Disinfecting Effect of Three Disinfectants on the Ultrasonic Scaling Unit Waterline
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摘要:
目的 评估3种临床常用消毒剂对超声洁牙机单元水路的消毒效果。 方法 将12台牙周超声洁牙机按消毒方案随机分为4组：A组蒸馏水、B组3%过氧化氢（H2O2）、C组500 mg/L含氯消毒剂和D组5%聚维酮碘。每台洁牙机用于日常牙周治疗，每天有效工作6 h。分别在基线、消毒后即刻和消毒后1～7 d收集水样。对可培养细菌进行计数、分离和纯化，通过16S rRNA 基因测序进行鉴定，基因扩增子序列按操作分类单元（OTUs）进行聚类。扫描电子显微镜（SEM）观察消毒7 d后水路内壁生物膜的形态和厚度。 结果 所有组别基线菌落总数均超过了100 CFU/mL。但在消毒后，各组菌落总数均显著降低（P < 0.05）。3% H2O2消毒后3 d内、500 mg/L含氯消毒剂消毒后6 d内和5%聚维酮碘消毒后4 d内，菌落总数保持在100 CFU/mL以下（P < 0.05）。在超声洁牙机单元水路中检测到了嗜麦芽窄食单胞菌（Stenotrophomonas maltophilia）等病原体。扫描电镜显示，与对照组相比，3% H2O2组和5%聚维酮碘组生物膜厚度更薄（P < 0.05）。 结论 牙科超声洁牙机单元水路中存在致病菌污染，对患者和医务人员构成潜在的感染风险。在日益严峻的感控背景下应根据临床实际制定适宜的消毒方案。 Abstract:Objective To assess the efficacy of three disinfectants in disinfecting the ultrasonic scaling unit waterline. Methods Twelve periodontal ultrasonic scalers were randomly divided into four groups based on the disinfection protocol: distilled water （A group）, 3% hydrogen peroxide （B group）, 500 mg/L chlorine disinfectant （C group） and 5% povidone-iodine （D group）. Each scaler was used for daily periodontal treatment and worked effectively for 6 hours per day. Water samples were collected at baseline, after disinfection, and 1-7 days post-disinfection. Scanning electron microscopy （SEM） was used to observe biofilm formation. Culturable bacteria were counted, isolated and purified, then identified through 16S rRNA gene sequencing. Sequences of 16S rRNA gene amplicons were clustered by operational taxonomic units （OTUs）. Results Baseline colony counts exceeded 100 CFU/mL in all groups. However, after disinfection, the colony counts decreased significantly in all groups （P < 0.05）. The colony counts remained below 100 CFU/mL within 3 d after disinfection with 3% H2O2, within 6 days after disinfection with 500 mg/L chlorine-containing disinfectant, and within 4 d after disinfection with 5% povidone-iodine （P < 0.05）.Pathogens such as Stenotrophomonas maltophilia were detected in the ultrasonic scaler unit water circuit. SEM showed thinner biofilm thickness in the 3% H2O2 and 5% povidone-iodine groups compared to the control group （P < 0.05）. Conclusions Bacterial contamination is present in the ultrasonic scaling unit waterline, posing a potential infection risk to periodontal staff and patients. In the context of increasingly severe nosocomial infections, appropriate disinfection protocols should be developed based on clinical realities. -
Key words:
- Ultrasonic scaler /
- Dental unit waterline /
- Plaque biofilms /
- Hydrogen peroxide /
- Sodium hypochlorite /
- Povidone iodine
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图 1 超声洁牙机水线（USUWLs）
A：拆除的超声洁牙机水线；B：超声洁牙机水线内壁的生物膜。
Figure 1. Utrasonic scaler unit waterlines （USUWLs）
图 2 不同方案消毒后即刻菌落总数变化
A组：蒸馏水；B组：3%过氧化氢；C组：500 mg/L含氯消毒剂；D组：5%聚维酮碘。*P < 0.05。
Figure 2. Changes in the total number of colonies immediately after disinfection with different protocols
图 3 消毒后7 d的消毒持续性分析
注：Day 0代表消毒后即刻采样；Day 1-7代表消毒后第1天至第7天采样；A：蒸馏水组；B：3%过氧化氢组；C：500 mg/L含氯消毒剂组；D：5%聚维酮碘组。*P < 0.05；**P < 0.01；***P < 0.001。
Figure 3. Disinfection duration analysis 7d after disinfection
图 4 菌落计数和种类的系统发育树聚类
注：Group_Baseline代表基线；Group_0代表消毒后即刻；Group_1～7代表相应分组消毒后的第1～7 天；A：蒸馏水组；B：3%过氧化氢组；C：500 mg/L含氯消毒剂组；D：5%聚维酮碘组。
Figure 4. Phylogenetic tree clustering of colony counts and species
图 5 超声洁牙机水路内壁生物膜扫描电镜
A：蒸馏水组；B：3%过氧化氢组；C：500 mg/L含氯消毒剂组；D：5%聚维酮碘组；E：空白对照（对全新的管内壁进行扫描）。A1-E1为生物膜表面（比例尺20 μm），A2-E2为生物膜横截面（比例尺100 μm）。*P < 0.05；**P < 0.01。
Figure 5. SEM image of biofilm on the inner wall of the water piping of the ultrasonic scaler.
表 1 A、B、C、D 组不同时间点可培养菌落的描述性分析[ M（P25，P75），CFU/mL]
Table 1. Descriptive analysis of culturable colonies at different time points in groups A，B，C，D [ M（P25，P75），CFU/mL]
时间 A组 B组 C组 D组 基线 200（160，660） 360（240，940） 120（100，140） 280（160，400） 消毒后即刻 20（0，80） 20（0，40） 0（0，20） 0（0，0） 消毒后第1天 0（0，20） 0（0，0） 0（0，0） 0（0，20） 消毒后第2天 20（20，240） 0（0，0） 0（0，0） 0（0，20） 消毒后第3天 80（20，460） 0（0，0） 0（0，0） 0（0，0） 消毒后第4天 220（60，300） 280（220，360） 0（0，0） 20（0，40） 消毒后第5天 420（220，640） 40（20，80） 40（0，80） 140（140，200） 消毒后第6天 620（200，700） 40（20，40） 40（0，100） 0（0，0） 消毒后第7天 840（320，960） 100（80，260） 420（380，480） 760（640， 1000 ）
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表 2 不同组别消毒后7 d的重复测量秩和检验
Table 2. Repeated-measures rank-sum test 7 d after disinfection in different groups
组别 χ2 df P A组 18.657 7 0.009 B组 20.079 7 0.005 C组 15.621 7 0.029 D组 17.604 7 0.014
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