scholarly journals Qualitative Analysis of Bacterial Aerosols Generated during Ultrasonic Dental Scaling

Author(s):  
Angabeen Anjum ◽  
Mervyn Hosein ◽  
Saima Akram Butt ◽  
Fakhuruddin . ◽  
Yousra Shafiq

Aims: To compare the efficacy of two mouth rinses (0.2% Chlorhexidine and 5% green tea mouth rinse) in reducing the bacterial load (CFUs) in aerosol samples collected during ultrasonic dental scaling and to do the qualitative analysis of bacterial isolates. Study Design: Quasi experimental study. Place and Duration of Study: Department of Periodontics (Ziauddin college of Dentistry), Ziauddin University, Karachi, between January 2019 to August 2019. Methodology: This study comprised of seventy patients (43 males and 27 females) within the age group of 20 to 65 years having gingival and plaque score between 1 and 3 and mean probing depth less than 5 mm. All study subjects were divided into 2 equal groups (group 1 and group 2). A split mouth design was used for ultrasonic scaling (oral prophylaxis). Control side was scaled without pre rinsing while the test side was scaled after pre procedural mouth rinsing. Group 1 study subjects were instructed to rinse with 10 ml 0.2% Chlorhexidine mouth rinse for one minute and Group 2 rinsed with 10 ml 5% green tea mouth rinse for a minute. Fresh blood agar plates were used for air sampling, which were then transported to Microbiology laboratory (JPMC) for aerobic culturing and microbiological examination. Results: Greater percentage of Gram positive bacteria were found in aerosol samples generated during ultrasonic scaling. Gram positive cocci (Staph epidermidis and Micrococci species) were in abundance and very few gram negative bacteria were detected. Conclusion: Dental health care providers and patients can easily acquire infections because of contaminated aerosols and splatters and so all infection control measures should be taken to minimize these risks. Pre procedural mouth rinsing with effective mouthwashes should be done before dental procedures as it is easiest and much economical way of reducing cross infection.

Author(s):  
Angabeen Anjum ◽  
Mervyn Hosein ◽  
Saima Akram Butt ◽  
Fakhuruddin . ◽  
Bina Fawad ◽  
...  

Aims: The aim of this study was to compare the efficacy of two mouth washes namely Chlorhexidine 0.2% and 5% green tea mouth rinse when used as pre-procedural rinses in reducing the number of CFU in aerosol generated during ultrasonic scaling. Study Design:  Quasi experimental study. Place and Duration of Study: Department of Periodontology, Ziauddin college of Dentistry, Ziauddin University, Karachi, between January 2019 to August 2019. Methodology: 70 subjects were recruited in this study (43 males, 27 females: age range 18-65 years with presence of minimum 20 permanent functional teeth, less than 5 mm mean probing depth and plaque and gingival score between 1-3. Subjects were randomly divided into two groups, group 1 and group 2. Each group comprised of 35 patients. A split mouth design technique was used for collecting the aerosol samples on blood agar plates. For every patient, there was a control side and test side of mouth. Ultrasonic scaling was done on control side without pre procedural rinsing and vice versa. Group 1 used 0.2% Chlorhexidine while group 2 rinsed with 5% green tea mouthwash. The blood agar plates were then transported to Microbiology lab and incubated for counting the colony forming units (CFU). Results: Significant reduction of CFU occurred with pre procedural rinsing with both mouthwashes as compared to non-rinsing before ultrasonic scaling and 0.2% Chlorhexidine found to be superior to 5% green tea in reducing bacterial load in aerosol samples Conclusion: Pre procedural mouth rinsing with effective mouthwashes significantly reduces aerosol contamination and should be used before all dental procedures that results in formation of aerosols and splatters along with some other infection control protocol to minimize the risks of cross infection in clinical settings.


2020 ◽  
Vol 10 (01) ◽  
pp. e5-e10 ◽  
Author(s):  
Iram Musharaf ◽  
Sibasis Daspal ◽  
John Shatzer

Abstract Background Endotracheal intubation is a skill required for resuscitation. Due to various reasons, intubation opportunities are decreasing for health care providers. Objective To compare the success rate of video laryngoscopy (VL) and direct laryngoscopy (DL) for interprofessional neonatal intubation skills in a simulated setting. Methods This was a prospective nonrandomized simulation crossover trial. Twenty-six participants were divided into three groups based on their frequency of intubation. Group 1 included pediatric residents; group 2 respiratory therapists and transport nurses; and group 3 neonatal nurse practitioners and physicians working in neonatology. We compared intubation success rate, intubation time, and laryngoscope preference. Results Success rates were 100% for both DL and VL in groups 1 and 2, and 88.9% for DL and 100% for VL in group 3. Median intubation times for DL and VL were 22 seconds (interquartile range [IQR] 14.3–22.8 seconds) and 12.5 seconds (IQR 10.3–38.8 seconds) in group 1 (p = 0.779); 17 seconds (IQR 8–21 seconds) and 12 seconds (IQR 9–16.5 seconds) in group 2 (p = 0.476); and 11 seconds (IQR 7.5–15.5 seconds) and 15 seconds (IQR 11.5–36 seconds) in group 3 (p = 0.024). Conclusion We conclude that novice providers tend to perform better with VL, while more experienced providers perform better with DL. In this era of decreased clinical training opportunities, VL may serve as a useful tool to teach residents and other novice health care providers.


2006 ◽  
Vol 72 (2) ◽  
pp. 174-179
Author(s):  
Om P. Sharma ◽  
Diane M. Scala-Barnett ◽  
Michael F. Oswanski ◽  
Amy Aton ◽  
Shekhar S. Raj

Delayed diagnosis of injury (DDI) during hospitalization and missed injuries (MI) on autopsy in trauma deaths result in untoward outcomes. Autopsy is an effective educational tool for health care providers to evaluate trauma care. A retrospective study of trauma registry patients and coroner's records was categorized into groups 1 (alive patients) and 2 (trauma deaths) and analyzed. DDI incidence was similar in group 1 (1.8%) and group 2 (1.9%). Autopsy analysis (163 patients) yielded 139 MI in 94 patients (57.6%), <3 per cent of MI had negative impact on survival. Bony injuries comprised 68 per cent of DDI and 19 per cent of MI. Group 1 DDI patients were sicker with higher injury severity score (ISS: 16.07) than their cohorts (ISS 7.13, P value <0.05). These patients had higher Glasgow Coma Scale (14.41) and lower ISS (16.07) as compared with group 2 MI patients (ISS: 33.49, GCS: 6.45, P value <0.05). Autopsy rate was 99.5 per cent in trauma deaths, 57 per cent for nontrauma deaths, and 79 per cent for all deaths. Less than 3 per cent of MI had negative impact on survival. Routine ongoing patient assessment with pertinent diagnostic workup is essential in reducing DDI. Trauma autopsies reveal MI, which aid performance improvement (PI).


2017 ◽  
Vol 9 ◽  
pp. 176 ◽  
Author(s):  
Diah Ayu Maharani ◽  
Alia Ramadhani ◽  
Melissa Adiatman ◽  
Yuniardini Septorini Wimardhani ◽  
Linda Kusdhany ◽  
...  

Objective: This study aimed at comparing the antiplaque, anticalculus, and antigingivitis potentials of a mouth rinse containing essential oil, alcohol,zinc, and fluoride with a mouth rinse containing cetylpyridinium chloride (CPC) 0.1% over 1-, 2-, and 3-month periods.Methods: This study was a double-blind, parallel randomized clinical trial with a 3-day run-in phase. Respondents were asked to gargle twice dailywith 15 ml of mouth rinse for 30 seconds after brushing teeth. Respondents were 80 females with a mean age of 21 years, and a single dental examinerwas employed throughout the study to decrease the variance. Prophylaxis was performed for all respondents before the intervention. Three mouthrinses were tested: Group 1 with the mouth rinse containing CPC 0.1%, Group 2 as the negative control, and Group 3 as the positive control with amouth rinse containing alcohol. Evaluations were conducted by plaque index, gingival index, calculus index, and CariScreen examinations.Results: The clinical trial showed that the mouth rinse with alcohol and the mouth rinse containing CPC 0.1% were effective in inhibiting bacterialbuildup (antiplaque) and have anticalculus properties, but with no statistically significant antigingivitis effect.Conclusion: It was found that the mouth rinse containing alcohol has similar effectiveness with CPC 0.1% mouth rinse, but side effects, such as aburning sensation, were reported in the alcohol-containing mouth rinse.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Gatsura ◽  
V Deriushkin ◽  
O Gatsura ◽  
E Ulyanova

Abstract Background Non severe community acquired pneumonia (CAP) is a common problem in primary care. So called “walking” CAP is frequently caused by atypical intracellular pathogens Chlamydia pneumoniae and Mycoplasma pneumonia which are resistant to beta-lactams and can be transmitted from an infected person to a healthy one. Taking into account medical and epidemiologic importance of this problem we aimed to estimate appropriateness of the antimicrobial agent (AM) choice for outpatient treatment of mild CAP by current and future primary care providers with regard to atypical pathogens coverage. Methods Total 240 final year medical students of A.I.Yevdokimov Moscow State University of Medicine and Dentistry (Group 1) and 206 Moscow primary care physicians (Group 2) were surveyed in 2019. Respondents were asked to specify in writing what particular AM they would recommend to 35 year old previously healthy male patient with subfebrile body temperature (37.3 °C), non-productive cough and documented CAP. Chi-square test was used to compare the data obtained in both groups. Results Group 1 respondents returned questionnaires with 271 recommendations, Group 2 participants named 230 items. AMs with atypical pathogens coverage (macrolides, fluoroquinolones and doxycycline) accounted for just 33.2% in Group 1 versus 20.0% in Group 2 (p=.0009). Amoxicillin/clavulanate was the leading choice equally popular both in students and physicians (42.1% and 40.9% respectively). The rest of recommendations in both Groups included amoxicillin and various cephalosporins. Conclusions Only one of three students and one of five physicians made the right choice in offered clinical scenario. A majority of respondents in both groups hastily recommended beta-lactams instead of clinical estimation of atypical CAP probability in given situation, but students indicated appropriate AMs more often. This problem obviously persists and requires action from both academics and healthcare managers. Key messages Medical students and primary care physicians’ awareness of atypical CAP presentation and treatment is not quite satisfactory. Resulting undertreatment of atypical CAP may harm the patient and promote further spread of causative pathogen within the community.


1999 ◽  
Vol 19 (4) ◽  
pp. 376-379 ◽  
Author(s):  
Laura Troidle ◽  
Nancy Gorban–Brennan ◽  
Alan S. Kliger ◽  
Fredric O. Finkelstein

Objective Long-term chronic peritoneal dialysis (CPD) therapy has been associated with alterations in peritoneal membrane structure and peritoneal macrophage function. We thus reviewed our experience with the development of peritonitis among patients maintained on CPD therapy for various time periods to determine if the spectrum of organisms, rates of peritonitis, and outcome changed with the duration of CPD therapy. Setting and Patients Patients maintained on CPD therapy in our out-patient unit in New Haven, Connecticut. Design Retrospective review of the charts of patients maintained on CPD therapy (HomeChoice Cycler or Ultrabag, Baxter, McGaw Park, IL, U.S.A.) between 1 January 1997 and 31 March 1998. These patients were divided into three groups: group 1, patients maintained on CPD therapy < 12 months; group 2, patients maintained on CPD therapy for 13 - 36 months; and group 3, patients maintained on CPD therapy for ≥ 37 months. Results The study included 256 patients: 101 patients in group 1, 110 patients in group 2, and 45 patients in group 3. All groups of patients were similar in age. There were significantly fewer Caucasians and fewer males in group 3 in comparison to groups 1 and 2. The incidence of diabetes mellitus, coronary artery disease, and peripheral vascular disease was significantly lower among patients in group 3 in comparison to groups 1 and 2. There were 155 episodes of peritonitis during the study period for an overall rate of 1 episode in 18.7 patient-months. The overall, gram-positive, and gram-negative rates of peritonitis were not significantly different among the patients in groups 1, 2, and 3. There were more episodes of Staphylococcus aureus peritonitis among patients in group 3 in comparison to group 2 (1 episode in 59.6 vs 1 episode in 280.2 patient-months, respectively). Two weeks after the development of peritonitis, 94.6% of the patients in group 3 continued CPD therapy, while 79.4% of the patients in group 1 continued CPD therapy ( p < 0.05). No patient in group 3 transferred to hemodialysis, while 10.3% and 8.2% of the patients in groups 1 and 2 transferred to hemodialysis ( p < 0.05). The death rate 2 weeks after the onset of peritonitis was 10.3%, 9.8%, and 5.4% in groups 1, 2, and 3, respectively ( p = NS). Conclusions Despite the immunological and morphological changes that occur in the peritoneal cavity with increased time on CPD therapy, there was no difference in the overall, gram-positive, or gram-negative rates of peritonitis for patients maintained on CPD therapy for various time periods. Patients in group 3 continued CPD therapy more often than did patients in group 1. Patients in group 3 transferred to hemodialysis less often than did the remaining patients in the study period. The incidence of death was not significantly different for the three groups of patients.


2019 ◽  
Vol 70 (8) ◽  
pp. 2873-2878
Author(s):  
Galina Pancu ◽  
Gianina Iovan ◽  
Simona Stoleriu ◽  
Nicoleta Tofan ◽  
Antonia Moldovanu ◽  
...  

The aim of the study is to asses, by using microhardness technique, the remineralization effect of some products used in the treatment of early dental caries adjacent to fixed orthodontic appliances. The study was performed on a group of 32 patients receiving fixed orthodontic therapy. The patients were randomly divided in two groups, accordingly to the administered preventive protocol: in group 1 (control) toothpaste Splat Professional Biocalcium (without fluoride) was applied twice a day; in group 2 (study group) toothpaste and mouthwash Vitis anticaries with natrium monofluorophosphate 1450 ppm F, respectively 226 ppm F, twice a day were used. After 60 days, the extraction of premolars was made and the preparation of the samples was done. The microhardness analysis was performed using the device CV 400 DAT (Namicon). The analysis of the results found lower microhardness for the samples submitted to brushing with fluoridated toothpaste and rinsing with fluoridated mouthwash solution, comparing to control (samples submitted only to brushing with non-fluoridated toothpaste). The conclusions of this study confirm the effectiveness of a proper prophylactic protocol (toothbrushing with fluoridated toothpaste, mouth rinsing with fluoridated mouthwashes) associated to the fixed orthodontics therapy, in the prevention of the early enamel demineralization onset adjacent to brackets.


2020 ◽  
Vol 9 (3) ◽  
pp. 187-194
Author(s):  
Natalia Garcia Santaella ◽  
◽  
Maiara Gabriela Gonçales ◽  
Lázara Joyce Oliveira Martins ◽  
Bárbara Margarido Brondino ◽  
...  

Objective: To evaluate the perception and acceptance of using polyhexanide (PHMB) and chlorhexidine digluconate (CLX) in individuals at a risk of developing oral mucositis induced by chemoradiotherapy. Materials and Methods: This is a randomised comparative study. Participants were randomised into two groups: Group 1 (PHMB 0.2%) and Group 2 (CLX 0.12%), these groups performed a mouth rinse with the respective solutions for 1 minute every 12 hours during an antineoplastic treatment cycle. The participants were evaluated at three different times: before (t0), during (t1) and after a cycle of antineoplastic treatment (t2). Severity of oral mucositis (OM), mouth pain, quality of life (OHIP-14), oral hygiene index and assessment of the acceptance of the substances in the mouth were assessed. Results: There were 23 individuals, 12 in Group 1 (G1) and 11 in Group 2 (G2). Both groups presented with OM in all three evaluations. Reported mouth pain was lower in G1 than in G2. The PHMB had a better acceptance (p=0.012) than the CLX for the time of mouth rinse at t0. There was a lower impact in the quality of life from oral health in the physical pain aspect (p=0.019) and in social incapacity (p=0.037) in G1 than in G2. Conclusions: PHMB has the same acceptance compared to CLX and is a good option for antiseptic mouth rinse with less adverse effects


2021 ◽  
pp. 68-76
Author(s):  
A. B. Zemlianoi ◽  
T. A. Zelenina ◽  
V. V. Salukhov

Introduction. Long-lasting ulcerative defects in patients with diabetic foot syndrome (DFS) are prone to reinfection, persistence of primary and hospital-acquired infection, and the infectious process is often caused by multidrug-resistant organisms (MDRO).Aim of the study: to compare the prevalence and specific characteristics of the severe diabetic foot infection pathogens during the inpatient and outpatient stages of treatment.Materials and methods. We included 62 type 2 diabetic inpatients (group 1) with severe foot infection and 102 diabetic foot outpatients (group 2) with postoperative wounds, who had been operated on and discharged from the hospital, in to the study.Cultures were obtained after surgery interventions immediately and on 14 days of hospitalization in group 1 of patients and in group 2 of patients with clinical signs of infection. Microbe species and resistant of pathogens to antibiotic were assessed.Results and discussion. Severe infection connected with polymicrobe pathogens in both groups of patients. However, the prevalence of Gram-positive and Gram-negative bacilli was different. The most frequently isolated pathogens were Gram-positive bacteria in the wound samples of group 1 of patients with acute infection obtained after surgery interventions immediately. In the wound cultures of group 1 on 14 day of hospitalization and group 2 the prevalence of Gram-positive and Gram-negative bacilli was the same. It should be noted that there is still a high total frequency of isolation of non-fermenting Gram-negative bacilli among Gram-negative pathogens in complicated diabetic foot infection both at the inpatient and outpatient stages of treatment.Conclusion. The great finding of the study is the identification of a parallel of the same prevalence of Gram-positive and Gramnegative pathogens in a prolonged infection at the inpatient and outpatient stages of treatment. The role of Enterobacterales increased with duration of infection. The prevalence of multidrug resistant Enterobacterales makes this group of microorganisms as important as Staphylococcaceae in the complicated course of the infectious process. Polyvalent microbial spectrum of pathogens significantly reduces the effectiveness of treatment.


Author(s):  
І.М. Shifris ◽  
I.O. Dudar ◽  
V.F. Krot ◽  
V.T. Kruglikov ◽  
N.G. Aleksieva ◽  
...  

Bacterial infections in chronic kidney disease stage VD (CKD VD st.)patients are associated with increased risk of hospitalization and death.   The aim was to study of opportunistic pathogenic bacteria spectrum, their antibacterial resistance and the correlation between carriage and hospitalization and mortality rate in adult patients with CKD V D st. Materials and methods. This prospective cohort, open-label, randomized, two-phase study included 146 patients with CKD V D st., 118 of whom were treated by hemodialysis (HD) and 28 by peritoneal dialysis (PD). The microbiological screening was conducted in the first stage. The examined material was throat/nose swabs and wet smears from skin of dialysis access site. On the second stage all patients were randomized on two groups: the group 1 (n=61) included patients with identified MRSA / VRE colonization and group 2 (n=85) included patients with colonization of other strains of opportunistic pathogenic bacteria. The groups were representative according to gender, age, type of kidney affections and renal replacement therapy (RRT) modality. The microbiological examination consisted of inoculation of hard medium by examined material. The end points were total amount of hospitalization and death events evaluated for 24 months after randomization. Results. The colonization of some biotype of opportunistic pathogenic bacteria was established in 100% ofpatients. In total were isolated 347 strains of gram-positive bacteria: 284 and 63 in HD and PD patients, respectively. Without statistical significance approximately 20% of microorganism strains were resistant to 10 and more antibiotics according to dialysis modality. The MRSA colonization was identified in 49 (33.6%) patients (37/31.4% and 12/42.9% of HD u PD patients, respectively; p=0,246). The VRE colonization was established in 12 patients (10/8.5% and 2/7.1% of HD and PD patients, respectively; p=0.81). The 70 hospitalization episodes were recorded during monitoring period. The significant majority was established in group 1 of patients (39/64% vs. 31/36.5 %; %2 =10.733, p=0,001) irrespective ofRRTmodality. The specific share ofdead persons in group 1 was in three times more than such share in group 2 (9/14.8% vs. 4/4.7 %; %2=4.42, p= 0.0355). The relative risks of hospitalization and death in the presence of MRSA/VRE colonization increased in 1.75 (95% CI: 1.252.5) and 3.14(95% CI: 1.01-9.7) times. Conclusion. In this study was demonstrated that MRSA/VRE colonization in adult patients with CKD V D st. is a risk marker and a predictor of negative clinical prognosis. The RRT modality hadn’t significant effect on rate of negative consequences, particularly on rate of hospitalization and death in population of CKD V D st. patients.


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