3种消毒剂对超声洁牙机单元水路的消毒效果研究

Disinfecting Effect of Three Disinfectants on the Ultrasonic Scaling Unit Waterline

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(H_(2)O_(2))、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%H_(2)O_(2)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%H_(2)O_(2)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。

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 postdisinfection.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%H_(2)O_(2),within 6 days after disinfection with 500 mg/L chlorine-containing disinfectant,and within 4 d after disinfection with 5%povidoneiodine(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%H_(2)O_(2) 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.