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Jaber MA, Kamate W, Luke AM, Karande GS. Knowledge, Practices, and Nasal Carriage Rate of MRSA Amongst Dental Professionals. Int Dent J 2024; 74:199-206. [PMID: 37612155 PMCID: PMC10988263 DOI: 10.1016/j.identj.2023.07.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 07/28/2023] [Accepted: 07/29/2023] [Indexed: 08/25/2023] Open
Abstract
OBJECTIVE Resistance of Staphylococcus aureus (S. aureus) against common antibiotics has been increasing given the rampant use of antibiotics. Methicillin-resistant S. aureus (MRSA) is particularly important because it has been reported to present in hospital-acquired as well as community-acquired infections. Our aim was to study the types and subtypes of MRSA isolated from nasal swabs taken from volunteering dental school students and to assess and analyse the knowledge of dental health care workers (DHCWs) on MRSA and prevention of its infection. METHODS A total of 100 participants, which included staff, students, and dental auxiliaries, from the School of Dental Sciences, Krishna Institute of Medical Sciences, Deemed to Be University, Karad, India, were included in the study which was conducted from June 2020 to 1 June 2021. All the participants completed a survey and underwent collection of nasal swabs. The samples were cultured and underwent microbiological and molecular analysis for MRSA. The questionnaire was sent out electronically via SurveyMonkey. RESULTS Sixty-three percent of the participants were female. The majority were undergraduate students (66%) and younger than 25 years (77%). The prevalence of MRSA in the sample was the MRSA type SCCmec type V (54.8%). The survey reports a lack of knowledge amongst dental students on MRSA and prevention of its infection. The majority (69%) of participants had not heard of MRSA infection and had inadequate knowledge of MRSA infection. Only 29% of the participants think that a healthy person may have MRSA without feeling ill. Eighty-five percent of the participants reported that they have written polices and guidelines to control MRSA. Eighty-five percent of the participants indicated that they are less confident in their knowledge on MRSA infection control protocols, and 94% mentioned that the dental clinics have written guidelines for hand hygiene. CONCLUSIONS DHCWs have limited knowledge of MRSA infection, emphasising the need for appropriate clinical training. Academic institutions should promote effective infection control training to protect students, faculty, and other employees.
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Affiliation(s)
- Mohamed A Jaber
- Clinical Sciences Department, College of Dentistry, Ajman University, Ajman, UAE; Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, UAE
| | - Wasim Kamate
- Department of Oral Pathology and Microbiology, School of Dental Sciences, Krishna Institute of Medical Sciences (Deemed to Be University), Karad, Maharashtra, India
| | - Alexander Maniangat Luke
- Clinical Sciences Department, College of Dentistry, Ajman University, Ajman, UAE; Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, UAE.
| | - G S Karande
- Department of Microbiology, Krishna Institute of Medical Sciences (Deemed to Be University), Karad, Maharashtra, India
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Sultana S, Parvin R, Parvin MS, Islam MT, Bari ASM, Chowdhury EH. Prevalence of Methicillin and β−Lactamase Resistant Pathogens Associated with Oral and Periodontal Disease of Children in Mymensingh, Bangladesh. Pathogens 2022; 11:pathogens11080890. [PMID: 36015011 PMCID: PMC9414569 DOI: 10.3390/pathogens11080890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 07/31/2022] [Accepted: 08/02/2022] [Indexed: 11/16/2022] Open
Abstract
Oral and periodontal diseases (OPD) is considered one of the main problems of dentistry worldwide. This study aimed to estimate the prevalence of oral and periodontal pathogenic bacteria along with their antimicrobial resistance pattern in 131 children patients aged between 4–10 years who attended in Mymensingh Medical College Hospital during October 2019 to March 2020. OPD pathogens were identified through isolation, cultural and biochemical properties, and nucleic acid detection. The isolates were subjected to antimicrobial susceptibility to 12 antibiotics commonly used in dentistry. In addition, the isolates were analyzed molecularly for the presence of six virulence and three antibacterial resistance genes. Five pathogens were identified, of which Staphylococcus aureus (S. aureus) (49%) and S. salivarius (46%) were noticed frequently; other bacteria included S. mutans (16.8%), S. sobrinus (0.8%) and L. fermentum (13.7%). The virulence genes—clumping factor A (clfA) was detected in 62.5% isolates of S. aureus, and gelatinase enzyme E (gelE) gene was detected in 5% isolates of S. salivarius, while other virulence genes were not detected. All the tested isolates were multidrug-resistant. The overall prevalence of MDR S. aureus, Streptococcus spp. and L. fermentum was 92.2%, 95.1% and 100%, respectively. It was observed that a high proportion of isolates were found resistant to 5–8 antibiotics. A majority of S. aureus, Streptococcus spp., and L. fermentum isolates tested positive for the β−lactamase resistance genes blaTEM and cfxA, as well as the methicillin resistance gene mecA. Phylogenetically, the resistance genes showed variable genetic character among Bangladeshi bacterial pathogens. In conclusion, S. aureus and S. salivarius were major OPD pathogens in patients attended in Mymensingh Medical College Hospital of Bangladesh, and most were Beta-lactam and methicillin resistant.
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Affiliation(s)
- Sharmin Sultana
- Department of Pathology, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh 2202, Bangladesh
| | - Rokshana Parvin
- Department of Pathology, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh 2202, Bangladesh
| | - Mst. Sonia Parvin
- Population Medicine and AMR Laboratory, Department of Medicine, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh 2202, Bangladesh
| | - Md. Taohidul Islam
- Population Medicine and AMR Laboratory, Department of Medicine, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh 2202, Bangladesh
| | - Abu Saleh Mahfuzul Bari
- Department of Pathology, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh 2202, Bangladesh
| | - Emdadul Haque Chowdhury
- Department of Pathology, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh 2202, Bangladesh
- Correspondence:
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Godijk NG, Bootsma MCJ, Bonten MJM. Transmission routes of antibiotic resistant bacteria: a systematic review. BMC Infect Dis 2022; 22:482. [PMID: 35596134 PMCID: PMC9123679 DOI: 10.1186/s12879-022-07360-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 03/28/2022] [Indexed: 11/16/2022] Open
Abstract
Background Quantification of acquisition routes of antibiotic resistant bacteria (ARB) is pivotal for understanding transmission dynamics and designing cost-effective interventions. Different methods have been used to quantify the importance of transmission routes, such as relative risks, odds ratios (OR), genomic comparisons and basic reproduction numbers. We systematically reviewed reported estimates on acquisition routes’ contributions of ARB in humans, animals, water and the environment and assessed the methods used to quantify the importance of transmission routes. Methods PubMed and EMBASE were searched, resulting in 6054 articles published up until January 1st, 2019. Full text screening was performed on 525 articles and 277 are included. Results We extracted 718 estimates with S. aureus (n = 273), E. coli (n = 157) and Enterobacteriaceae (n = 99) being studied most frequently. Most estimates were derived from statistical methods (n = 560), mainly expressed as risks (n = 246) and ORs (n = 239), followed by genetic comparisons (n = 85), modelling (n = 62) and dosage of ARB ingested (n = 17). Transmission routes analysed most frequently were occupational exposure (n = 157), travelling (n = 110) and contacts with carriers (n = 83). Studies were mostly performed in the United States (n = 142), the Netherlands (n = 87) and Germany (n = 60). Comparison of methods was not possible as studies using different methods to estimate the same route were lacking. Due to study heterogeneity not all estimates by the same method could be pooled. Conclusion Despite an abundance of published data the relative importance of transmission routes of ARB has not been accurately quantified. Links between exposure and acquisition are often present, but the frequency of exposure is missing, which disables estimation of transmission routes’ importance. To create effective policies reducing ARB, estimates of transmission should be weighed by the frequency of exposure occurrence. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07360-z.
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Affiliation(s)
- Noortje G Godijk
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - Martin C J Bootsma
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Department of Mathematics, Faculty of Sciences, Utrecht University, Utrecht, The Netherlands
| | - Marc J M Bonten
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Srivastava A, Andersen MR, Alshehri AM, Lara B, Bashiri R, Li G, Chambers MS. Effectiveness of a Chairside Acrylic Adjustment Cabinet in Reducing Dental Acrylic Debris and Aerosols. J Prosthodont 2021; 31:488-495. [PMID: 34855263 DOI: 10.1111/jopr.13463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Chairside prosthesis adjustment procedures generate contaminated acrylic particle debris that include visible splatter (particles >50 μm) as well as invisible aerosols (<50 µm). The purpose of this study was to evaluate the effectiveness of a chairside acrylic adjustment cabinet (CAAC) in reducing airborne aerosol particles (<10 µm) and visible acrylic debris, time required for airborne aerosols to return to baseline levels after an acrylic adjustment procedure, and the effect on operatory turnover time. MATERIALS AND METHODS A total of 40 acrylic adjustment procedures were carried out in a simulated setting with (experiment) and without (control) a CAAC. Standardized acrylic samples of self-polymerized, and heat polymerized polymethylmethacrylate resins, Triad™ and Fastray™ custom tray materials were evaluated. Airborne aerosol measurements were done using a handheld Lase.r Particle Counter for absolute particle counts of sizes 0.3, 0.5, 1.0, 2.5, 5.0, and 10.0 μm before, during, and immediately after adjustment and 10 minutes postadjustment. Spread of aerosols was assessed at three distinct locations within the dental operatory specific to the provider, the patient, and the caregiver/guest. Visible acrylic debris and operatory turnover time were evaluated immediately postadjustments by a blinded investigator. Repeated measures ANOVA was used to estimate group effect, time effect and interaction between group and time for air particle analysis. Independent samples T-tests were used for group differences between operatory turnover time, and time for aerosols to return to baseline. Chi-square test was used for visible surface analysis. RESULTS In the control group, total aerosol particle counts increased from 6542.7 ± 162.6 particles at baseline to 598378.7 ± 586363.2 and 367569.9 ± 432220.8 particles during and immediately postadjustment, respectively. Adjustments made in the experiment group led to significantly reduced aerosol counts during (97738.9 ± 97866.5) and immediately postadjustment (19786.5 ± 14004.9; F = 17.8, p = 0.006). Similar trends were noted for the patient and guest positions. Time for aerosol particles to return to baseline was significantly lower in the experiment group (20.56 ± 14.5 minutes) compared to the control group (37.9 ± 31.96 minutes; p = 0.03). Visible acrylic debris analysis showed a significant decrease of 78% in the experiment group (p < 0.001). No significant differences were noted in operatory turnover time between the two groups (p = 0.61). CONCLUSIONS Acrylic adjustment procedures generated aerosols of particle sizes less than 10 µm and were measured in significant quantities throughout the dental operatory for up to 115 minutes. Chairside acrylic adjustment cabinets significantly decreased airborne aerosols, visible acrylic particle debris, and reduced the time for airborne aerosols to return to baseline levels.
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Affiliation(s)
- Akanksha Srivastava
- Department of Surgery, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Michael R Andersen
- Department of Hospital Dentistry, Naval Medical Center, San Diego, CA, USA
| | - Abdulkareem M Alshehri
- Maxillofacial Prosthodontics Surgical Dentistry, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Bryan Lara
- Private practice, Inwood, West Virginia, USA
| | - Rafiullah Bashiri
- Division of Comprehensive Oral Health, Adams School of Dentistry, The University of North Carolina, Chapel Hill, NC, USA
| | - Guojun Li
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Mark S Chambers
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
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Baudet A, Guillaso M, Grimmer L, Regad M, Florentin A. Microbiological Contamination of the Office Environment in Dental and Medical Practice. Antibiotics (Basel) 2021; 10:antibiotics10111375. [PMID: 34827313 PMCID: PMC8614722 DOI: 10.3390/antibiotics10111375] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/03/2021] [Accepted: 11/08/2021] [Indexed: 12/19/2022] Open
Abstract
The microbiological contamination of the environment in independent healthcare facilities such as dental and general practitioner offices was poorly studied. The aims of this study were to describe qualitatively and quantitatively the bacterial and fungal contamination in these healthcare facilities and to analyze the antibiotic resistance of bacterial pathogens identified. Microbiological samples were taken from the surfaces of waiting, consulting, and sterilization rooms and from the air of waiting room of ten dental and general practitioner offices. Six surface samples were collected in each sampled room using agar contact plates and swabs. Indoor air samples were collected in waiting rooms using a single-stage impactor. Bacteria and fungi were cultured, then counted and identified. Antibiograms were performed to test the antibiotic susceptibility of bacterial pathogens. On the surfaces, median concentrations of bacteria and fungi were 126 (range: 0–1280) and 26 (range: 0–188) CFU/100 cm2, respectively. In indoor air, those concentrations were 403 (range: 118–732) and 327 (range: 32–806) CFU/m3, respectively. The main micro-organisms identified were Gram-positive cocci and filamentous fungi, including six ubiquitous genera: Micrococcus, Staphylococcus, Cladosporium, Penicillium, Aspergillus, and Alternaria. Some antibiotic-resistant bacteria were identified in general practitioner offices (penicillin- and erythromycin-resistant Staphylococcus aureus), but none in dental offices. The dental and general practitioner offices present a poor microbiological contamination with rare pathogenic micro-organisms.
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Affiliation(s)
- Alexandre Baudet
- Faculté d’Odontologie, Université de Lorraine, F-54505 Vandœuvre-lès-Nancy, France
- Service d’Odontologie, CHRU-Nancy, F-54000 Nancy, France
- APEMAC, Université de Lorraine, F-54505 Vandœuvre-lès-Nancy, France;
- Correspondence:
| | - Monique Guillaso
- Département d’Hygiène, des Risques Environnementaux et Associés aux Soins, Faculté de Médecine, Université de Lorraine, F-54505 Vandœuvre-lès-Nancy, France; (M.G.); (L.G.); (M.R.)
| | - Léonie Grimmer
- Département d’Hygiène, des Risques Environnementaux et Associés aux Soins, Faculté de Médecine, Université de Lorraine, F-54505 Vandœuvre-lès-Nancy, France; (M.G.); (L.G.); (M.R.)
| | | | - Marie Regad
- Département d’Hygiène, des Risques Environnementaux et Associés aux Soins, Faculté de Médecine, Université de Lorraine, F-54505 Vandœuvre-lès-Nancy, France; (M.G.); (L.G.); (M.R.)
- Département Territorial d’Hygiène et de Prévention du Risque Infectieux, CHRU-Nancy, F-54505 Vandœuvre-lès-Nancy, France
| | - Arnaud Florentin
- APEMAC, Université de Lorraine, F-54505 Vandœuvre-lès-Nancy, France;
- Département d’Hygiène, des Risques Environnementaux et Associés aux Soins, Faculté de Médecine, Université de Lorraine, F-54505 Vandœuvre-lès-Nancy, France; (M.G.); (L.G.); (M.R.)
- Département Territorial d’Hygiène et de Prévention du Risque Infectieux, CHRU-Nancy, F-54505 Vandœuvre-lès-Nancy, France
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Indoor Air Quality in Healthcare and Care Facilities: Chemical Pollutants and Microbiological Contaminants. ATMOSPHERE 2021. [DOI: 10.3390/atmos12101337] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The indoor air quality of healthcare and care facilities is poorly studied. The aim of this study was to qualitatively and quantitatively describe the chemical pollution and the microbiological contaminations of the indoor environment of these facilities. Methods: A wide range of chemical compounds (39 volatile and 13 semi-volatile organic compounds, carbon dioxide, fine particulate matter) and microorganisms (fungi and bacteria) were studied. Sampling campaigns were conducted in two French cities in summer 2018 and winter 2019 in six private healthcare facilities (general practitioner’s offices, dental offices, pharmacies) and four care facilities (nursing homes). Results: The highest median concentrations of chemical compounds (μg/m3) were measured for alcohols (ethanol: 378.9 and isopropanol: 23.6), ketones (acetone: 18.8), aldehydes (formaldehyde: 11.4 and acetaldehyde: 6.5) and terpenes (limonene: 4.3). The median concentration of PM2.5 was 9.0 µg/m3. The main bacteria of these indoor environments were Staphylococcus, Micrococcus and Bacillus genera, with median bacterial concentrations in the indoor air of 14 cfu/m3. The two major fungal genera were Cladosporium and Penicillium, with median fungal concentrations of 7 cfu/m3. Conclusions: Indoor air in healthcare and care facilities contains a complex mixture of many pollutants found in higher concentrations compared to the indoor air in French hospitals in a previous study.
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Lerche N, Holtfreter S, Walther B, Semmler T, Al'Sholui F, Dancer SJ, Daeschlein G, Hübner NO, Bröker BM, Papke R, Kohlmann T, Baguhl R, Seifert U, Kramer A. Staphylococcus aureus nasal colonization among dental health care workers in Northern Germany (StaphDent study). Int J Med Microbiol 2021; 311:151524. [PMID: 34371345 DOI: 10.1016/j.ijmm.2021.151524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 06/10/2021] [Accepted: 07/16/2021] [Indexed: 10/20/2022] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) can colonize dental patients and students, however, studies on the prevalence of MRSA and methicillin-susceptible S. aureus (MSSA) among dental health care workers (DHCW) including use of personal protective equipment (PPE) are scarce. We conducted an observational study (StaphDent study) to (I) determine the prevalence of MRSA and MSSA colonization in DHCW in the region of Mecklenburg Western-Pomerania, Germany, (II) resolve the S. aureus population structure to gain hints on possible transmission events between co-workers, and (III) clarify use of PPE. Nasal swabs were obtained from dentists (n = 149), dental assistants (n = 297) and other dental practice staff (n = 38). Clonal relatedness of MSSA isolates was investigated using spa typing and, in some cases, whole genome sequencing (WGS). PPE use was assessed by questionnaire. While 22.3% (108/485) of the participants were colonized with MSSA, MRSA was not detected. MSSA prevalence was not associated with size of dental practices, gender, age, or duration of employment. The identified 61 spa types grouped into 17 clonal complexes and four sequence types. Most spa types (n = 47) were identified only once. In ten dental practices one spa type occurred twice. WGS data analysis confirmed a close clonal relationship for 4/10 isolate pairs. PPE was regularly used by most dentists and assistants. To conclude, the failure to recover MRSA from DHCW reflects the low MRSA prevalence in this region. Widespread PPE use suggests adherence to routine hygiene protocols. Compared to other regional HCW MRSA rates the consequent usage of PPE seems to be protective.
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Affiliation(s)
- Nadine Lerche
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, DE-17475, Greifswald, Germany.
| | - Silva Holtfreter
- Institute of Immunology, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, DE-17475, Greifswald, Germany.
| | - Birgit Walther
- ZBS 4, Advanced Light and Electron Microscopy, Robert Koch Institute, Seestraße 10, DE-13353, Berlin, Germany.
| | - Torsten Semmler
- Microbial Genomics (NG1), Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany.
| | - Fawaz Al'Sholui
- Institute of Immunology, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, DE-17475, Greifswald, Germany.
| | - Stephanie J Dancer
- Department of Microbiology, Hairmyres Hospital, NHS Lanarkshire, G75 8RG, UK; School of Applied Sciences, Edinburgh Napier University, Edinburgh, EH11 4BN, UK.
| | - Georg Daeschlein
- Department of Dermatology, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, DE-17475, Greifswald, Germany.
| | - Nils-Olaf Hübner
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, DE-17475, Greifswald, Germany; Central Unit for Infection Prevention and Control, University Medicine Greifswald, 17475, Greifswald, Germany.
| | - Barbara M Bröker
- Institute of Immunology, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, DE-17475, Greifswald, Germany.
| | - Roald Papke
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, DE-17475, Greifswald, Germany.
| | - Thomas Kohlmann
- Institute for Community Medicine, Methodical Subdivision, University Medicine Greifswald, Walther-Rathenau-Str. 48, DE-17475, Greifswald, Germany.
| | - Romy Baguhl
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, DE-17475, Greifswald, Germany.
| | - Ulrike Seifert
- Friedrich Loeffler Institute of Medical Microbiology, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, DE-17475, Greifswald, Germany.
| | - Axel Kramer
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, DE-17475, Greifswald, Germany.
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Pandora's box in the dental clinic. Infect Control Hosp Epidemiol 2021; 43:742-746. [PMID: 34011423 DOI: 10.1017/ice.2021.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND In June 2018, the Ministry of Health received notification from 2 hospitals about 2 patients who presented with overwhelming Enterobacter kobei sepsis that developed within 24 hours after a dental procedure. We describe the investigation of this outbreak. METHODS The epidemiologic investigation included site visits in 2 dental clinics and interviews with all involved healthcare workers. Chart reviews were conducted for case and control subjects. Samples were taken from medications and antiseptics, environmental surfaces, dental water systems, and from the involved healthcare professionals. Isolate similarity was assessed using repetitive element sequence-based polymerase chain reaction (REP-PCR). RESULTS The 2 procedures were conducted in different dental clinics by different surgeons and dental technicians. A single anesthesiologist administered the systemic anesthetic in both cases. Cultures from medications, fluids and healthcare workers' hands were negative, but E. kobei was detected from the anesthesiologist's portable medication cart. The 2 human isolates and the environmental isolate shared the same REP-PCR fingerprinting profile. None of the 21 patients treated by the anesthesiologist in a general hospital during the same period, using the hospital's medications, developed infection following surgery. CONCLUSIONS An outbreak of post-dental-procedure sepsis was linked to a contaminated medication cart, emphasizing the importance of medication storage standards and strict aseptic technique when preparing intravenous drugs during anesthesia. Immediate reporting of sepsis following these outpatient procedures enabled early identification and termination of the outbreak.
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Taheri S, Shahabinezhad G, Torabi M, Parizi ST. Investigation of Microbial Contamination in the Clinic and Laboratory of the Prosthodontics Department of Dental School. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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10
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Diagnosis and Treatment of Lip Infections. J Oral Maxillofac Surg 2020; 79:133-140. [PMID: 32673574 DOI: 10.1016/j.joms.2020.06.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/16/2020] [Accepted: 06/16/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE Staphylococcus aureus is a gram-positive, facultative anaerobic, cocci bacterium that naturally colonizes the skin. S aureus can cause a mild to severe infection depending on the location, depth of invasion, and immune status. Guidelines regarding treatment of patients with lip infections are scant. The purpose of this study was to present the diagnosis, management, and outcome of a cohort of patients with lip infections caused by S aureus. MATERIALS AND METHODS This was a retrospective cohort study of patients with a lip infection caused by S aureus treated by Emory Oral and Maxillofacial Surgery Service (Atlanta, GA). Predictor variables were patient demographic characteristics, clinical presentation, laboratory findings, imaging characteristics, intervention, and length of stay. The outcome variable was infection resolution or persistence. Data were collected using a standardized collection form. Descriptive statistics were computed. RESULTS Seven patients (mean age, 38 years) with lip swelling met the inclusion criteria. The patients did not undergo recent hospitalization and/or recent surgery. Patients had immunodeficiency virus or other medical comorbidities. Radiographic findings were consistent with abscess formation. Management consisted of antibiotics only or surgical intervention with antibiotics. Lip cultures showed S aureus with methicillin-sensitive or -resistant S aureus. Treatment was intravenous followed by oral antibiotics. The average length of inpatient stay was 4 days. There were no postoperative complications. All lip infections achieved complete clinical resolution. CONCLUSIONS In this cohort, treatment of lip swelling caused by S aureus required surgical intervention and/or antibiotics. Immune compromise and antibiotic resistance should be considered in a patient with a similar presentation.
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Rao NS, Nayak PP, Prasad K. Nasal conveyance of Methicillin-resistant Staphylococcus aureus (MRSA) strains among dental professionals with varying levels of clinical exposure: A comparative study. J Oral Biol Craniofac Res 2020; 10:310-313. [PMID: 32695566 PMCID: PMC7365827 DOI: 10.1016/j.jobcr.2019.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 07/08/2019] [Accepted: 12/17/2019] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Any control program for MRSA requires identifying the whole hospital reservoir. The likelihood of conveyance of MRSA may be higher in dental settings. Hence, the aim was to compare the nasal conveyance MRSA among dental professionals with varying levels of clinical exposure in a tertiary dental hospital in South India. METHODS A total of 81 volunteers were stratified based on the number of years of clinical exposure. The nasal swabs were subjected to catalase and coagulase tests as well as antibiotic susceptibility test. Chi- Square test was done to compare the different types of organisms isolated from dental professionals with varied levels of clinical exposure. RESULTS Out of the total 81 isolates, 62.96% of the isolates were MSCONS (Methicillin sensitive coagulase negative staphylococcus), 20.98% of them were MRCONS (Methicillin resistant coagulase negative staphylococcus), 9.87% were MSSA (Methicillin sensitive staphylococcus aureus) and 3.7% were MRSA positive and 2.46% were other gram negative organisms. CONCLUSIONS MRCONS, MSSA and MRSA were shown to increase with an increase in the clinical exposure years.
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Affiliation(s)
| | - Prajna Pramod Nayak
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
| | - K.V.V. Prasad
- Department of Public Health Dentistry, SDM College of Dental Sciences, Dharwad, India
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Senok A, Nassar R, Kaklamanos EG, Belhoul K, Abu Fanas S, Nassar M, Azar AJ, Müller E, Reissig A, Gawlik D, Monecke S, Ehricht R. Molecular Characterization of Staphylococcus aureus Isolates Associated with Nasal Colonization and Environmental Contamination in Academic Dental Clinics. Microb Drug Resist 2020; 26:661-669. [PMID: 31910349 DOI: 10.1089/mdr.2019.0318] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Aim: To determine the genetic makeup of methicillin-sensitive/methicillin-resistant Staphylococcus aureus (MSSA/MRSA) from nasal colonization and environmental contamination in dental clinics. Materials and Methods: Nasal swabs from students and health care workers and environmental swabs were obtained at two academic dental clinics in the United Arab Emirates. The StaphyType DNA microarray-based assay was used for molecular characterization. Results: Forty-eight S. aureus isolates were identified phenotypically (nasal: n = 43; environmental: n = 5), but 6 of these were assigned to S. argenteus by genotyping. These were CC(argenteus)2596, CC(arg)2250-MSSA, CC(arg)2250-MSSA-(Panton Valentine leukocidin [PVL]+) (n = 2), and CC(arg)2198-MSSA (n = 2). MRSA nasal colonization rate was 5.4% (n/N = 8/146) with the following strain affiliations: CC5-MRSA-[IV+fus+ccrAB], "Maltese Clone"; CC6-MRSA-IV, "WA MRSA-51"; CC22-MRSA-IV (PVL+/tst+); CC22-MRSA-[IV+fus+ccrAA/(C)]; and two each of CC5-MRSA-[VI+fus] and CC97-MRSA-[V/VT+fus]. The SCC-borne fusidic acid resistance (fusC) gene was detected in MRSA (n = 5) and MSSA (n = 1). Some MSSA strains, CC1-MSSA-[fus+ccrAB1] and ST1278-MSSA-[ccrA1], harbored recombinase genes. A CC30-MSSA harbored ACME locus/arc-genes, while ST1278-MSSA-[ccrA1] had an ACME-III element. Enterotoxin genes were commonly carried, but tst-1 gene was found in only CC22, CC30, and CC34 strains, while pvl genes were identified in CC(arg)2250 and CC22-MRSA-IV. Of the 51 noncoagulase staphylococci (CoNS) identified, 18 were mecA positive. Conclusion: The findings demonstrate the first report of rare strains (ST1278 MSSA, CC(arg)2198, CC(arg)2596, and PVL+CC(arg)2250) in our region. Detection of MSSA with recombinase genes and ACME loci alongside mecA-positive CoNS is of clinical significance as this could provide a milieu for acquisition and transfer of SCC-elements, either with different ACME types, with fusC or the mecA gene resulting in conversion of MSSA into MRSA.
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Affiliation(s)
- Abiola Senok
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Rania Nassar
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.,Oral and Biomedical Sciences, School of Dentistry, Cardiff University, Cardiff, United Kingdom
| | - Eleftherios G Kaklamanos
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Khawla Belhoul
- Dubai Dental Hospital, Dubai Healthcare City, Dubai, United Arab Emirates
| | - Salem Abu Fanas
- College of Dentistry, Ajman University, Ajman, United Arab Emirates
| | - Mohannad Nassar
- RAK College of Dental Sciences, RAK Medical and Health Sciences University, Ras Al-Khaimah, United Arab Emirates
| | - Aida J Azar
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Elke Müller
- InfectoGnostics Research Campus Jena, Jena, Germany.,Leibniz Institute of Photonic Technology (IPHT), Jena, Germany
| | - Annett Reissig
- InfectoGnostics Research Campus Jena, Jena, Germany.,Leibniz Institute of Photonic Technology (IPHT), Jena, Germany
| | - Darius Gawlik
- Alere Technologies GmbH/Abbott, Jena, Germany.,Institute of Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany
| | - Stefan Monecke
- InfectoGnostics Research Campus Jena, Jena, Germany.,Leibniz Institute of Photonic Technology (IPHT), Jena, Germany.,Medical Faculty "Carl Gustav Carus," Institute for Medical Microbiology and Hygiene, Technische Universität Dresden, Dresden, Germany
| | - Ralf Ehricht
- InfectoGnostics Research Campus Jena, Jena, Germany.,Leibniz Institute of Photonic Technology (IPHT), Jena, Germany.,Institute of Physical Chemistry, Friedrich Schiller University Jena, Jena, Germany
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13
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Gonçalves E, Carvalhal R, Mesquita R, Azevedo J, Coelho MJ, Magalhães R, Ferraz MP, Manso MC, Gavinha S, Pina C, Lopes Cardoso I. Detection of Staphylococcus aureus (MRSA/MSSA) in surfaces of dental medicine equipment. Saudi J Biol Sci 2019; 27:1003-1008. [PMID: 32256160 PMCID: PMC7105652 DOI: 10.1016/j.sjbs.2019.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 11/26/2019] [Accepted: 12/02/2019] [Indexed: 11/25/2022] Open
Abstract
Methicillin-Resistant Staphylococcus aureus (MRSA) represents one of the major causes of nosocomial infections, leading to high mortality. Surfaces in clinics, as well as the attending uniform and the hands of the dental doctor can be MRSA reservoirs. Having this in mind, the purpose of this study was to evaluate the presence of Methicillin-Sensitive Staphylococcus aureus (MSSA) and MRSA on dental medicine equipment surfaces. 354 Samples were collected from six equipment surfaces in six attendance areas before and after patient consultation and cultured in a selective medium. Polymerase Chain Reaction (PCR) was used to confirm the identity of bacterial strains as MRSA or MSSA. Data analysis was performed with chi-square tests with Bonferroni correction. It was observed 55.6% of uncontaminated samples. Contamination was: 17.5% MRSA (5.9% of samples collected before patient attendance and 11.6% after); 39.3% MSSA (14.1% collected before and 25.2% after). The prevalence of MRSA and MSSA was significantly higher after patient care. Integrated Clinic represented the most contaminated attendance area (MRSA − 41.7%, MSSA − 51.2%), the chair arm rest was the most contaminated surface for MRSA (29.7%) and the dental spittoon the most contaminated surface for MSSA (23.5%). Although a low level of contamination was observed, dental clinics, through patients possibly carrying bacteria, may be reservoirs for MRSA and MSSA transmission, and might contribute to potential nosocomial infections.
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Affiliation(s)
- Eva Gonçalves
- Health Sciences Faculty, University Fernando Pessoa, Porto, Portugal
| | - Rui Carvalhal
- Health Sciences Faculty, University Fernando Pessoa, Porto, Portugal
| | - Rita Mesquita
- Health Sciences Faculty, University Fernando Pessoa, Porto, Portugal
| | - Joana Azevedo
- Health Sciences Faculty, University Fernando Pessoa, Porto, Portugal
| | - Maria João Coelho
- Health Sciences Faculty, University Fernando Pessoa, Porto, Portugal.,FP-ENAS - UFP Energy, Environment and Health Research Unit, University Fernando Pessoa, Porto, Portugal
| | - Ricardo Magalhães
- Health Sciences Faculty, University Fernando Pessoa, Porto, Portugal.,FP-ENAS - UFP Energy, Environment and Health Research Unit, University Fernando Pessoa, Porto, Portugal
| | - Maria Pia Ferraz
- Health Sciences Faculty, University Fernando Pessoa, Porto, Portugal.,FP-ENAS - UFP Energy, Environment and Health Research Unit, University Fernando Pessoa, Porto, Portugal
| | - Maria Conceição Manso
- Health Sciences Faculty, University Fernando Pessoa, Porto, Portugal.,FP-ENAS - UFP Energy, Environment and Health Research Unit, University Fernando Pessoa, Porto, Portugal.,LAQV, REQUIMTE, University of Porto, Porto, Portugal
| | - Sandra Gavinha
- Health Sciences Faculty, University Fernando Pessoa, Porto, Portugal
| | - Cristina Pina
- Health Sciences Faculty, University Fernando Pessoa, Porto, Portugal.,FP-ENAS - UFP Energy, Environment and Health Research Unit, University Fernando Pessoa, Porto, Portugal
| | - Inês Lopes Cardoso
- Health Sciences Faculty, University Fernando Pessoa, Porto, Portugal.,FP-ENAS - UFP Energy, Environment and Health Research Unit, University Fernando Pessoa, Porto, Portugal
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14
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Patil AK, Namineni S, Cheruku SR, Penmetsa C, Penmetcha S, Mallineni SK. Prevalence of Community-Associated Methicillin-Resistant Staphylococcus aureus in Oral and Nasal Cavities of 4 to 13-year-old Rural School Children: A Cross-sectional Study. Contemp Clin Dent 2019; 10:99-104. [PMID: 32015650 PMCID: PMC6974982 DOI: 10.4103/ccd.ccd_452_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Aim: This study aimed to investigate the oral and nasal prevalence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in 4 to 13-year-old rural schoolchildren. Materials and Methods: A total of 100 children aged 4 to 13 years were randomly selected and divided into ten groups based on their age (Group 1 = 4-year-old children to Group 10 = 13-year-old children). From each participating child, sampling was done from the anterior nares and dorsum of the tongue. All samples were inoculated into Baird–Parker agar medium and HiCrome™ MeReSa agar medium for the isolation of SA and MRSA. Both the culture plates were checked for the presence of SA and MRSA and overall SA and MRSA carriage. The distribution of SA and MRSA was evaluated. Descriptive statistics were performed using SPSS software (version 17.0). Results: Overall SA in 4–13 years’ age group was 47%, while CA-MRSA was 35%. On the tongue, 16 children had concomitant MRSA and SA, while only 23.8% (n = 20) of the children comprised the presence of SA when MRSA was absent (P < 0.001). In the nasal cavity, 30 children had concomitant MRSA and SA, while only 21.4% (n = 15) of the children had the presence of SA when MRSA was absent (P < 0.001). When tongue and nose were assessed, 11 children encompassed concomitant MRSA and SA, while only 16.9% (n = 13) of the children had the presence of SA when MRSA was absent in both sites (P < 0.001). Conclusion: A significant relation was found between nasal SA and CA-MRSA carriage, with oral SA and CA-MRSA carriage. The study concludes that oral cavity is possibly as important as the nasal area as a zone of SA and MRSA. Dentists dealing with pediatric population should take proper precautions to prevent cross contamination of SA and MRSA in the dental clinic.
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Affiliation(s)
- Anil Kumar Patil
- Department of Pedodontics and Preventive Dentistry, Sri Sai College of Dental Surgery, Vikarabad, Hyderabad, Telangana, India
| | - Srinivas Namineni
- Department of Pedodontics and Preventive Dentistry, Sri Sai College of Dental Surgery, Vikarabad, Hyderabad, Telangana, India
| | - Sampath Reddy Cheruku
- Department of Pedodontics and Preventive Dentistry, Sri Sai College of Dental Surgery, Vikarabad, Hyderabad, Telangana, India
| | - Chandana Penmetsa
- Department of Pedodontics and Preventive Dentistry, Sri Sai College of Dental Surgery, Vikarabad, Hyderabad, Telangana, India
| | - Sarada Penmetcha
- Department of Pedodontics and Preventive Dentistry, Sri Sai College of Dental Surgery, Vikarabad, Hyderabad, Telangana, India
| | - Sreekanth Kumar Mallineni
- Department of Pedodontics and Preventive Dentistry, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India.,Department of Preventive Dental Science, College of Dentistry, Majmaah University, Al-Zulfi, KSA
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15
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Boriollo MFG, Bassi RC, Höfling JF. Isoenzymatic genotyping of Staphylococcus aureus from dairy cattle and human clinical environments reveal evolutionary divergences. Rev Inst Med Trop Sao Paulo 2018; 60:e54. [PMID: 30231148 PMCID: PMC6169399 DOI: 10.1590/s1678-9946201860054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 12/18/2017] [Indexed: 11/24/2022] Open
Abstract
Background The genetic variability of 610 S. aureus isolates from the
hands of professional dentists (A), dental clinic environment air (B),
bovine milk from cows with and without mastitis (C), an insufflator for
milking equipment (D) and milking environment air (E) was studied by
isoenzyme genotyping and genetic and cluster analysis. Results Monoclonal and polyclonal patterns of S. aureus were
detected in every bacterial population; however, isolates belonging to the
same strain were not found among the populations, suggesting the genetic
heterogeneity and the intrapopulation spread of strains. Genetic
relationship analysis revealed the co-existence of highly related strains at
low frequency among populations. Conclusion The data suggest that some strains can adapt and colonize new
epidemiologically unrelated habitats. Consequently, the occurrence of an
epidemiological genotypic identity can assume a dynamic character (spread to
new habitats), however infrequently. A tendency of microevolutionary and
genetic divergences among populations of S. aureus from
human sources (AB) and bovine milk (DE), and especially the mammary quarter
(C), is also suggested. This research can contribute to the knowledge on the
distribution and dissemination of strains and the implementation of control
measures and eradication of S. aureus in important dental
clinic environments, as well as animal environments and dairy
production.
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Affiliation(s)
- Marcelo Fabiano Gomes Boriollo
- Departamento de Diagnóstico Oral, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Piracicaba, São Paulo, Brazil
| | - Rodrigo Carlos Bassi
- Departamento de Diagnóstico Oral, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Piracicaba, São Paulo, Brazil
| | - José Francisco Höfling
- Departamento de Diagnóstico Oral, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Piracicaba, São Paulo, Brazil
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16
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Bernardo WLDC, Silva JJD, Höfling JF, Rosa EAR, Boriollo MFG. Dynamics of the seasonal airborne propagation of Staphylococcus aureus in academic dental clinics. J Appl Oral Sci 2018; 26:e20170141. [PMID: 29641749 PMCID: PMC5912401 DOI: 10.1590/1678-7757-2017-0141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 09/26/2017] [Indexed: 12/05/2022] Open
Abstract
Objective Staphylococcus aureus strains can be disseminated during dental treatments and occasionally lead to the contamination and infection of patients and dentists, which is an important public health problem. The dynamics of the airborne propagation and the genetic diversity of S. aureus isolated in an academic dental clinic environment were investigated using isoenzyme typing. Material and Methods The isoenzymes of 44 previously reported isolates were obtained from fresh cultures and extracted using glass beads. Nine isoenzymes were investigated using multilocus enzyme electrophoresis (MLEE). The genetic diversity and relationship among the strains (electrophoretic type – ET) were determined using statistics previously described by Nei25 (1972) and the SAHN grouping method (UPGMA algorithm). Results Clonal pattern analyses indicated a high level of genetic polymorphism occurring among the 33 ETs, which were grouped into five taxa. Each taxon presented one or more clusters that were moderately related and that contained two or more identical/highly related isolates, revealing seasonal airborne propagation in these dental clinic environments. Conclusions These data suggest the occurrence of active microevolutionary processes in S. aureus as well as the possibility of environmental propagation during a 14-month time span. Such findings are important to show that multiuser academic dental clinics can retain certain strains that are spreadable to different niches.
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Affiliation(s)
- Wagner Luiz de Carvalho Bernardo
- Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba, Departamento de Diagnóstico Oral, Laboratório de Microbiologia e Imunologia, Piracicaba, São Paulo, Brasil
| | - Jeferson Júnior da Silva
- Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba, Departamento de Diagnóstico Oral, Laboratório de Microbiologia e Imunologia, Piracicaba, São Paulo, Brasil.,Universidade José do Rosário Vellano, Faculdade de Medicina, Laboratório de Farmacogenética e Biologia Molecular, Alfenas, Minas Gerais, Brasil
| | - José Francisco Höfling
- Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba, Departamento de Diagnóstico Oral, Laboratório de Microbiologia e Imunologia, Piracicaba, São Paulo, Brasil
| | - Edvaldo Antônio Ribeiro Rosa
- Pontifícia Universidade Católica do Paraná, Escola de Ciências da Vida, Unidade de Pesquisa com Xenobióticos, Curitiba, Paraná, Brasil
| | - Marcelo Fabiano Gomes Boriollo
- Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba, Departamento de Diagnóstico Oral, Laboratório de Microbiologia e Imunologia, Piracicaba, São Paulo, Brasil.,Universidade José do Rosário Vellano, Faculdade de Medicina, Laboratório de Farmacogenética e Biologia Molecular, Alfenas, Minas Gerais, Brasil
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17
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Yoo YJ, Kwak EJ, Jeong KM, Baek SH, Baek YS. Knowledge, attitudes and practices regarding methicillin-resistant Staphylococcus aureus (MRSA) infection control and nasal MRSA carriage rate among dental health-care professionals. Int Dent J 2018; 68:359-366. [PMID: 29577266 DOI: 10.1111/idj.12388] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Dental health-care professionals (DHCPs) with nasal colonisation of methicillin-resistant Staphylococcus aureus (MRSA) can serve as a reservoir for MRSA transmission to others and be exposed to self-contamination with MRSA. Evaluating the knowledge, attitudes and actual practice of DHCPs is imperative for appropriate infection control. METHODS Dentists, dental hygienists and dental technologists from Seoul National University Dental Hospital were recruited to participate in a cross-sectional survey and undergo nasal sampling of MRSA. The survey included demographic questions, six questions about knowledge, eight questions about attitudes/perceptions and six questions about practices/behaviours regarding MRSA infection control. Nasal samples from the participants were analysed for MRSA presence, antimicrobial susceptibility and staphylococcal cassette chromosome mec (SCCmec) typing. MRSA carriers underwent decolonisation with topical mupirocin. RESULTS Among 139 DHCPs, four (2.9%) were nasal MRSA carriers. Decolonisation was successful in three participants. One participant was decolonised with topical fusidic acid after failure to decolonise with mupirocin. Dentists had a higher knowledge score compared with the other professionals (P < 0.05). Dental hygienists scored higher on practice questions compared with the other professionals (P < 0.05). There was a significant, positive correlation between attitude and practice scores (P < 0.01). CONCLUSIONS The nasal MRSA carriage rate among DHCPs is 2.9%, which is higher than that in the general population but lower than that in other health-care professionals. Further education of DHCPs on MRSA, especially regarding its seriousness, is needed to improve MRSA infection control in a dental hospital setting.
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Affiliation(s)
- Yeon-Jee Yoo
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University School of Dentistry, Seoul National University Dental Hospital, Seoul, Korea.,Department of Comprehensive Treatment Center, Seoul National University Dental Hospital, Seoul, Korea
| | - Eun-Jung Kwak
- Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Seoul, Korea
| | - Kyung Muk Jeong
- Department of Dermatology, College of Medicine, Korea University, Seoul, Korea
| | - Seung-Ho Baek
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University School of Dentistry, Seoul National University Dental Hospital, Seoul, Korea
| | - Yoo Sang Baek
- Department of Dermatology, College of Medicine, Korea University, Seoul, Korea
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18
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Faden A. Methicillin-resistant Staphylococcus aureus (MRSA) screening of hospital dental clinic surfaces. Saudi J Biol Sci 2018; 26:1795-1798. [PMID: 31762660 PMCID: PMC6864161 DOI: 10.1016/j.sjbs.2018.03.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 01/31/2018] [Accepted: 03/08/2018] [Indexed: 11/16/2022] Open
Abstract
We assessed the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) strains on surfaces of hospital dental clinics. Specimens were obtained from 5 clinically symptoms-free patients of five different specialties clinics (Implantology, Pediatric Dentistry, Prosthetics, Restorative Dentistry, and Oral Medicine) of the Dental Clinic Hospital of King Saud University before and after each patient. A Q-tip swabs were used from 10 surfaces in each clinic (Arm rest of dental chair, floor beneath dental chair, sink/faucet, towel dispenser, instrument table handle, light handle, X-ray viewer, paper dental records, head rest, and bench). Specimens were cultured in CHROMagar MRSA medium. Prevalence of MRSA colonization was compared between periods before and after patients visited each clinic for treatment. The results showed that the prevalence of MRSA was remarkably increased after patients visited the area. The results indicate that dental clinics should be considered as possible reservoirs of MRSA in the hospital setting.
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Affiliation(s)
- Asmaa Faden
- Department of Oral Medicine and Diagnostics Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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19
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Khairalla AS, Wasfi R, Ashour HM. Carriage frequency, phenotypic, and genotypic characteristics of methicillin-resistant Staphylococcus aureus isolated from dental health-care personnel, patients, and environment. Sci Rep 2017; 7:7390. [PMID: 28784993 PMCID: PMC5547136 DOI: 10.1038/s41598-017-07713-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 06/28/2017] [Indexed: 01/03/2023] Open
Abstract
There is limited data on methicillin-resistant Staphylococcus aureus (MRSA) carriage in dental clinics. 1300 specimens from patients, health personnel, and environmental surfaces of a dental clinic in Egypt were tested for MRSA. Antibiotic susceptibility, biofilm formation, Staphylococcal protein A (spa) typing, SCCmec typing, and PCR-based assays were used to detect mecA, mecC, vanA, Panton-Valentine Leukocidin toxin (PVL), and toxic shock syndrome toxin-1 (tst) genes. Among 34 mecA-positive MRSA isolates, five (14.7%) were PVL-positive, seventeen (50%) were tst-positive, ten (29.4%) were vanA-positive, while none harboured mecC. MRSA hand carriage rates in patients, nurses, and dentists were 9.8%, 6.6%, and 5%. The respective nasal colonization rates were 11.1%, 6.7%, and 9.7%. 1.3% of the environmental isolates were MRSA-positive. Strong and moderate biofilm-forming isolates represented 23.5% and 29.4% of MRSA isolates. 24 MRSA isolates (70.6%) were multi-resistant and 18 (52.9%) harboured SCCmec IV. Among eight spa types, t223 (26.5%), t267 (23.5%), and t14339 (23.5%) were predominant. We noted an alarming genetic relatedness between 7 (20.6%) MRSA isolates and the epidemic EMRSA-15 clone, as well as a combined occurrence of tst and PVL in 3 (8.8%) isolates. Results suggest high MRSA pathogenicity in dental wards highlighting the need for more efficient surveillance/infection control strategies.
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Affiliation(s)
- Ahmed S Khairalla
- Department of Microbiology & Immunology, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
| | - Reham Wasfi
- Department of Microbiology & Immunology, Faculty of Pharmacy, October University for Modern Sciences and Arts (MSA), Giza, Egypt
| | - Hossam M Ashour
- Department of Biological Sciences, College of Arts and Sciences, University of South Florida St. Petersburg, St. Petersburg, Florida, USA.
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo, Egypt.
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20
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Torlak E, Korkut E, Uncu AT, Şener Y. Biofilm formation by Staphylococcus aureus isolates from a dental clinic in Konya, Turkey. J Infect Public Health 2017; 10:809-813. [PMID: 28214190 DOI: 10.1016/j.jiph.2017.01.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 12/01/2016] [Accepted: 01/07/2017] [Indexed: 11/26/2022] Open
Abstract
The ability of Staphylococcus aureus to form biofilm is considered to be a major virulence factor influencing its survival and persistence in both the environment and the host. Biofilm formation in S. aureus is most frequently associated with production of polysaccharide intercellular adhesion by ica operon-encoded enzymes. The present work aimed at evaluating the in vitro biofilm production and presence of the icaA and icaD genes in S. aureus isolates from a dental clinic in Konya, Turkey. The surfaces of inanimate objects were sampled over a period of six months. S. aureus isolates were subjected to Congo Red Agar (CRA) and crystal violet (CV) staining assays to evaluate their ability of biofilm production, while the presence of the icaA and icaD genes was determined by polymerase chain reaction. S. aureus contamination was detected in 13.2% of the environmental samples. All the 32 isolates were observed to be positive for both the icaA and icaD genes. Phenotypic evaluations revealed that CV staining assay is a more reliable alternative to CRA assay to determine biofilm formation ability. A high percentage of agreement (91%) was observed between the results from CV staining and ica genes' detection assays. Phenotypic and genotypic evaluations should be combined to detect biofilm formation in S. aureus. Our findings indicate that dental clinic environments should be considered as potential reservoir for biofilm-producing S. aureus and thus cross contamination.
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Affiliation(s)
- Emrah Torlak
- Department of Molecular Biology and Genetics, Faculty of Science, Necmettin Erbakan University, Konya, Turkey.
| | - Emre Korkut
- Department of Pediatric Dentistry, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
| | - Ali T Uncu
- Department of Molecular Biology and Genetics, Faculty of Science, Necmettin Erbakan University, Konya, Turkey
| | - Yağmur Şener
- Department of Pediatric Dentistry, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
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21
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Hema N, Raj NS, Chaithanya ED, Chincholi R, Iswariya M, Hema KN. Prevalence of nasal carriers of methicillin-resistant Staphylococcus aureus among dental students: An in vivo study. J Oral Maxillofac Pathol 2017; 21:356-359. [PMID: 29391708 PMCID: PMC5763856 DOI: 10.4103/jomfp.jomfp_212_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Aim The aim of this study is to evaluate the prevalence of nasal carriage of coagulase positive methicillin-resistant Staphylococcus aureus (MRSA) among dental students. Materials and Methods Four hundred dental students, divided into two groups - undergraduates (200) and postgraduates (200), were screened using sterile cotton swabs for carriage of MRSA in anterior nares. The samples were inoculated on HiCrome MeReSa Agar Base-with cefoxitin supplement. Further confirmatory tests were done by Gram-staining, Tube coagulase and Cefoxitin disc diffusion test on Mueller-Hinton agar. Results MRSA was positive among 25 (12.50%) undergraduates and 49 (24.50%) postgraduates students. Further confirmatory test also showed the same results. MRSA colonization was significantly more in postgraduate students, who are exposed to more number of patients and have put in more clinical hours as compared to undergraduate students who have just entered clinics and have limited clinical exposure. Conclusion The present study concluded that rate of MRSA colonization was 18.5% in the dental school population. The colonization rate was significantly (P = 0.002%) higher in postgraduate students as compared to undergraduate students emphasizing the need to follow infection control protocols stringently. Clinical Significance Awareness about MRSA among dental doctors is mandatory so as to prevent transmission of MRSA in dental settings.
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Affiliation(s)
- N Hema
- Department of Pedodontics, KGF College of Dental Science and Hospital, Kolar, Karnataka, India
| | - N Sunil Raj
- Department of Pedodontics, Bangalore Institute of Dental Sciences, Bengaluru, Karnataka, India
| | - E D Chaithanya
- Department of Pedodontics, AECS Maruti College of Dental Sciences Research Centre, Bengaluru, Karnataka, India
| | - Rashmi Chincholi
- Department of Pedodontics, Al Ameen Dental College, Bijapur, Karnataka, India
| | - M Iswariya
- Department of Periodontics, AECS Maruti College of Dental Sciences Research Centre, Bengaluru, Karnataka, India
| | - K N Hema
- Department of Oral Pathology, V S Dental College and Hospital, Bengaluru, Karnataka, India
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Merghni A, Bekir K, Kadmi Y, Dallel I, Janel S, Bovio S, Barois N, Lafont F, Mastouri M. Adhesiveness of opportunistic Staphylococcus aureus to materials used in dental office: In vitro study. Microb Pathog 2016; 103:129-134. [PMID: 27993700 DOI: 10.1016/j.micpath.2016.12.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 12/05/2016] [Accepted: 12/06/2016] [Indexed: 12/01/2022]
Abstract
Staphylococcus aureus (S. aureus) is one of several opportunistic microbial pathogens associated with many healthcare problems. In the present study, S. aureus was assessed for its biofilm-forming ability on materials routinely used in dental offices, including stainless steel (SS), polyethylene (PE), and polyvinyl chloride (PVC). Materials that were tested were characterized for roughness (Ra) and surface free energy (SFE). The adhesion forces exerted by S. aureus to each substratum were investigated using atomic force microscopy (AFM), and biofilm formation was quantitatively assessed by crystal violet staining assay. AFM measurements demonstrated that the strongest adhesion forces (20 nN) were exerted on the PE surfaces (P < 0.05) and depended more on Ra. In addition, the results of biofilm formation capability indicated that S. aureus exhibited more affinity to SS materials when compared to the other materials (P < 0.05). This ability of biofilm formation seems to be more correlated to SFE (R = 0.65). Hence, control of the surface properties of materials used in dental practices is of crucial importance for preventing biofilm formation on dental materials to be used for patients' dental care.
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Affiliation(s)
- Abderrahmen Merghni
- Laboratory of Infectious Diseases and Biological Agents (LR99ES27), Faculty of Pharmacy, Monastir University, Monastir, Tunisia.
| | - Karima Bekir
- Laboratory of Analysis, Treatment and Valorization of Environmental Pollutants and Products (LR01ES16), Faculty of Pharmacy, Monastir University, Monastir, Tunisia
| | - Yassine Kadmi
- Université d'Artois, EA 7394, Institut Charles VIOLLETTE, Lens, F-62300, France; ISA Lille, EA 7394, Institut Charles VIOLLETTE, Lille, F-59000, France; Ulco, EA 7394, Institut Charles VIOLLETTE, Boulogne sur Mer, F-62200, France; Université de Lille, EA 7394, Institut Charles VIOLLETTE, Lille, F-59000, France
| | - Ines Dallel
- Orthodontic Department of Monastir Dental Clinic, Laboratory of Oral Health and Orofacial Rehabilitation (LR12ES11), Tunisia
| | | | | | | | - Frank Lafont
- BioImaging Center Lille-FR3642, Lille, France; Cellular Microbiology and Physics of Infection Group - Center of Infection and Immunity of Lille: CNRS UMR8204, INSERM U1019, Institut Pasteur de Lille, Lille Regional University Hospital Centre, Lille University, France
| | - Maha Mastouri
- Laboratory of Infectious Diseases and Biological Agents (LR99ES27), Faculty of Pharmacy, Monastir University, Monastir, Tunisia; Laboratory of Microbiology, University Hospital of Fattouma Bourguiba, Monastir, Tunisia
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Baek YS, Baek SH, Yoo YJ. Higher nasal carriage rate of methicillin-resistant Staphylococcus aureus among dental students who have clinical experience. J Am Dent Assoc 2016; 147:348-53. [PMID: 26778005 DOI: 10.1016/j.adaj.2015.12.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 11/29/2015] [Accepted: 12/02/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Methicillin-resistant Staphylococcus aureus (MRSA) has been isolated from dental clinical surfaces, dental patients, and dental health care professionals. The authors conducted a study to determine the prevalence rate of nasal MRSA colonization among dental school students and to identify the characteristics of the isolated strains. METHODS The authors collected nasal samples from 159 dental students. The authors performed mecA gene detection, staphylococcal cassette chromosome mec (SCCmec) typing, and antimicrobial susceptibility tests on each sample. The authors compared the results of 2 groups (students who had clinical experience and students who did not have clinical experience). RESULTS Five (3.1%) dental students had MRSA colonization, as confirmed by the presence of the mecA gene in the nasal cavity. Prior clinical experience was associated significantly with nasal MRSA carriage (P < .05). Four of the strains were SCCmec type IV, and 1 strain was SCCmec type I. All isolates were resistant to amoxicillin and clavulanic acid, imipenem, and oxacillin, but were susceptible to several antimicrobial agents including mupirocin, trimethoprim and sulfamethoxazole, and rifampin. The nasal MRSA colonization was eradicated with the use of mupirocin ointment. CONCLUSIONS Nasal MRSA colonization occurs in some dental students, especially those who have clinical experience. PRACTICAL IMPLICATIONS Education about MRSA colonization and transmission, as well as infection prevention and control measures is necessary for dental students, especially when they participate in clinical practice.
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Petti S, Polimeni A. Risk of Methicillin-Resistant Staphylococcus aureus Transmission in the Dental Healthcare Setting: A Narrative Review. Infect Control Hosp Epidemiol 2015; 32:1109-15. [DOI: 10.1086/662184] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective.Information on the risk of methicillin-resistant Staphylococcus aureus (MRSA) infection transmission in dental healthcare settings was incomplete only few years ago; therefore, MRSA infection control guidelines were necessarily based on data extrapolated from other fields. Recently, publication of specific studies have made it possible to review such risk.Methods.Studies of MRSA infection in dentistry were searched for using EMBASE, MEDLINE, and Google and were allocated into the following sections: (1) direct evidence: documented cases of MRSA transmission in dentistry; (2) indirect evidence: carriage rates among dental healthcare providers (DHCPs) and patients (high carriage rates suggest that transmission is likely); (3) speculative evidence: MRSA occurrence in the dental environment (high environmental contamination probably increases the risk of infection); and (4) speculative evidence: MRSA carriage in human dental plaque and saliva (oral carriers may spread MRSA in the environment during dental therapy, with consequent environmental contamination and probable increased risk of infection).Results.Our findings were as follows. First, transmission has been ascertained during surgical interventions, particularly in surgical units and among head and neck cancer patients. Second, carriage rates among DHCPs were lower than those among other healthcare workers. Carriage rates among adult patients were low, whereas among pedodontic and special care patients rates were higher than those in the general population. Third, MRSA has been detected in the environment of emergency and surgical units and in dental hospitals. Some individuals in poor general condition were oral MRSA carriers.Conclusions.The occupational risk of MRSA infection among DHCPs is minimal. Among special patients (eg, special care, hospitalized and cancer patients) the risk of infection is high, whereas among the remaining patients undergoing conventional therapy such risk is probably low.
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25
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McCormack MG, Smith AJ, Akram AN, Jackson M, Robertson D, Edwards G. Staphylococcus aureus and the oral cavity: an overlooked source of carriage and infection? Am J Infect Control 2015; 43:35-7. [PMID: 25564121 DOI: 10.1016/j.ajic.2014.09.015] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 09/14/2014] [Accepted: 09/18/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND The role of intraoral Staphylococcus aureus in disease and cross-infection sources is controversial. We present a 10-year retrospective analysis of laboratory data reporting isolation of S aureus from oral and perioral clinical specimens. METHODS A review of laboratory records for specimens where S aureus was isolated were collated and analyzed from January 1998-December 2007 at the Oral Microbiology Laboratory, Glasgow Dental Hospital. RESULTS There were 11,312 specimens submitted to the laboratory over the study time period. S aureus was isolated from 1,986 specimens (18%). Of these, 1,782 (90%) were methicillin-sensitive S aureus (MSSA), and 204 (10%) were methicillin-resistant S aureus (MRSA). The most common specimen type from which MSSA was isolated was an oral rinse, whereas for MRSA this was a tongue swab. Most of the MRSA isolates were EMRSA-15 or EMRSA-16 lineage. CONCLUSION These findings suggest that S aureus continues to be a frequent isolate in the oral cavity and perioral region. The oral cavity should be considered a source of S aureus in terms of cross-infection and dissemination to other body sites. The role of S aureus in the pathogenesis of certain oral diseases should also be considered as part of a differential diagnosis.
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Affiliation(s)
- M G McCormack
- College of Medical, Veterinary & Life Sciences, Glasgow Dental Hospital & School, University of Glasgow, Glasgow, Scotland, UK
| | - A J Smith
- College of Medical, Veterinary & Life Sciences, Glasgow Dental Hospital & School, University of Glasgow, Glasgow, Scotland, UK.
| | - A N Akram
- Govan Dental Care, Glasgow, Scotland, UK
| | - M Jackson
- College of Medical, Veterinary & Life Sciences, Glasgow Dental Hospital & School, University of Glasgow, Glasgow, Scotland, UK
| | - D Robertson
- College of Medical, Veterinary & Life Sciences, Glasgow Dental Hospital & School, University of Glasgow, Glasgow, Scotland, UK
| | - G Edwards
- Scottish MRSA Reference Laboratory, Glasgow Royal Infirmary, Glasgow, Scotland, UK
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26
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Vidana R, Sillerström E, Ahlquist M, Lund B. Potential for nosocomial transmission ofEnterococcus faecalisfrom surfaces in dental operatories. Int Endod J 2014; 48:518-27. [DOI: 10.1111/iej.12342] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 07/22/2014] [Indexed: 11/30/2022]
Affiliation(s)
- R. Vidana
- Division of Endodontics; Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
| | - E. Sillerström
- Division of Clinical Microbiology; Department of Laboratory Medicine; Karolinska Institutet; Huddinge Sweden
| | - M. Ahlquist
- Division of Endodontics; Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
| | - B. Lund
- Division of Oral and Maxillofacial Surgery; Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
- Department of Oral and Maxillofacial Surgery; Karolinska University Hospital; Huddinge Sweden
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27
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Güngör ND, Kadaifçiler DG, Peker OÖ. Investigation of the bacterial load and antibiotic susceptibility of dental units. ENVIRONMENTAL MONITORING AND ASSESSMENT 2014; 186:1847-1853. [PMID: 24197558 DOI: 10.1007/s10661-013-3498-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 10/23/2013] [Indexed: 06/02/2023]
Abstract
The aim of this study was to evaluate the bacterial contamination level and to determine the antibiotic susceptibility of the isolated bacteria from dental unit waterlines (DUWLs) in Istanbul. Bacterial quality of DUWLs is very important, as patients and dental staff are regularly exposed to water and aerosols generated by the unit. If opportunistic pathogens such as Staphylococcus aureus, Pseudomonas aeruginosa, and Legionella pneumophila are present in DUWLs, patient and dental staff can be infected. One hundred water samples were collected from high-speed drills and input waters from 50 dental units. Aerobic heterotrophic bacteria counts and the presence of Legionella, Pseudomonas, oral streptococci, and Staphylococcus were investigated in dental unit waters and aerosol samples. In addition, the antibiotic susceptibility of the isolated and identified bacteria from DUWLs was examined. This research found that 37 out of 50 dental unit water samples exceeded the American Dental Association's limit of 200 colony-forming units (CFU)/mL(-1). Legionella, oral streptococci, and S. aureus were not detected in any water or aerosol samples, but P. aeruginosa was isolated in three DUWLs. Also, Pseudomonas and Staphylococcus were found in water and aerosol samples. Cefoperazone, ofloxacin, gentamicin, ciprofloxacin, and piperacillin were the most effective antibiotics against the isolated bacteria from DUWLs.
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Affiliation(s)
- Nihal Dogruöz Güngör
- Department of Biology, Faculty of Science, Istanbul University, 34134, Vezneciler, Istanbul, Turkey,
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28
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Higher prevalence of meticillin-resistant Staphylococcus aureus among dental students. J Hosp Infect 2014; 86:216-8. [DOI: 10.1016/j.jhin.2013.12.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Accepted: 12/20/2013] [Indexed: 11/20/2022]
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Effect of disposable barriers, disinfection, and cleaning on controlling methicillin-resistant Staphylococcus aureus environmental contamination. Am J Infect Control 2013; 41:836-40. [PMID: 23375575 DOI: 10.1016/j.ajic.2012.09.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Revised: 09/10/2012] [Accepted: 09/11/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Environmental contamination and transmission of methicillin-resistant Staphylococcus aureus (MRSA) have been reported in dental health care settings. National professional dental associations recommend controlling surface contamination using disposable barriers or disinfection. Because these procedures may be costly, impractical, and/or toxic, we compared their effect against traditional detergent-based cleaning for decontaminating a dental chair sprayed with MRSA. METHODS Five MRSA strain suspensions were aerosolized to give a density of approximately 10 colony-forming units/cm(2) MRSA on the dental chair 5 minutes after dispersal. Three different decontamination protocols were applied: protocol 1: disposable barriers positioned before aerosol production and removed after 5 minutes; protocol 2: disinfection (wipe-rinse method) with 1:10 dilution of 5.25% to 6.15% sodium hypochlorite solution; protocol 3: cleaning (wipe-rinse method) with a sodium-lauryl-sulphate-based detergent. Contact plates containing Mannitol Salt Agar were used to assess the level of MRSA contamination. RESULTS All 3 protocols decreased MRSA surface load by >99%. Residual densities on the dental chair were 0.030 ± 0.010 (protocol 1), 0.029 ± 0.09 (protocol 2), and 0.030 ± 0.011 (protocol 3) colony-forming units/cm(2). CONCLUSION Cleaning (wipe-rinse method) using a sodium-lauryl-sulphate-based detergent demonstrated equivalence with disposable barrier placement or disinfection-based protocol for reducing MRSA contamination on dental chairs. This has practical and cost implications for controlling MRSA transmission in dental health care settings.
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30
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Decontamination technology assessments - who assesses the assessments? Br Dent J 2013; 215:65-7. [PMID: 23887525 DOI: 10.1038/sj.bdj.2013.681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2013] [Indexed: 11/08/2022]
Abstract
The driver to improve surgical instrument decontamination has been the introduction of vCJD into the UK population over the last two decades, although concerns over transmission of other infectious agents remain valid. Though significant improvements have been made in primary care, this is usually in spite of limited access to technical advice on decontamination equipment. A technology assessment for key elements of equipment and processes used in this environment should be welcomed. However, two reports by the Scottish Health Technology Assessment Panel are flawed in estimating costs associated with wrapping instruments, omission of appropriate references and inaccurate data in the costing models. These assessments contribute little to health economics debates, confuse practitioners and frustrate technical experts.
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31
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Whitworth C. Infection control: achieving best practice. Prim Dent J 2013; 1:18-22. [PMID: 23720911 DOI: 10.1308/205016812803838500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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32
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Commercial mouthwashes are ineffective against oral MRSA biofilms. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 115:624-9. [DOI: 10.1016/j.oooo.2012.12.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Revised: 12/19/2012] [Accepted: 12/21/2012] [Indexed: 11/17/2022]
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33
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Risk factors for variant Creutzfeldt-Jakob disease in dental practice: a case-control study. Br Dent J 2012; 213:E19. [DOI: 10.1038/sj.bdj.2012.1089] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2012] [Indexed: 11/08/2022]
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34
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Laheij AMGA, Kistler JO, Belibasakis GN, Välimaa H, de Soet JJ. Healthcare-associated viral and bacterial infections in dentistry. J Oral Microbiol 2012; 4:JOM-4-17659. [PMID: 22701774 PMCID: PMC3375115 DOI: 10.3402/jom.v4i0.17659] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Revised: 05/11/2012] [Accepted: 05/11/2012] [Indexed: 12/19/2022] Open
Abstract
Infection prevention in dentistry is an important topic that has gained more interest in recent years and guidelines for the prevention of cross-transmission are common practice in many countries. However, little is known about the real risks of cross-transmission, specifically in the dental healthcare setting. This paper evaluated the literature to determine the risk of cross-transmission and infection of viruses and bacteria that are of particular relevance in the dental practice environment. Facts from the literature on HSV, VZV, HIV, Hepatitis B, C and D viruses, Mycobacterium spp., Pseudomonas spp., Legionella spp. and multi-resistant bacteria are presented. There is evidence that Hepatitis B virus is a real threat for cross-infection in dentistry. Data for the transmission of, and infection with, other viruses or bacteria in dental practice are scarce. However, a number of cases are probably not acknowledged by patients, healthcare workers and authorities. Furthermore, cross-transmission in dentistry is under-reported in the literature. For the above reasons, the real risks of cross-transmission are likely to be higher. There is therefore a need for prospective longitudinal research in this area, to determine the real risks of cross-infection in dentistry. This will assist the adoption of effective hygiene procedures in dental practice.
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Affiliation(s)
- A M G A Laheij
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
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35
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Isolation of Staphylococcus aureus from environmental surfaces in an academic dental clinic. J Am Dent Assoc 2012; 143:164-9. [DOI: 10.14219/jada.archive.2012.0127] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Roberts MC, Soge OO, Horst JA, Ly KA, Milgrom P. Methicillin-resistant Staphylococcus aureus from dental school clinic surfaces and students. Am J Infect Control 2011; 39:628-632. [PMID: 21962840 DOI: 10.1016/j.ajic.2010.11.007] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2010] [Revised: 11/15/2010] [Accepted: 11/16/2010] [Indexed: 11/18/2022]
Abstract
BACKGROUND Methicillin-resistant Staphylococcus aureus (MRSA) isolated from frequently touched dental school clinic surfaces were compared with MRSA isolated nasal cultures of dental students. METHOD Sixty-one dental students and 95 environmental surfaces from 7 clinics were sampled using SANICULT (Starplex Scientific Inc, Etobicoke, Ontario, Canada) swabs. Antimicrobial susceptibility testing was performed, and pulsed-field gel electrophoresis analysis, the mecA gene, multilocus sequence type, and SCCmec type were determined by polymerase chain reaction and sequencing. RESULTS Thirteen (21%) dental students and 8 (8.4%) surfaces were MRSA positive. Three MRSA strains were SCCmec type IV, whereas 3 were nontypeable isolates and Panton-Valentine leukocidin positive (PVL+), and none were USA300. One surface and 1 student isolate shared the same multilocus sequence type ST 8 and were 75% related. Two groups of students carried the same MRSA strains. CONCLUSION The MRSA-positive samples were from 4 of 7 dental clinics. In addition, 21% of the dental students carried MRSA, which is > 10 times higher than the general public and twice as frequent as in other university students. This is the first study to characterize MRSA from dental clinic surfaces and dental students and suggests that both may be reservoirs for MRSA. Further studies are needed to verify this premise.
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Affiliation(s)
- Marilyn C Roberts
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA.
| | - Olusegun O Soge
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA
| | - Jeremy A Horst
- Department of Oral Biology, University of Washington, Seattle, WA
| | - Kiet A Ly
- Department of Dental Public Health Sciences, University of Washington, Seattle, WA
| | - Peter Milgrom
- Department of Dental Public Health Sciences, University of Washington, Seattle, WA; Northwest Center to Reduce Oral Health Disparities, School of Dentistry, University of Washington, Seattle, WA
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37
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Readily achievable. Br Dent J 2011; 211:152. [DOI: 10.1038/sj.bdj.2011.687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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O'Leary E, Lockhart DEA, Smith A. Coming to a practice near you? Community-acquired meticillin resistant Staphylococcus aureus (CA-MRSA). ACTA ACUST UNITED AC 2011; 38:254-6, 259-60. [PMID: 21714406 DOI: 10.12968/denu.2011.38.4.254] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
UNLABELLED Hospital-acquired meticillin resistant Staphylococcus aureus (HA-MRSA) arose in the 1960s, but the last decade saw the emergence of a new entity: community-acquired MRSA (CA-MRSA). Unlike HA-MRSA, patients affected by CA-MRSA have no obvious risk factors and may present with recurrent skin and soft tissue infections (SSTI) or, rarely, severe necrotizing pneumonia. This article provides an overview of CA-MRSA and reinforces the standard infection control procedures required to prevent further spread. CLINICAL RELEVANCE The dental team require an awareness of emerging infections, their relevance to dentistry and the infection control procedures necessary to prevent transmission.
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Affiliation(s)
- Emer O'Leary
- Glasgow Dental School, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow
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39
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Vassey M, Budge C, Poolman T, Jones P, Perrett D, Nayuni N, Bennett P, Groves P, Smith A, Fulford M, Marsh PD, Walker JT, Sutton JM, Raven NDH. A quantitative assessment of residual protein levels on dental instruments reprocessed by manual, ultrasonic and automated cleaning methods. Br Dent J 2011; 210:E14. [DOI: 10.1038/sj.bdj.2011.144] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2010] [Indexed: 11/09/2022]
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40
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Methicillin Resistant Staphylococcus Aureus Infections of Soft Issues of the Oral Cavity, Face and Neck in Patients Hospitalized at the Cranio-maxillofacial Surgery Department. POLISH JOURNAL OF SURGERY 2011; 83:212-5. [DOI: 10.2478/v10035-011-0032-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
Decontamination of reusable dental instruments has been a subject of debate within the dental profes sion since the publication in 2009 of Health Technical Memorandum 01-05: Decontamination in primary care dental practices. This paper provides a brief history of instrument reprocessing in dentistry and reviews the evidence on pre-soaking, cleaning, sterilisation and storage.
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42
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Smith AJ. Health Technical Memorandum 01-05 - a view from north of the border. J Infect Prev 2010. [DOI: 10.1177/1757177410386401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A large scale observational survey of instrument decontamination processes in general dental A practice has demonstrated gaps between required guidance, standards, legislation and current practice. Guidance, to help dental practices close the gap and replace previous infection prevention guidelines, has been published in England and Wales in the form of Health Technical Memorandum 01-05. This review provides an overview of its rationale, evidence base and comparison with other existing guidance in the United Kingdom.
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Affiliation(s)
- Andrew John Smith
- College of Medicine, Veterinary & Life Sciences, University of Glasgow, 378 Sauchiehall Street, Glasgow, UK,
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Smith AJ, Lockhart DEA, McDonald E, Creanor S, Hurrell D, Bagg J. Design of dental surgeries in relation to instrument decontamination. J Hosp Infect 2010; 76:340-4. [PMID: 20888669 DOI: 10.1016/j.jhin.2010.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2009] [Accepted: 06/02/2010] [Indexed: 10/19/2022]
Abstract
Recent guidelines advise that the decontamination of dental instruments should be undertaken outwith the treatment area. The aim of this study was to determine the physical area of rooms in dental surgeries that decontaminate instruments within and outwith the treatment area respectively, and other factors relating to practice layout and ventilation. Data were collected by interview and observation of dental healthcare workers in dental practice in Scotland, UK. Room layouts were recorded and measured at floor, benchtop and above benchtop heights. Thirteen surgeries with instrument decontamination processes occurring in the treatment area and seven surgeries with instrument decontamination outwith the treatment area were selected at random for detailed analysis of room dimensions. Of the 179 dental surgeries surveyed, 55% were located in converted residential premises and most practitioners (91%) did not share premises with other healthcare providers. The median number of rooms in the practices was 8 (range: 2-21) and the median number of surgeries present was 3 (range: 1-6). Regardless of whether instrument decontamination facilities were housed within the treatment area or not, the average treatment area room size for both was 15.8m(2) (range: 7.3-23.9) (P=0.862), with 20% of the room area available as work surfaces. The median size of the seven instrument decontamination rooms (local decontamination units) was 7.6m(2) (range: 2.9-16.0), with, on average, 63% of the room used for work surfaces. This survey suggests that the historical location of dental surgeries in converted residential properties places many restrictions on appropriate design for healthcare premises.
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Affiliation(s)
- A J Smith
- Infection & Immunity Research Group, Glasgow Dental Hospital and School, Faculty of Medicine, University of Glasgow, Glasgow, UK.
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Cell surface hydrophobicity, biofilm formation, adhesives properties and molecular detection of adhesins genes in Staphylococcus aureus associated to dental caries. Microb Pathog 2010; 49:14-22. [DOI: 10.1016/j.micpath.2010.03.007] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2009] [Revised: 03/09/2010] [Accepted: 03/10/2010] [Indexed: 11/18/2022]
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Tuzuner-Oncul AM, Ungor C, Dede U, Kisnisci RS. Methicillin-resistant Staphylococcus aureus (MRSA) osteomyelitis of the mandible. ACTA ACUST UNITED AC 2009; 107:e1-4. [PMID: 19464635 DOI: 10.1016/j.tripleo.2009.03.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2008] [Revised: 02/03/2009] [Accepted: 03/03/2009] [Indexed: 10/20/2022]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a type of Staphylococcus that is resistant to certain antibiotics, such as methicillin, oxacillin, penicillin, and amoxicillin. This nosocomial pathogen has become a great threat in hospitals globally. Up to 40% of the normal population carries S. aureus in the anterior nares, and this rate is often higher in hospitalized patients and their attendants. This case report presents a patient with serious MRSA osteomyelitis of the mandible demonstrating purulent discharge. The patient failed to recover despite prolonged postoperative treatment and the administration of several antibiotics. There was a resulting nonunion along with chronic MRSA infection. The treatment protocol involved a multimodal approach with parenteral clindamycin infusion, local rifampicin irrigation, and intermaxillary fixation of the jaws.
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Bonetti D, Young L, Black I, Cassie H, Ramsay CR, Clarkson J. Can't do it, won't do it! Developing a theoretically framed intervention to encourage better decontamination practice in Scottish dental practices. Implement Sci 2009; 4:31. [PMID: 19500342 PMCID: PMC2701915 DOI: 10.1186/1748-5908-4-31] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2008] [Accepted: 06/05/2009] [Indexed: 12/02/2022] Open
Abstract
Background Guidance on the cleaning of dental instruments in primary care has recently been published. The aims of this study are to determine if the publication of the guidance document was enough to influence decontamination best practice and to design an implementation intervention strategy, should it be required. Methods A postal questionnaire assessing current decontamination practice and beliefs was sent to a random sample of 200 general dental practitioners. Results Fifty-seven percent (N = 113) of general dental practitioners responded. The survey showed large variation in what dentists self-reported doing, perceived as necessary or practical to do, were willing to do, felt able to do, as well as what they planned to change. Only 15% self-reported compliance with the five key guideline-recommended individual-level decontamination behaviours; only 2% reported compliance with all 11 key practice-level behaviours. The results also showed that our participants were almost equally split between dentists who were completely unmotivated to implement best decontamination practice or else highly motivated. The results suggested there was scope for further enhancing the implementation of decontamination guidance, and that an intervention with the greatest likelihood of success would require a tailored format, specifically targeting components of the theory of planned behaviour (attitude, perceived behavioural control, intention) and implementation intention theory (action planning). Conclusion Considerable resources are devoted to encouraging clinicians to implement evidence-based practice using interventions with erratic success records, or no known applicability to a specific clinical behaviour, selected mainly by means of researchers' intuition or optimism. The methodology used to develop this implementation intervention is not limited to decontamination or to a single segment of primary care. It is also in accordance with the preliminary stages of the framework for evaluating complex interventions suggested by the medical research council. The next phases of this work are to test the intervention feasibility and evaluate its effectiveness in a randomised control trial.
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Affiliation(s)
- Debbie Bonetti
- Dental Health Services Research Unit, University of Dundee, MacKenzie Building, Kirsty Semple Way, Dundee, DD2 4BF, UK.
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Zimmerli M, Widmer AF, Dangel M, Filippi A, Frei R, Meyer J. Methicillin-resistant Staphylococcus aureus (MRSA) among dental patients: a problem for infection control in dentistry? Clin Oral Investig 2008; 13:369-73. [PMID: 19104851 DOI: 10.1007/s00784-008-0244-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2008] [Accepted: 12/08/2008] [Indexed: 11/25/2022]
Abstract
We assessed the frequency of carriers of methicillin-resistant Staphylococcus aureus (MRSA) among 500 dental patients of a university clinic. From each participant, two specimens were taken from the anterior nares and the pharynx and analysed by culture. The participants completed a questionnaire on possible risk factors of MRSA infection. Two hundred ten individuals carried S. aureus, 90 in the nares only, 51 in the throat only and 69 in nares and throat. Isolates of 208 patients were methicillin-sensitive; two isolates were methicillin-resistant, both carried in the throat exclusively. In conclusion, the frequency of nasal and/or throat carriers of MRSA among dental patients was low and suggests few opportunities of exposure in the dental clinic assessed.
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Affiliation(s)
- Melanie Zimmerli
- Department of Oral Surgery, Oral Radiology and Oral Medicine, School of Dental Medicine, University of Basel, Basel, Switzerland
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Novel Light-Activated Antimicrobial Coatings Are Effective Against Surface-Deposited Staphylococcus aureus. Curr Microbiol 2008; 57:269-73. [DOI: 10.1007/s00284-008-9188-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2008] [Accepted: 04/09/2008] [Indexed: 11/30/2022]
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Al-Haroni M. Bacterial resistance and the dental professionals’ role to halt the problem. J Dent 2008; 36:95-103. [DOI: 10.1016/j.jdent.2007.11.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2007] [Revised: 11/12/2007] [Accepted: 11/16/2007] [Indexed: 02/04/2023] Open
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Super bugs: super problems. Int J Dent Hyg 2008; 6:72-3. [DOI: 10.1111/j.1601-5037.2007.00288.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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