Biofilm growth and microbial contamination of dental unit waterlines at Kuwait University dental center

Affiliations

01 September 2023

-

doi: 10.3389/froh.2022.1071018


Abstract

Biofilm formation in dental unit waterlines and the resulting microbial contamination of the water in the system has become a significant problem. Contaminated water in the dental units is a major concern in dental clinics due to potential risk of causing infections particularly in elderly and immunocompromised patients. The aim of this study was at first to determine microbial contamination of the dental unit waterlines and then to study the efficacy of a comprehensive disinfection protocol on decreasing the microbial load. Water samples were collected before and after disinfection procedure from handpieces and water storage bottles from the dental units, a small 1-cm tubing was cut from each unit and subjected to microbiological culture on different growth media. Identification of the predominant species was achieved by 16S rRNA gene sequencing. Microbial growth was observed in samples collected from all dental units. Upon disinfection procedure, microbial contamination in the water samples and in the tubing surfaces was significantly reduced (P > 0.05). 16S rRNA gene sequencing revealed the presence of several species belonging to the genera Staphylococcus, Corynebacterium and Roseomonas, some of which are implicated in human infections. Aggravation of the biofilm growth on the tubing surfaces and the microbial contamination in the water can be effectively controlled by implementing appropriate and routine disinfection protocols. This may help protect the dental unit staff and the patients being exposed to the risk of infections.

Keywords: 16S rRNA gene sequencing; biofilm; dental unit water line; microbial contamination; pathogenic species.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


Figures


Similar articles

Dental unit waterlines: biofilms, disinfection and recurrence.

Meiller TF, Depaola LG, Kelley JI, Baqui AA, Turng BF, Falkler WA.J Am Dent Assoc. 1999 Jan;130(1):65-72. doi: 10.14219/jada.archive.1999.0030.PMID: 9919033

Disinfection of dental unit waterlines with an oral antiseptic.

Meiller TF, Kelley JI, Baqui AA, DePaola LG.J Clin Dent. 2000;11(1):11-5.PMID: 11460287

Microbial Contamination of Dental Unit Waterlines and Potential Risk of Infection: A Narrative Review.

Spagnolo AM, Sartini M, Cristina ML.Pathogens. 2020 Aug 13;9(8):651. doi: 10.3390/pathogens9080651.PMID: 32823641 Free PMC article. Review.

Effect of different disinfection protocols on microbial and biofilm contamination of dental unit waterlines in community dental practices.

Dallolio L, Scuderi A, Rini MS, Valente S, Farruggia P, Sabattini MA, Pasquinelli G, Acacci A, Roncarati G, Leoni E.Int J Environ Res Public Health. 2014 Feb 18;11(2):2064-76. doi: 10.3390/ijerph110202064.PMID: 24552789 Free PMC article.

Microbial contamination of dental unit waterlines.

Szymańska J, Sitkowska J, Dutkiewicz J.Ann Agric Environ Med. 2008;15(2):173-9.PMID: 19061251 Review.


KMEL References


References

  1.  
    1. Dahlen G. Biofilms in dental unit water lines. Monogr Oral Sci. (2021) 29:12–8. 10.1159/000510195 - DOI - PubMed
  2.  
    1. Douglas CW, van Noort R. Control of bacteria in dental water supplies. Br Dent J. (1993) 174(5):167–74. 10.1038/sj.bdj.4808114 - DOI - PubMed
  3.  
    1. Fayle SA, Pollard MA. Decontamination of dental unit water systems: a review of current recommendations. Br Dent J. (1996) 181(10):369–72. 10.1038/sj.bdj.4809262 - DOI - PubMed
  4.  
    1. Gilbert P, Das J, Foley I. Biofilm susceptibility to antimicrobials. Adv Dent Res. (1997) 11(1):160–7. 10.1177/08959374970110010701 - DOI - PubMed
  5.  
    1. Nichols WW, Evans MJ, Slack MP, Walmsley HL. The penetration of antibiotics into aggregates of mucoid and non-mucoid Pseudomonas aeruginosa. J Gen Microbiol. (1989) 135(5):1291–303. 10.1099/00221287-135-5-1291 - DOI - PubMed
  6.  
    1. Walker JT, Marsh PD. Microbial biofilm formation in DUWS and their control using disinfectants. J Dent. (2007) 35(9):721–30. 10.1016/j.jdent.2007.07.005 - DOI - PubMed
  7.  
    1. Fan C, Gu H, Liu L, Zhu H, Yan J, Huo Y. Distinct microbial community of accumulated biofilm in dental unit waterlines of different specialties. Front Cell Infect Microbiol. (2021) 11:670211. 10.3389/fcimb.2021.670211 - DOI - PMC - PubMed
  8.  
    1. Gungor ND, Kadaifciler DG, Peker OO. Investigation of the bacterial load and antibiotic susceptibility of dental units. Environ Monit Assess. (2014) 186(3):1847–53. 10.1007/s10661-013-3498-3 - DOI - PubMed
  9.  
    1. Walker JT, Bradshaw DJ, Bennett AM, Fulford MR, Martin MV, Marsh PD. Microbial biofilm formation and contamination of dental-unit water systems in general dental practice. Appl Environ Microbiol. (2000) 66(8):3363–7. 10.1128/AEM.66.8.3363-3367.2000 - DOI - PMC - PubMed
  10.  
    1. Walker JT, Bradshaw DJ, Finney M, Fulford MR, Frandsen E EOS, et al. Microbiological evaluation of dental unit water systems in general dental practice in Europe. Eur J Oral Sci. (2004) 112(5):412–8. 10.1111/j.1600-0722.2004.00151.x - DOI - PubMed
  11.  
    1. Reasoner DJ, Geldreich EE. A new medium for the enumeration and subculture of bacteria from potable water. Appl Environ Microbiol. (1985) 49(1):1–7. 10.1128/aem.49.1.1-7.1985 - DOI - PMC - PubMed
  12.  
    1. Anonymous. ADA Statement on dntal unit waterlines. J Am Dent Assoc. (1996):185–6.
  13.  
    1. Abdallah SA, Khalil AI. Impact of cleaning regimes on dental water unit contamination. J Water Health. (2011) 9(4):647–52. 10.2166/wh.2011.184 - DOI - PubMed
  14.  
    1. Paster BJ, Boches SK, Galvin JL, Ericson RE, Lau CN, Levanos VA, et al. Bacterial diversity in human subgingival plaque. J Bacteriol. (2001) 183(12):3770–83. 10.1128/JB.183.12.3770-3783.2001 - DOI - PMC - PubMed
  15.  
    1. Palleroni NJ. Introduction to the family Pseudomonadaceae. In: Starr HS MP, Trüper HG, Balows A, Schlegel HG, editors. The prokaryotes: A handbook on habitats, isolation, and identification of bacteria. New York: Springer; (1981). p. 1.
  16.  
    1. Pagano J, Levin JD, Trejo W. Diagnostic medium for differentiation of species of Candida. Antibiot Annu. (1957) 5:137–43. - PubMed
  17.  
    1. Hoogenkamp MA, Brandt BW, Laheij A, de Soet JJ, Crielaard W. The microbiological load and microbiome of the Dutch dental unit; “please, hold your breath”. Water Res. (2021) 200:117205. 10.1016/j.watres.2021.117205 - DOI - PubMed
  18.  
    1. Singh R, Stine OC, Smith DL, Spitznagel JK, Jr., Labib ME, Williams HN. Microbial diversity of biofilms in dental unit water systems. Appl Environ Microbiol. (2003) 69(6):3412–20. 10.1128/AEM.69.6.3412-3420.2003 - DOI - PMC - PubMed
  19.  
    1. Barbot V, Robert A, Rodier MH, Imbert C. Update on infectious risks associated with dental unit waterlines. FEMS Immunol Med Microbiol. (2012) 65(2):196–204. 10.1111/j.1574-695X.2012.00971.x - DOI - PubMed
  20.  
    1. Costerton W, Veeh R, Shirtliff M, Pasmore M, Post C, Ehrlich G. The application of biofilm science to the study and control of chronic bacterial infections. J Clin Invest. (2003) 112(10):1466–77. 10.1172/JCI200320365 - DOI - PMC - PubMed
  21.  
    1. Montebugnoli L, Chersoni S, Prati C, Dolci G. A between-patient disinfection method to control water line contamination and biofilm inside dental units. J Hosp Infect. (2004) 56(4):297–304. 10.1016/j.jhin.2004.01.015 - DOI - PubMed
  22.  
    1. Karpay RI, Plamondon TJ, Mills SE, Dove SB. Combining periodic and continuous sodium hypochlorite treatment to control biofilms in dental unit water systems. J Am Dent Assoc. (1999) 130(7):957–65. 10.14219/jada.archive.1999.0336 - DOI - PubMed
  23.  
    1. O'Donnell MJ, Shore AC, Coleman DC. A novel automated waterline cleaning system that facilitates effective and consistent control of microbial biofilm contamination of dental chair unit waterlines: a one-year study. J Dent. (2006) 34(9):648–61. 10.1016/j.jdent.2005.12.006 - DOI - PubMed
  24.  
    1. Seng R, Kitti T, Thummeepak R, Kongthai P, Leungtongkam U, Wannalerdsakun S, et al. Biofilm formation of methicillin-resistant coagulase negative staphylococci (MR-CoNS) isolated from community and hospital environments. PLoS One. (2017) 12(8):e0184172. 10.1371/journal.pone.0184172 - DOI - PMC - PubMed
  25.  
    1. Shao S, Guo X, Guo P, Cui Y, Chen Y. Roseomonas mucosa infective endocarditis in patient with systemic lupus erythematosus: case report and review of literature. BMC Infect Dis. (2019) 19(1):140. 10.1186/s12879-019-3774-0 - DOI - PMC - PubMed
  26.  
    1. Saez-Nieto JA, Medina-Pascual MJ, Carrasco G, Garrido N, Fernandez-Torres MA, Villalon P, et al. Paenibacillus spp. Isolated from human and environmental samples in Spain: detection of 11 new species. New Microbes New Infect. (2017) 19:19–27. 10.1016/j.nmni.2017.05.006 - DOI - PMC - PubMed
  27.  
    1. Kandi V, Palange P, Vaish R, Bhatti AB, Kale V, Kandi MR, et al. Emerging bacterial infection: identification and clinical significance of Kocuria Species. Cureus. (2016) 8(8):e731. 10.7759/cureus.731 - DOI - PMC - PubMed
  28.  
    1. Klotz P, Gottig S, Leidner U, Semmler T, Scheufen S, Ewers C. Carbapenem-resistance and pathogenicity of bovine Acinetobacter indicus-like isolates. PLoS One. (2017) 12(2):e0171986. 10.1371/journal.pone.0171986 - DOI - PMC - PubMed
  29.  
    1. Haydushka IA, Markova N, Kirina V, Atanassova M. Recurrent sepsis due to Bacillus licheniformis. J Glob Infect Dis. (2012) 4(1):82–3. 10.4103/0974-777X.93768 - DOI - PMC - PubMed
  30.  
    1. Szymanska J, Sitkowska J. Bacterial contamination of dental unit waterlines. Environ Monit Assess. (2013) 185(5):3603–11. 10.1007/s10661-012-2812-9 - DOI - PMC - PubMed