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Cultural and Molecular Evidence of Legionella spp. Colonization in Dental Unit Waterlines: Which Is the Best Method for Risk Assessment?

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  • Savina Ditommaso

    (Department of Public Health and Paediatrics, University of Turin, P.zza Polonia 94, Turin 10126, Italy)

  • Monica Giacomuzzi

    (Department of Public Health and Paediatrics, University of Turin, P.zza Polonia 94, Turin 10126, Italy)

  • Elisa Ricciardi

    (Department of Public Health and Paediatrics, University of Turin, P.zza Polonia 94, Turin 10126, Italy)

  • Carla M. Zotti

    (Department of Public Health and Paediatrics, University of Turin, P.zza Polonia 94, Turin 10126, Italy)

Abstract

Legionella spp . are ubiquitous in aquatic habitats and water distribution systems, including dental unit waterlines (DUWLs). The aim of the present study was to determine the prevalence of Legionella in DUWLs and tap water samples using PMA-qPCR and standard culture methods. The total viable counts (TVCs) of aerobic heterotrophic bacteria in the samples were also determined. Legionella spp. were detected and quantified using the modified ISO 11731 culture method. Extracted genomic DNA was analysed using the iQ-Check Quanti Legionella spp. kit, and the TVCs were determined according to the ISO protocol 6222. Legionella spp. were detected in 100% of the samples using the PMA-qPCR method, whereas these bacteria were detected in only 7% of the samples using the culture method. The number of colony forming units (CFUs) of the TVCs in the DUWL and tap water samples differed, with the bacterial load being significantly lower in the tap water samples ( p -value = 0). The counts obtained were within the Italian standard range established for potable water in only 5% of the DUWL water samples and in 77% of the tap water samples. Our results show that the level of Legionella spp. contamination determined using the culture method does not reflect the true scale of the problem, and consequently we recommend testing for the presence of aerobic heterotrophic bacteria based on the assumption that Legionella spp. are components of biofilms.

Suggested Citation

  • Savina Ditommaso & Monica Giacomuzzi & Elisa Ricciardi & Carla M. Zotti, 2016. "Cultural and Molecular Evidence of Legionella spp. Colonization in Dental Unit Waterlines: Which Is the Best Method for Risk Assessment?," IJERPH, MDPI, vol. 13(2), pages 1-10, February.
  • Handle: RePEc:gam:jijerp:v:13:y:2016:i:2:p:211-:d:63593
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    References listed on IDEAS

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    1. Erica Leoni & Laura Dallolio & Francesca Stagni & Tiziana Sanna & Giovanni D'Alessandro & Gabriela Piana, 2015. "Impact of a Risk Management Plan on Legionella Contamination of Dental Unit Water," IJERPH, MDPI, vol. 12(3), pages 1-15, February.
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    Cited by:

    1. Savina Ditommaso & Monica Giacomuzzi & Elisa Ricciardi & Carla M. Zotti, 2016. "Efficacy of a Low Dose of Hydrogen Peroxide (Peroxy Ag + ) for Continuous Treatment of Dental Unit Water Lines: Challenge Test with Legionella pneumophila Serogroup 1 in a Simulated Dental Unit Waterl," IJERPH, MDPI, vol. 13(7), pages 1-10, July.
    2. Sara Bonetta & Cristina Pignata & Silvia Bonetta & Lorenza Meucci & Donatella Giacosa & Elena Marino & Giorgio Gilli & Elisabetta Carraro, 2017. "Viability of Legionella pneumophila in Water Samples: A Comparison of Propidium Monoazide (PMA) Treatment on Membrane Filters and in Liquid," IJERPH, MDPI, vol. 14(5), pages 1-8, April.

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