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      Healthcare-associated viral and bacterial infections in dentistry

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          Abstract

          Infection prevention in dentistry is an important topic that has gained more interest in recent years and guidelines for the prevention of cross-transmission are common practice in many countries. However, little is known about the real risks of cross-transmission, specifically in the dental healthcare setting. This paper evaluated the literature to determine the risk of cross-transmission and infection of viruses and bacteria that are of particular relevance in the dental practice environment. Facts from the literature on HSV, VZV, HIV, Hepatitis B, C and D viruses, Mycobacterium spp., Pseudomonas spp., Legionella spp. and multi-resistant bacteria are presented. There is evidence that Hepatitis B virus is a real threat for cross-infection in dentistry. Data for the transmission of, and infection with, other viruses or bacteria in dental practice are scarce. However, a number of cases are probably not acknowledged by patients, healthcare workers and authorities. Furthermore, cross-transmission in dentistry is under-reported in the literature. For the above reasons, the real risks of cross-transmission are likely to be higher. There is therefore a need for prospective longitudinal research in this area, to determine the real risks of cross-infection in dentistry. This will assist the adoption of effective hygiene procedures in dental practice.

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          Mycobacterium tuberculosis: success through dormancy.

          Martin Gengenbacher, Stefan Kaufmann (2012)
          Tuberculosis (TB) remains a major health threat, killing nearly 2 million individuals around this globe, annually. The only vaccine, developed almost a century ago, provides limited protection only during childhood. After decades without the introduction of new antibiotics, several candidates are currently undergoing clinical investigation. Curing TB requires prolonged combination of chemotherapy with several drugs. Moreover, monitoring the success of therapy is questionable owing to the lack of reliable biomarkers. To substantially improve the situation, a detailed understanding of the cross-talk between human host and the pathogen Mycobacterium tuberculosis (Mtb) is vital. Principally, the enormous success of Mtb is based on three capacities: first, reprogramming of macrophages after primary infection/phagocytosis to prevent its own destruction; second, initiating the formation of well-organized granulomas, comprising different immune cells to create a confined environment for the host-pathogen standoff; third, the capability to shut down its own central metabolism, terminate replication, and thereby transit into a stage of dormancy rendering itself extremely resistant to host defense and drug treatment. Here, we review the molecular mechanisms underlying these processes, draw conclusions in a working model of mycobacterial dormancy, and highlight gaps in our understanding to be addressed in future research. © 2012 Federation of European Microbiological Societies. Published by Blackwell Publishing Ltd. All rights reserved.
          Article 0 comments Cited 239 times – based on 0 reviews     Review now
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            A systematic review of hepatitis C virus epidemiology in Asia, Australia and Egypt.

            William Sievert, Ibrahim Altraif, Homie A Razavi … (2011)
            The hepatitis C pandemic has been systematically studied and characterized in North America and Europe, but this important public health problem has not received equivalent attention in other regions. The objective of this systematic review was to characterize hepatitis C virus (HCV) epidemiology in selected countries of Asia, Australia and Egypt, i.e. in a geographical area inhabited by over 40% of the global population. Data references were identified through indexed journals and non-indexed sources. In this work, 7770 articles were reviewed and 690 were selected based on their relevance. We estimated that 49.3-64.0 million adults in Asia, Australia and Egypt are anti-HCV positive. China alone has more HCV infections than all of Europe or the Americas. While most countries had prevalence rates from 1 to 2% we documented several with relatively high prevalence rates, including Egypt (15%), Pakistan (4.7%) and Taiwan (4.4%). Nosocomial infection, blood transfusion (before screening) and injection drug use were identified as common risk factors in the region. Genotype 1 was common in Australia, China, Taiwan and other countries in North Asia, while genotype 6 was found in Vietnam and other Southeast Asian countries. In India and Pakistan genotype 3 was predominant, while genotype 4 was found in Middle Eastern countries such as Egypt, Saudi Arabia and Syria. We recommend implementation of surveillance systems to guide effective public health policy that may lead to the eventual curtailment of the spread of this pandemic infection. © 2011 John Wiley & Sons A/S.
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              Health-care workers: source, vector, or victim of MRSA?

              Werner Albrich, Stephan Harbarth (2008)
              There is ongoing controversy about the role of health-care workers in transmission of meticillin-resistant Staphylococcus aureus (MRSA). We did a search of the literature from January, 1980, to March, 2006, to determine the likelihood of MRSA colonisation and infection in health-care workers and to assess their role in MRSA transmission. In 127 investigations, the average MRSA carriage rate among 33 318 screened health-care workers was 4.6%; 5.1% had clinical infections. Risk factors included chronic skin diseases, poor hygiene practices, and having worked in countries with endemic MRSA. Both transiently and persistently colonised health-care workers were responsible for several MRSA clusters. Transmission from personnel to patients was likely in 63 (93%) of 68 studies that undertook genotyping. MRSA eradication was achieved in 449 (88%) of 510 health-care workers. Subclinical infections and colonisation of extranasal sites were associated with persistent carriage. We discuss advantages and disadvantages of screening and eradication policies for MRSA control and give recommendations for the management of colonised health-care workers in different settings.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Oral Microbiol
                Journal ID (iso-abbrev): J Oral Microbiol
                Journal ID (publisher-id): JOM
                Title: Journal of Oral Microbiology
                Publisher: Co-Action Publishing
                ISSN (Print): 0901-8328
                ISSN (Electronic): 2000-2297
                Publication date (Electronic): 12 June 2012
                Publication date Collection: 2012
                Volume: 4
                Electronic Location Identifier: 10.3402/jom.v4i0.17659
                Affiliations
                [1 ]Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
                [2 ]Department of Microbiology, Dental Institute, King's College London, London, United Kingdom
                [3 ]Section of Oral Microbiology and Immunology, Institute of Oral Biology, Center of Dental Medicine, Faculty of Medicine, University of Zürich, Zürich, Switzerland
                [4 ]Department of Virology, Haartman Institute, University of Helsinki, Helsinki, Finland
                [5 ]Department of Oral and Maxillofacial Surgery and HUSLAB, Helsinki University Hospital, Helsinki, Finland
                Author notes
                [* ] A.M.G.A. Laheij, Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands. Tel: +31 20 5980685, Fax: +31 20 5980333. Email: a.lahey@ 123456acta.nl
                Article
                Publisher ID: JOM-4-17659
                DOI: 10.3402/jom.v4i0.17659
                PMC ID: 3375115
                PubMed ID: 22701774
                SO-VID: 66f8e014-7585-4704-8a63-e0ff2e1d7dd6
                Copyright © © 2012 A. M. G. A. Laheij et al.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported License, permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 28 February 2012
                Date revision received : 11 May 2012
                Date accepted : 11 May 2012
                Categories
                Subject: Review Article

                ScienceOpen disciplines: Microbiology & Virology
                Keywords: viruses,healthcare-associated infections,bacteria,dentistry,cross-transmission,cross-infection
                Data availability:
                ScienceOpen disciplines: Microbiology & Virology
                Keywords: viruses, healthcare-associated infections, bacteria, dentistry, cross-transmission, cross-infection

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