Abstract
Monitoring the microbial quality of water in dental unit waterlines is an important part of infection control measures carried out in dental clinics. Fungal contamination of such waterlines has not been extensively studied, compared with bacterial contamination. This study aimed at assessing the magnitude and risk factors for fungal contamination of dental unit waterlines. This cross-sectional study included 82 dental units, randomly collected from 3 private clinics and 8 governmental hospitals in Alexandria, Egypt. A total of 204 water samples from dental unit waterlines output were membrane-filtered and cultured for fungal enumeration and species identification. The biofilm forming-ability was assessed for the most prevalent fungal species. The acceptability of samples was determined according to the Swedish drinking water guidelines. The acceptability of samples was 89.7%. The most common mould was Aspergillus flavus, while Candida spp. was the most common yeast (10 isolates), with unusual predominance of Candida dubliniensis (9 isolates). All isolates of Aspergillus flavus and Candida dubliniensis were biofilm-formers. The risk factors for fungal contamination of dental unit waterlines included: dental specialty (p = 0.042), time of sample collection (p < 0.001), older age of dental unit (p < 0.001) and use of 5-15% of sodium hypochlorite. The presence of biofilm-forming fungi in dental unit waterlines is a potential hazard, even when samples have acceptable levels of fungal counts. Risk factors for contamination are numerous and should be addressed.
Highlights
Monitoring the microbial quality of water in dental unit waterlines is an important part of infection control measures carried out in dental clinics
Contaminated Dental unit waterlines (DUWLs) may lead to the production of microorganisms-containing aerosols, which are dispersed in the clinical environment, leading to diseases among dental staff and patients [5,6]
In addition to one hospital, had 100.0% acceptable DUWLs output water samples, while 8 hospitals had variable degrees of acceptability, with fungal contamination of their DUWLs ranging between 5.9 - 29.4% (p = 0.017)
Summary
Monitoring the microbial quality of water in dental unit waterlines is an important part of infection control measures carried out in dental clinics. Fungal contamination of such waterlines has not been extensively studied, compared with bacterial contamination. This study aimed at assessing the magnitude and risk factors for fungal contamination of dental unit waterlines. The risk factors for fungal contamination of dental unit waterlines included: dental specialty (p = 0.042), time of sample collection (p < 0.001), older age of dental unit (p < 0.001) and use of 5-15% of sodium hypochlorite. Conclusions: The presence of biofilm-forming fungi in dental unit waterlines is a potential hazard, even when samples have acceptable levels of fungal counts. Contaminated DUWLs may lead to the production of microorganisms-containing aerosols, which are dispersed in the clinical environment, leading to diseases among dental staff and patients [5,6]
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