<i>Notes from the Field: Mycobacterium abscessus</i>Infections Among Patients of a Pediatric Dentistry Practice — Georgia, 2015

Peralta, Gianna; Tobin-D’Angelo, Melissa; Parham, Angie; Edison, Laura; Lorentzson, Lauren; Smith, Carol; Drenzek, Cherie

doi:10.15585/mmwr.mm6513a5

Cited by 50 publications

(20 citation statements)

References 6 publications

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“…In our opinion, recent infections among patients in a paediatric dental practice, and emerging molecular dental epidemiology data make mandatory to use drinking water in DUWL (1,90,91). Briefly, the bacterial contamination of drinking water ranges from two regulatory standard, from EN (i.e., < 100 CFU/mL at 22°C, < 20 CFU/mL at 37°C, and the absence of pathogens) and US Environmental Protection Agency (i.e., ≤ 500 CFU/mL of heterotrophic water bacteria) (1).…”

Section: Duwlmentioning

confidence: 99%

Implementation of Recent Infection Prevention Procedures Published by Centers for Disease Control and Prevention: Difficulties and Problems in Orthodontic Offices

Barenghi¹,

Barenghi²,

Blasio

2017

Iran J Ortho

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Context: The Centers for Disease Control and Prevention has recently published its "Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care", but information concerning compliance, occupational hazards, and specific recommendations for orthodontic facilities is less widely available. Evidence Acquisition: We searched electronic English articles published in PubMed and Google Scholar databases (2010-May 2016) using various combinations of the key indexing terms. Results: 95 articles were selected for comprehensive reading according to the inclusion criteria. Problems and difficulties for orthodontic offices in applying the recommendations have been divided into nine focus areas concerning the quality of supplies, the procedures necessary to adhere to the standard precautions of hand hygiene, the use of personal protective equipment (PPE), respiratory hygiene/cough etiquette, sharps safety, orthodontic instrument reconditioning, cleaning and disinfecting clinical contact surfaces and dental unit water lines, and impression disinfection. Conclusions: On the basis of our experience in a university department of orthodontics and private orthodontic offices, we believe that innovative thinking based on better knowledge, education and training, ergonomics, and task-specific, evidence-based guidelines and resources are required to improve compliance with infection control recommendations.

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Section: Duwlmentioning

confidence: 99%

Implementation of Recent Infection Prevention Procedures Published by Centers for Disease Control and Prevention: Difficulties and Problems in Orthodontic Offices

Barenghi¹,

Barenghi²,

Blasio

2017

Iran J Ortho

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“…Two immunocompromised patients have presented a dental abscess associated with Pseudomonas aeruginosa after exposure to DUWL water contaminated by this microorganism [6]. Groups of children developed infections with Mycobacterium abscessus after having pulpotomy in a hospital in which DUWL were contaminated by this nontuberculous mycobacterium [7,8]. Infectious risk can also affect the healthcare workers [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of BRS® and Alpron®/Bilpron® Disinfectants for Dental Unit Waterlines: A Six-Year Study

Baudet

Lizon²,

Martrette

et al. 2020

IJERPH

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Biofilms in dental unit waterlines (DUWL) are a potentially significant source of contamination posing a significant health risk as these may come into contact with patients and dental staff during treatment. The aim of this study was to evaluate the microbiological quality of DUWL water treated by Biofilm-Removing-System® (BRS®) and Alpron®/Bilpron® disinfectant solutions for six years in a French university hospital. The microbiological quality of water supplied by 68 dental units—initially shock treated with BRS®, then continuously treated by Alpron® with sterile water during working days and Bilpron® during inactivity period, and combined with purging every morning and after each patient—was assessed biannually during six years for total culturable aerobic bacteria at 22 °C and 36 °C, Legionella sp., Pseudomonas aeruginosa, and total coliforms. A total of 628 samples were analyzed, 99.8% were compliant with extended microbiological levels, and we never detected pathogen bacteria like Legionella sp. and P. aeruginosa. Only one sample (0.2%) was noncompliant with the level of total culturable aerobic bacteria at 36 °C, which exceeded 140 colony forming units per mL. The protocol implemented in our university hospital gives excellent results and enables control of the microbiological quality of DUWL water in the long term.

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“…Two outbreaks due to mycobacteria associated with contaminated water from the dental unit water lines have been reported in the USA; one in Atlanta, Georgia and the other in Orange County, California. The first outbreak in 2015 affected 24 children [19,20]. The outbreak in California, in 2016, affected 72 children [12].…”

Section: Discussionmentioning

confidence: 99%

“…Concerning the infection source in the USA outbreaks, examination of the water used during the dental procedure showed bacterial contamination far in excess of allowable concentrations, and M. abscessus was isolated from all water samples [19,20]. Water samples set for culture in California also grew other NTM species including M. chelonae, and M. franklinii (personal communication Katheleen O'Donnel).…”

Section: Discussionmentioning

confidence: 99%

Odontogenic cutaneous sinus tracts due to infection with nontuberculous mycobacteria: a report of three cases

et al. 2020

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Background: Soft tissue or skin infections due to nontuberculous mycobacteria (NTM) have been reported frequently and are mostly associated with trauma or cosmetic interventions like plastic surgery. However, infection with NTM as a result of a dental procedure have rarely been described and the lack of clinical suspicion and a clear clinical manifestation makes diagnosis challenging. Case presentation: We report on three patients with a facial cutaneous sinus tract of dental origin, due to an infection with respectively Mycobacterium fortuitum, M. abscessus and M. peregrinum. The infection source was the dental unit waterlines (DUWLs), which were colonized with NTM. Conclusions: Water of the DUWL can pose a health risk. This report emphasizes the need for quality control and certification of water flowing through DUWLs, including the absence of NTM. Our report also shows the need for a rapid recognition of NTM infections and accurate laboratory diagnosis in order to avoid long-term ineffective antibiotic treatment.

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Notes from the Field: Mycobacterium abscessusInfections Among Patients of a Pediatric Dentistry Practice — Georgia, 2015

Cited by 50 publications

References 6 publications

Implementation of Recent Infection Prevention Procedures Published by Centers for Disease Control and Prevention: Difficulties and Problems in Orthodontic Offices

Implementation of Recent Infection Prevention Procedures Published by Centers for Disease Control and Prevention: Difficulties and Problems in Orthodontic Offices

Efficacy of BRS® and Alpron®/Bilpron® Disinfectants for Dental Unit Waterlines: A Six-Year Study

Odontogenic cutaneous sinus tracts due to infection with nontuberculous mycobacteria: a report of three cases

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