口腔综合治疗台水路污染现状及水样16S rDNA高通量测序分析Current status of contamination of dental unit waterlines and 16S rDNA high-throughput sequencing of water samples
刘振华;姜楠;李洋;陈永刚;范婷文;杨怀义;王海青;富大鹏;
摘要(Abstract)：
目的 调查口腔综合治疗台水路(DUWLs)污染现状，探讨预防控制措施。方法 选取北京市某医院13台独立水源口腔综合治疗台，采用7.5‰的次氯酸钠消毒管路，采集消毒前、后三用枪和高速手机水样，计算菌落总数，采集其中两台牙椅三用枪和高速手机水样进行16S rDNA高通量测序进行物种相对丰度、β多样性分析。结果 DUWLs三用枪位点消毒前菌落总数为(1 621±853)CFU/ml,消毒后菌落总数为(3±7)CFU/ml;高速手机位点消毒前菌落总数为(2 787±1 239)CFU/ml,消毒后菌落总数为(3±8)CFU/ml; DUWLs消毒前后三用枪和高速手机水样菌落总数比较均有统计学差异(P<0.05)。DUWLs水样中主要门是变形菌门，相对丰度超过65%,其他门包括浮霉菌门、拟杆菌门、蓝藻门、放线菌门、螺旋菌门等，消毒后，物种相对丰度降低，尤其是鞘氨醇单胞菌属、浮霉菌属。Beta多样性分析显示，消毒前后两组间β多样性差异有统计学意义(P<0.05)。结论 DUWLs存在微生物污染，其内壁有生物膜，存在引起医院感染的潜在风险。使用7.5‰的次氯酸钠消毒剂对DUWLs具有较好的消毒效果，可常规应用于临床口腔综合治疗台。
关键词(KeyWords)： 口腔综合治疗台;水路污染;消毒;次氯酸钠;菌落总数;16S rDNA高通量测序
基金项目(Foundation): 海淀区卫生健康发展科研培育计划项目(HP2021-12-20201)
作者(Authors): 刘振华;姜楠;李洋;陈永刚;范婷文;杨怀义;王海青;富大鹏;
参考文献(References)：
- [1] 苏静.口腔综合治疗台水路管理的现状与思考[J].中国实用口腔科杂志，2018,11(12):713-717.
- [2] 刘晓杰，庄华君，王艳秋，等.口腔综合治疗台水系统污染现状及控制措施[J].中国消毒学杂志，2011,28(1):93-95.
- [3] 章小缓，凌均棨，姬亚昆，等.口腔综合治疗台水路生物膜观察与消毒干预[J].中国感染控制杂志，2011,10(1):9-14,35.
- [4] Baudet A,Lizon J,Martrette JM,et al.Dental unit waterlines:a survey of practices in eastern France[J].Int J Environ Res Public Health,2019,16(21):4242.
- [5] 谭晓娟，胡欣.口腔综合治疗台水路微生物污染及防治研究现状[J].全科口腔医学电子杂志，2019,6(26):15-16.
- [6] Martin MV.The significance of the bacterial contamination of dental unit water systems[J].Br Dent J,1987,163(5):152-154.
- [7] Atlas RM,Williams JF,Huntington MK.Legionella contamination of dental-unit waters[J].Appl Environ Microbiol,1996,62(4):1491.
- [8] 中华人民共和国卫生部，国家标准化管理委员会.中华人民共和国国家标准生活饮用水卫生标准[J].城镇供水，2007(4):27-31.
- [9] Federici G,Soddu S.Variants of uncertain significance in the era of high-throughput genome sequencing:a lesson from breast and ovary cancers[J].J Exp Clin Cancer Res,2020,39(1):46.
- [10] 纪学悦.口腔综合治疗台水路污染与生物膜研究进展[J].中国消毒学杂志，2012,29(11):1016-1018.
- [11] Ditommaso S,Giacomuzzi M,Ricciardi E,et al.Cultural and molecular evidence of Legionella spp.colonization in dental unit waterlines:which is the best method for risk assessment?[J].Int J Environ Res Public Health,2016,13(2):211.
- [12] O′Donnell MJ,Boyle MA,Russell RJ,et al.Management of dental unit waterline biofilms in the 21st century[J].Future Microbiol,2011,6(10):1209-1226.
- [13] 关素敏，贺建军.牙科综合治疗台水路污染及其对策[J].牙体牙髓牙周病学杂志，2013,23(10):669-673.
- [14] 韩艺.不同消毒方法对口腔综合治疗台水路消毒效果的临床研究[D].南京：南京中医药大学，2016.
- [15] Karpay RI,Plamondon T,Mills SE,et al.Combining periodic and continuous sodium hypochlorite treatment to control biofilms in dental unit water systems[J].J Am Dent Assoc,1999,130(7):957-965.
- [16] Volgenant CMC,Persoon IF.Microbial water quality management of dental unit water lines at a dental school[J].J Hosp Infect,2019,103(1):e115-e117.
- [17] Fan CC,Gu HJ,Liu LM,et al.Distinct microbial community of accumulated biofilm in dental unit waterlines of different specialties[J].Front Cell Infect Microbiol,2021,11:670211.
- [18] Holinger EP,Ross KA,Robertson CE,et al.Molecular analysis of point-of-use municipal drinking water microbiology[J].Water Res,2014,49:225-235.
- [19] Wirthlin MR,Marshall GW Jr,Rowland RW.Formation and decontamination of biofilms in dental unit waterlines[J].J Periodontol,2003,74(11):1595-1609.
- [20] Hoogenkamp MA,Brandt BW,de Soet JJ,et al.An in-vitro dynamic flow model for translational research into dental unit water system biofilms[J].J Microbiol Methods,2020,171:105879.
- [21] Huang KL,Zhang XX,Shi P,et al.A comprehensive insight into bacterial virulence in drinking water using 454 pyrosequencing and Illumina high-throughput sequencing[J].Ecotoxicol Environ Saf,2014,109:15-21.