [74]; however, it may cause pleurisy, inflammation of the eye, dermatitis, and brain abscesses. |
C. novyi | 1 | 2.9 | aetiological agent of severe soft tissue infections in injection heroin users; bacteraemia and hepatic gas gangrene in a patient with gastric cancer and diabetes [75,76] |
L. boronitolerans | 1 | 2.9 | no literature data available |
L. coleohominis | 1 | 2.9 | considered non-pathogenic; isolated from urine and cervix without clinical description [77] |
L. paracasei | 1 | 2.9 | caries, sepsis, pneumonia, infective endocarditis, or splenic abscesses in immunocompromised patients [78] |
Paenibacillus spp. (Gram-positive or Gram-variable) | 1 | 2.9 | no literature data available |
Gram-negative bacilli | |||
B. aurantiaca | 2 | 5.9 | Usually nosocomial infections. The role of this microorganism in human pathogenicity needs further studies but it was linked to two cases of bloodstream infection [79]. |
B. diminuta | 3 | 8.8 | nosocomial infections; peritonitis in a patient with end-stage renal failure; lower leg ulceration in a patient with glomerulonephritis; keratitis; pleurisy; bacteraemia in diabetic and haematological patients [79] |
Brevundimonas spp. | 1 | 2.9 | nosocomial infections [79]. |
S. paucimobilis | 1 | 2.9 | nosocomial (hospital-acquired) and community-acquired infections in patients with chronic diseases and immunosuppressed patients; sepsis, septic pulmonary embolism, septic arthritis, and intraocular inflammation [14,80], wound infections [8,20], septic shock in a patient with burns [4], catheter-related bacteraemia [19], pneumonia [19], splenic abscesses [31], urinary tract infection, empyema [10], peritonitis [5,8,12,19,30]. There were also cases of invasive infections such as meningitis, osteomyelitis [33]. It was reported that S. paucimobilis was isolated from maxillary sinus washouts in four patients, as the irrigation solution (saline) was contaminated with this microorganism [81]. |
Fungi and mould | |||
C. parapsilosis | 2 | 5.9 | opportunistic pathogen, superficial and systemic candidiasis in oncological patients [82] |
Rhodotorula spp. | 1 | 2.9 | fungemia in patients with impaired immune system function; catheter-related sepsis [82]; endocarditis, meningitis [83] |
Alternaria spp. | 17 | 50 | sinusitis, skin infections in immunosuppressed patients [82] |
A. niger | 3 | 8.8 | ear infection, pulmonary aspergillosis in immunocompromised patients [81,82], sinusitis [84] |
Cladosporium spp. | 9 | 26.47 | rarely pathogenic [80] |
Fusarium spp. | 2 | 5.9 | sinusitis in patients with leukemia [82,84], keratitis, pneumonia, hematogenous spread [84] |
F. oxysporum | 13 | 38.2 | isolated from the blood of a patient with leukemia and invasive fusariosis [82] |
Penicilum spp. | 4 | 11.76 | keratitis, pneumonia, endocarditis [85] |
Other | |||
A. Toluolicum | 1 | 2.9 | no literature data available |
Category | Unit | Bottle under the Dental Chair | Cup CFU/mL | Water Container in the Room |
---|---|---|---|---|
Surgical | 1 | S. cohnii 2.7 × 103 C. novyi 3.8 × 103 | S. warneri 8.5 × 103 | |
1 | ||||
2 | M. luteus 7 × 103 S. pasteuri 1.35 × 104 | |||
4 | S. pasteuri 3.4 × 103 S. warneri 2.7 × 103 | |||
6 | Rhodotorula spp. 1.99 × 104 | |||
7 | R. pickettii 1.4 × 103 | |||
8 | B. mycoides 1.1 × 103 L. shinshuensis 4.2 × 103 C. metallidurans 6.4 × 103 | |||
Conservative | 1 | C. metallidurans 1.3 × 103 B. cepacia 6 × 102 | R. pickettii 4.3 × 104 S. epidermidis 1.2 × 103 | |
1 | ||||
2 | B. cepacia 1.3 × 103 | B. simplex 1.2 × 103 S. aureus 4.6 × 102 | ||
2 | S. epidermidis 7.1 × 103 | |||
1 | ||||
2 | S. epidermidis 1.02 × 104 B. pumilus 2.08 × 104 | |||
3 | M. luteus 2.6 × 104 | |||
4 | R. picketti 1.0 × 103 | S. epidermidis 1.14 × 104 | ||
3 | S. epidermidis 6.1 × 103 | |||
1 | ||||
2 | M. luteus 2.2 × 103 | B. pumilus 3.00 × 104 | ||
4 | R. picketti 3.3 × 103 S. warneri 1.6 × 103 S. haemolyticus 1.6 × 103 C. metallidurans 1.9 × 103 | R. amarae 7.6 × 103 | ||
5 | M. luteus 1.2 × 103 B. cepacia 1.4 × 103 | |||
4 | B. pumilus 2.13 × 104 M. luteus 8.8 × 103 | R. picketti 4.7 × 103 S. aureus 1.09 × 103 | ||
1 | ||||
2 | C. pauculus 3.8 × 104 | M. luteus 2.1 × 103 C. pauculus 1.4 × 104 | ||
3 | S. epidermidis 2.2 × 103 S. capitis 9.2 × 103 B. diminuta 4.7 × 103 | |||
4 | R. pickettii 6.46 × 104 R. amarae 5.01 × 102 S. epidermidis 3.5 × 103 | S. pasteuri 1.12 × 104 A. citratiphilum 6.46 × 104 B. pumilus 7.6 × 103 | ||
Periodontal | 1 | B. simplex 6 × 102 | S. epidermidis 1.2 × 104 R. pickettii 2.9 × 103 | |
2 | ||||
2 | S. epidermidis 2.9 × 104 S. pasteuri 1.64 × 104 | R. pickettii 5.4 × 103 S. epidermidis 2.34 × 103 | ||
4 |
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Błaszczyk, B.; Pajączkowska, M.; Nowicka, J.; Szymonowicz, M.; Zakrzewski, W.; Lubojański, A.; Hercuń-Jaskółka, M.; Synowiec, A.; Fedorowicz, S.; Dobrzyński, W.; et al. Microbiological Evaluation of Water Used in Dental Units. Water 2022, 14, 915. https://doi.org/10.3390/w14060915
Błaszczyk B, Pajączkowska M, Nowicka J, Szymonowicz M, Zakrzewski W, Lubojański A, Hercuń-Jaskółka M, Synowiec A, Fedorowicz S, Dobrzyński W, et al. Microbiological Evaluation of Water Used in Dental Units. Water. 2022; 14(6):915. https://doi.org/10.3390/w14060915
Chicago/Turabian StyleBłaszczyk, Bartłomiej, Magdalena Pajączkowska, Joanna Nowicka, Maria Szymonowicz, Wojciech Zakrzewski, Adam Lubojański, Marlena Hercuń-Jaskółka, Aleksandra Synowiec, Sebastian Fedorowicz, Wojciech Dobrzyński, and et al. 2022. "Microbiological Evaluation of Water Used in Dental Units" Water 14, no. 6: 915. https://doi.org/10.3390/w14060915