scholarly journals Sources of SARS-CoV-2 and Other Microorganisms in Dental Aerosols

2021 ◽  
pp. 002203452110159
Author(s):  
A.P. Meethil ◽  
S. Saraswat ◽  
P.P. Chaudhary ◽  
S.M. Dabdoub ◽  
P.S. Kumar
Keyword(s):  
Infection Control ◽  
Dental Treatment ◽  
Quantitative Polymerase Chain Reaction ◽  
The United States ◽  
Control Measures ◽  
Personal Protection ◽  
Personal Protection Equipment ◽  
Linear Discriminant ◽  
16S Sequencing ◽  
Asymptomatic Patients

On March 16, 2020, 198,000 dentists in the United States closed their doors to patients, fueled by concerns that aerosols generated during dental procedures are potential vehicles for transmission of respiratory pathogens through saliva. Our knowledge of these aerosol constituents is sparse and gleaned from case reports and poorly controlled studies. Therefore, we tracked the origins of microbiota in aerosols generated during ultrasonic scaling, implant osteotomy, and restorative procedures by combining reverse transcriptase quantitative polymerase chain reaction (to identify and quantify SARS-CoV-2) and 16S sequencing (to characterize the entire microbiome) with fine-scale enumeration and source tracking. Linear discriminant analysis of Bray-Curtis dissimilarity distances revealed significant class separation between the salivary microbiome and aerosol microbiota deposited on the operator, patient, assistant, or the environment ( P < 0.01, analysis of similarities). We also discovered that 78% of the microbiota in condensate could be traced to the dental irrigant, while saliva contributed to a median of 0% of aerosol microbiota. We also identified low copy numbers of SARS-CoV-2 virus in the saliva of several asymptomatic patients but none in aerosols generated from these patients. Together, the bacterial and viral data encourage us to conclude that when infection control measures are used, such as preoperative mouth rinses and intraoral high-volume evacuation, dental treatment is not a factor in increasing the risk for transmission of SARS-CoV-2 in asymptomatic patients and that standard infection control practices are sufficiently capable of protecting personnel and patients from exposure to potential pathogens. This information is of immediate urgency, not only for safe resumption of dental treatment during the ongoing COVID-19 pandemic, but also to inform evidence-based selection of personal protection equipment and infection control practices at a time when resources are stretched and personal protection equipment needs to be prioritized.

Eye in COVID-19: A Brief Review

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Muhammad Mohsin Ali ◽  
Qudsia Anwar Dar ◽  
Zahid Kamal ◽  
Alishba Khan
Keyword(s):  
Infection Control ◽  
Respiratory Symptoms ◽  
Literature Search ◽  
Control Measures ◽  
Transmission Route ◽  
Ocular Manifestation ◽  
Personal Protection ◽  
Personal Protection Equipment ◽  
Ocular Manifestations ◽  
Infection Control Measures

This is a brief review covering the currently available literature on ocular manifestations of COVID-19, andprevention strategies for ophthalmologists. A literature search was carried out of Pubmed, Google Scholar andWHO database of publications on COVID. Keywords used in the search were eye, ocular manifestations,ophthalmology, COVID-19, nCoV-2019, and coronavirus disease. All available articles were reviewed and thosepertinent to the study topic were included. Considering the dearth of information available, ophthalmology journals were also searched separately for relevant articles. Major ocular manifestation of COVID reported in literature is red eye, which usually presents before the onset of respiratory symptoms. Since the eye can be a possible transmission route for SARS-CoV-2, infection control measures should be undertaken by ophthalmologists, including use of personal protection equipment and eye/face covering. A framework for structuring ophthalmological services during the COVID pandemic is also presented in this review.

scholarly journals Knowledge and perception regarding personal protection equipment and infection control measures against COVID-19 among dental practitioners of Saudi Arabia

2021 ◽  
Vol 8 (2) ◽  
pp. 98
Author(s):  
SaeedAli Alqahtani ◽  
MashaelObaid Alshahrani ◽  
MonaOweidh Alnefaie ◽  
AbdullahMana Almofrej ◽  
FahadHassan Aldaghsh ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Infection Control ◽  
Control Measures ◽  
Personal Protection ◽  
Personal Protection Equipment ◽  
Infection Control Measures ◽  
Dental Practitioners

scholarly journals Aggressive Colonization Screening and Infection Control Measures in Containment of NDM-5 Carbapenemase-Producing CRE

2020 ◽  
Vol 41 (S1) ◽  
pp. s458-s459
Author(s):  
Ishrat Kamal-Ahmed ◽  
Kate Tyner ◽  
Teresa Fitzgerald ◽  
Heather Adele Moulton-Meissner ◽  
Gillian McAllister ◽  
...  
Keyword(s):  
Public Health ◽  
Infection Control ◽  
Acute Care Hospital ◽  
Healthcare Facility ◽  
The United States ◽  
Control Measures ◽  
Care Hospital ◽  
Clinical Culture ◽  
Medical Histories ◽  
Asymptomatic Case

Background: In April 2019, Nebraska Public Health Laboratory identified an NDM-producing Enterobacter cloacae from a urine sample from a rehabilitation inpatient who had recently received care in a specialized unit (unit A) of an acute-care hospital (ACH-A). After additional infections occurred at ACH-A, we conducted a public health investigation to contain spread. Methods: A case was defined as isolation of NDM-producing carbapenem-resistant Enterobacteriaceae (CRE) from a patient with history of admission to ACH-A in 2019. We conducted clinical culture surveillance, and we offered colonization screening for carbapenemase-producing organisms to all patients admitted to unit A since February 2019. We assessed healthcare facility infection control practices in ACH-A and epidemiologically linked facilities by visits from the ICAP (Infection Control Assessment and Promotion) Program. The recent medical histories of case patients were reviewed. Isolates were evaluated by whole-genome sequencing (WGS). Results: Through June 2019, 7 cases were identified from 6 case patients: 4 from clinical cultures and 3 from 258 colonization screens including 1 prior unit A patient detected as an outpatient (Fig. 1). Organisms isolated were Klebsiella pneumoniae (n = 5), E. cloacae (n = 1), and Citrobacter freundii (n = 1); 1 patient had both NDM-producing K. pneumoniae and C. freundii. Also, 5 case patients had overlapping stays in unit A during February–May 2019 (Fig. 2); common exposures in unit A included rooms in close proximity, inhabiting the same room at different times and shared caregivers. One case-patient was not admitted to unit A but shared caregivers, equipment, and devices (including a colonoscope) with other case patients while admitted to other ACH-A units. No case patients reported travel outside the United States. Screening at epidemiologically linked facilities and clinical culture surveillance showed no evidence of transmission beyond ACH-A. Infection control assessments at ACH-A revealed deficiencies in hand hygiene, contact precautions adherence, and incomplete cleaning of shared equipment within and used to transport to/from a treatment room in unit A. Following implementation of recommended infection control interventions, no further cases were identified. Finally, 5 K. pneumoniae of ST-273 were related by WGS including carriage of NDM-5 and IncX3 plasmid supporting transmission of this strain. Further analysis is required to relate IncX3 plasmid carriage and potential transmission to other organisms and sequence types identified in this study. Conclusions: We identified a multiorganism outbreak of NDM-5–producing CRE in an ACH specialty care unit. Transmission was controlled through improved infection control practices and extensive colonization screening to identify asymptomatic case-patients. Multiple species with NDM-5 were identified, highlighting the potential role of genotype-based surveillance.Funding: NoneDisclosures: Muhammad Salman Ashraf reports that he is the principal investigator for a study funded by an investigator-initiated research grant.

scholarly journals 510. Exposure Investigation Following a Confirmed Case of Candida auris and Multiple Carbapenemase-Producing Carbapenem-Resistant Organisms

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S247-S247
Author(s):  
Frances Nicholson ◽  
Melanie Curless ◽  
Maggie Schiffhauer ◽  
Sean Zhang ◽  
Patricia Simner ◽  
...  
Keyword(s):  
Infection Control ◽  
Index Patient ◽  
The United States ◽  
Point Prevalence ◽  
Control Measures ◽  
Candida Auris ◽  
Infection Control Measures ◽  
Carbapenem Resistant ◽  
Surveillance Cultures ◽  
Routine Surveillance

Abstract Background Co-infections of Candida auris and carbapenemase-producing carbapenem-resistant Gram-negative organisms (CP-CRO) are an increasing global concern and rarely seen in the United States. We report the case of a 59-year-old male, with recent hospitalization in India, admitted to our facility with C. auris isolated from urine and axilla/groin specimens and CP-CRO from five body sites. Methods Travel screening in the emergency department identified a patient at high risk for colonization/infection with multidrug-resistant organisms (MDRO). Contact precautions were initiated. Eight CP-CRO isolates were subsequently identified from clinical and routine surveillance cultures from five separate sites. Of the isolates, seven contained one or more carbapenemase-producing genes detected by Xpert Carba-R assay (Cepheid, Sunnyvale, CA) (Table 1). The microbiology laboratory alerted the infection control department of a presumptive positive C. auris from a clinical urine culture from the same patient. Enhanced mitigation strategies were initiated in regards to cleaning and disinfection. An exposure investigation was also conducted using a point prevalence approach. Surveillance cultures were obtained from inpatients currently admitted to the same unit as the index patient. Axilla/groin specimens were collected for C. auris testing, and rectal specimens were collected for CP-CRO gene testing (CRE Real-Time PCR). Results Eighteen patients in addition to the index patient were hospitalized on the acute medicine unit. One patient refused testing for CP-CRO; therefore, 17 patients were tested for CP-CRO, and 18 patients were tested for C. auris. Neither CP-CRO nor C. auris were recovered from any patient. Conclusion A patient co-infected with C. auris and multiple CP-CRO was identified by clinical and routine surveillance cultures at Johns Hopkins Hospital. Travel screening allowed proactive isolation upon presentation. Enhanced infection control measures were implemented and a point prevalence surveillance study was conducted on the general acute care medicine inpatient unit. No transmission of either C. auris or CP-CRO was detected, likely due in part to rapid identification and strict infection control measures. Disclosures All authors: No reported disclosures.

scholarly journals The Saudi Infection Control Guidance for Re-opening Dental Services in Governmental and Private Sectors During Coronavirus Disease-2019 Pandemic

2021 ◽  
Vol 15 (1) ◽  
pp. 64-70
Author(s):  
Ali AlAhdal ◽  
Haila Al-Huraishi ◽  
Ahmad Almalag ◽  
Adel Alrusayes ◽  
Saud M Orfali
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Infection Control ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Dental Treatment ◽  
Dental Health ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Dental Services ◽  
And Control

Objective: Novel newly discovered coronavirus, also known as severe acute respiratory syndrome coronavirus-2, is a recently emerging virus that has been rapidly spreading globally since December 2019. Due to the vicinity inoro-dental treatment and aerosol production, people inside the dental office are at high risk of being infected with severe acute respiratory syndrome coronavirus-2. This guideline aims to protect the dental health-care workers during their plans to re-open and increasingly continue their routine services until further notice from their governing body. Methods: A panel of experts in dentistry and infection prevention and control reviewed the local and global research and guidelines related to infection prevention and control during coronavirus disease-2019, along with the re-opening guidance provided by different entities. Results: Such a document might either be adopted or adapted to any regional and international organization that wishes to use a revised professional guideline in infection prevention and control dental services. Conclusion: A careful re-opening plan should be developed and implemented, including strict infection control measures before resuming the dental practice.

scholarly journals Ward renovation and PPE use procedures to protect medical staff from COVID-19 infection

2020 ◽  
Vol 14 (06) ◽  
pp. 554-558
Author(s):  
Zhengze Lin ◽  
Hongmei Shu ◽  
Dongping Jiang ◽  
Yanlan He ◽  
Hongtao Xia ◽  
...  
Keyword(s):  
Medical Staff ◽  
General Ward ◽  
Control Measures ◽  
Personal Protection ◽  
Personal Protection Equipment ◽  
Underdeveloped Countries ◽  
Infection Control Measures ◽  
Medical Institutions ◽  
Number Of Patients ◽  
Late Stages

In the early stages of the coronavirus disease 2019 (COVID-19) outbreak in Wuhan, many cross-infections occurred due to the limited number of wards and insufficient medical staff, which could not cope with the large number of patients visiting the hospital. A series of new infection control measures were implemented in our institution and a Wuhan hospital supported by our medical team, mainly including temporarily transforming the general ward into a passage for the staff to enter the infectious ward and standardizing the procedure for the wearing and removal of personal protection equipment (PPE). These measures significantly improved the situation, and no member of our medical staff was infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the middle and late stages of the disease epidemic. We hope that these experiences can provide references for medical institutions that may face an outbreak of COVID-19, especially those in underdeveloped countries and regions.

scholarly journals Knowledge and attitudes of dental patients towards cross-infection control measures in dental practice

1997 ◽  
Vol 3 (2) ◽  
pp. 263-273
Author(s):  
Adel A. Mousa ◽  
Nadia M. Mahmoud ◽  
Azza M. Tag El Din
Keyword(s):  
Infectious Diseases ◽  
Infection Control ◽  
Dental Treatment ◽  
Cross Infection ◽  
Control Measures ◽  
Dental Practice ◽  
Dental Patients ◽  
Knowledge And Attitudes ◽  
Infection Control Measures ◽  
Dental Clinics

The knowledge and attitudes of 460 dental patients attending outpatient dental clinics in Alexandria, Tanta, and El-Mansoura universities were studied. Every patient was interviewed individually using a questionnaire concerning the routine use of protective gloves, masks and spectacles. The results revealed that 90% of the patients expected dentists to wear gloves, 73% expected them to wear face masks and 37% to wear spectacles. Most patients believed that gloves were for the patient’s protection while face masks and spectacles were for the dentist’s protection. About 50% of patients believed that they could contract infectious diseases during dental treatment;the more educated, the greater the concern of infection. Tanta patients were more concerned about cross infection than other patients

scholarly journals Which policies most effectively reduce SARS-CoV-2 transmission in schools?

2020 ◽  
Author(s):  
Anna Bershteyn ◽  
Hae-Young Kim ◽  
Jessica McGillen ◽  
R. Scott Braithwaite
Keyword(s):  
New York ◽  
Infection Control ◽  
Primary Source ◽  
The United States ◽  
Control Measures ◽  
Infection Control Measures ◽  
Symptom Screening ◽  
Local Case ◽  
Transmission Reduction ◽  
The Impact

AbstractIntroductionNew York City (NYC) has the largest public school system in the United States (US). During the SARS-CoV-2 pandemic, NYC was the first major US city to open schools for in-person learning in the 2020-2021 academic year. Several policies were implemented to reduce the risk of in-school transmission, including infection control measures (facemasks, physical distancing, enhanced indoor ventilation, cohorting of small groups, and hand hygiene), option of all-remote instruction, alternative options for how class schedules would rotate in-person and remote instruction, daily symptom screening, and testing 10-20% of students and staff weekly or monthly depending on local case rates. We sought to determine which of these policies had the greatest impact on reducing the risk of in-school transmission.MethodsWe evaluated the impact of each policy by referring to global benchmarks for the secondary attack rate (SAR) of SARS-CoV-2 in school settings and by simulating the potential for transmission in NYC’s rotating cohort schedules, in which teachers could act as “bridges” across rotating cohorts. We estimated the impact of (1) infection control measures, (2) providing an option of all-remote instruction, (3) choice of class scheduling for in-person learners, (4) daily symptom screening, (5) testing to curtail transmission, and (6) testing to identify school outbreaks. Each policy was assessed independently of other policies, with the exception of symptom screening and random testing, which were assessed both independently and jointly.ResultsAmong the policies analyzed, the greatest transmission reduction was associated with the infection control measures, followed by small class cohorts with an option for all-remote instruction, symptom screening, and finally randomly testing 10-20% of school attendees. Assuming adult staff are the primary source of within-school SARS-CoV-2 transmission, weekly testing of staff could be at least as effective as symptom screening, and potentially more so if testing days occur in the beginning of the workweek with results available by the following day. A combination of daily symptom screening and testing on the first workday of each week could reduce transmission by 70%.ConclusionsAdherence to infection control is the highest priority for safe school re-opening. Further transmission reduction can be achieved through small rotating class cohorts with an option for remote learning, widespread testing at the beginning of the work week, and daily symptom screening and self-isolation. Randomly testing 10-20% of attendees weekly or monthly does not meaningfully curtail transmission and may not detect outbreaks before they have spread beyond a handful of individuals. School systems considering re-opening during the SARS-CoV-2 pandemic or similarly virulent respiratory disease outbreaks should consider these relative impacts when setting policy priorities.

scholarly journals Awareness and knowledge of undergraduate dental students about the signs and symptoms of Corona viral infection (COVID-19), and the required infection control measures to prevent its spread

2021 ◽  
Vol 45 (1) ◽  
Author(s):  
Rasha F. Sharaf ◽  
Nihal Kabel
Keyword(s):  
Infection Control ◽  
Personal Protective Equipment ◽  
Dental Treatment ◽  
Signs And Symptoms ◽  
Dental Students ◽  
Control Measures ◽  
Protective Equipment ◽  
Common Symptom ◽  
Infection Control Measures ◽  
High Level

Abstract Background Coronavirus disease (COVID-19) is considered a highly contagious disease with flu-like symptoms and causing relatively high level of death. It can be transmitted from a person to another through droplets and that makes the dentists at high risk of infection. Therefore, the aim of the current study was to assess the awareness and knowledge of dental students about the signs and symptoms of Coronavirus disease (COVID-19) and to evaluate their awareness about the required infection control measures during the dental treatment to control the spread of the disease. A questionnaire was formed using Google forms and distributed among dental students and interns in different universities in Cairo, Egypt. Questions were about signs and symptoms of COVID-19, attitude of the dentists toward dental treatment of suspected patients and the required personal protective equipment (PPE) and infection control measures at the dental clinic. Results The majority of the participants strongly agreed/agreed that COVID-19 is a highly dangerous disease, Participants reported that the most common symptom is difficulty in breathing (89.4%) followed by fever (84.4%). Face shield was the most recommended personal protective equipment (PPE) during dental treatment (98.6%) followed by disposable gown (96.3%). The majority of participants (84.8%) recommended using 70% ethyl alcohol as the first method to disinfect surfaces in between dental visits, followed by sodium hypochlorite. Conclusions Dental students and interns in Cairo, Egypt, have good knowledge and awareness about COVID-19 and the necessary precautions required to provide adequate dental treatment for the patients during the pandemic COVID-19; however, the importance of infection control should be highlighted for both clinical and preclinical dental students, to provide safe dental treatment to the patients as well as protection of the dentists and healthcare workers.

scholarly journals Post COVID-19 changes in the perception of the parents towards dentistry for their child

2021 ◽  
Vol 7 (3) ◽  
pp. 155-160
Author(s):  
Nahid Iftikhar ◽  
Shalini Dixit ◽  
Aditi Yadav
Keyword(s):  
Infection Control ◽  
Dental Treatment ◽  
Pediatric Dentistry ◽  
Behavioral Changes ◽  
Control Measures ◽  
Cross Sectional ◽  
Infection Control Measures ◽  
Pediatric Dentists ◽  
Dental Setting ◽  
Almost All

The aim of the study is to evaluate the post COVID changes in the perception of the parents towards dentistry for their child/children.A cross-sectional questionnaire based survey was conducted among the parents of children &#60;18 years of age to assess the behavioral changes in the parents after the COVID-19 outbreak towards pediatric dentistry. The survey was carried out with a sample of 5110 respondents.Majority of the parents had correct knowledge regarding the COVID-19 with increase in their anxiety level post COVID-19 outbreak. Almost all the parents were taking the measures regarding the hygiene of their children. Nearly half of the parents were not willing to take their children to the dentist even in the emergency dental condition due to the risk of encountering corona virus at the dental clinic.The majority of respondents lacked confidence towards dentistry, their treatment environments, and the infection control measures taken, and were worried about contracting COVID-19 infection from the dental setting. Parents, however, demanded better infection control measures during the SARS outbreak. From the results of our survey, it is imperative that dentists and dental specialist like pediatric dentists should offer more confidence building measures towards the patients & their parents, involving them in the dental treatment planning as well as decision making and providing them timely appraisal regarding the same.

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