치과대학 임상 시뮬레이션 실습실 치과용 유니트 수계의 세균 오염도 조사
Bacterial Contamination of Dental Unit Water Systems in a Student Clinical Simulation Laboratory of College of Dentistry
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이 연구는 강릉원주대학교 치과대학 학생들의 임상실습을 위해 사용되고 있는 DCU에서 배출되는 물 속 종속영양세균의 수준을 평가하면서 사용빈도에 따른 세균 오염수준의 차이를 확인하고 기회 감염성 병원균의 존재를 분자생물학적 방법을 사용하여 확인하였다. 임상 실습실에서 사용되는 DCU 36개를 대상으로 초음파치석제거기에서 물 시료를수집하여 평균 CFU/ml를 조사하고 초음파치석제거기의 한달 사용빈도에 따라 DCU를 세 집단으로 분류하여 세균오염수준을 비교하였다. 또한 수집한 물 시료에서 세균의genomic DNA를 추출한 후 PCR 분석을 통해 기회감염성병원균의 존재를 확인한 결과는 다음과 같다. 학생 실습에 사용한 DCU에서 수집한 물 시료의 평균 종속영양세균수준은 16,095 CFU/ml로 ADA에서 권장하는 200 CFU/ml 이하의 수준에 적합하지 않은 것을 확인하였다. 초음파 치석제거기의 한 달 사용빈도에 따라 3집단으로 나누어 CFU/ml 를 조사하였을 때, 초음파치석제거기를 한 달에 1번 이상 3 번 미만 사용한 DCU에서 평균 CFU/ml가 20,070 CFU/ml 로 가장 높게 나타났으며, 3번 이상 사용한 유니트는CFU/ml 평균이 8,420 CFU/ml로 가장 적게 나타났다. 3개군의 CFU/ml 차이는 통계학적으로 유의성이 있는 것을 보여주었고(p＜0.05), 그 중 사용빈도가 가장 높은 군에서 유의하게 낮은 CFU/ml를 보여주었다. 치과에서 사용하는DCU에 존재하는 기회감염성 병원균이 학생실습에 사용하는 DCU에서도 분리되었다. 36개의 genomic DNA 시료 중1개의 시료에서 Pseudomonas species가 검출되었고, 2개의 시료에서 비결핵성 Mycobacterium species가 검출되었다. 따라서 학생실습용으로 사용되는 DCU는 학생들과 대상자에게 잠재적 감염의 원인이 될 수 있으며, 실습 전 학생들의 보호장비 착용과 실습 후 수관관리가 필요하다.
Abstract
The water supplied from dental unit water systems (DUWS) in dentistry may be heavily contaminated with bacteria and thus may be a potential source of infection for both practice staff and patients. The aim of this study was to evaluate the level of heterotrophic bacteria and to confirm the presence of opportunistic pathogens from DUWS in student clinical simulation laboratory of college of dentistry. Water samples were collected from 36 ultrasonic scalers in student clinical simulation laboratory. The levels of heterotrophic bacteria in water samples were quantified by counting colony forming units (CFUs) on R2A agar media. In addition, opportunistic pathogens were detected by using the polymerase chain reaction (PCR) method. The mean CFUs were 16,095 CFU/ml for water samples and all of water samples exceeded current American Dental Association recommendations of 200 CFU/ml. Pseudomonas species and non-tuberculous Mycobacterium species were detected in the one sample and two samples, respectively, among the 36 water samples by the PCR with specific primers for these bacteria. Our study indicated that DUWS in student clinical simulation laboratory can cause potential infection in students and participants. This study suggested the dental unit water line management and wearing personal protective equipment in student clinical simulation laboratory will be needed to reduce bacterial contamination.
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