Low prevalence of multi-resistant bacteria in undergraduate dental students; an observational case-control multi-centre study in Europe.

C M C Volgenant, M A Hoogenkamp, G Dahlén, S Kalfas, S Petti, J J De Soet
Author Information
  1. C M C Volgenant: Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. ORCID
  2. M A Hoogenkamp: Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
  3. G Dahlén: Department of Public Health and Infectious Diseases, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Sweden.
  4. S Kalfas: Division of Preventive Dentistry Periodontology and Implant Biology, Aristotle University of Thessaloniki, Thessaloniki Greece.
  5. S Petti: Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy.
  6. J J De Soet: Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. ORCID

Abstract

This study assessed the prevalence of MRSA, ESBL and VRE in students from four dental schools in Europe. The hand, tongue and nostrils of the students who treated patients (study group) and who did not treat patients (control group) were sampled. After incubation in TSB and subculturing in the presence of 4 µg/ml oxacillin, positive cultures were identified for by Mannitol salt agar and agglutination tests. The presence of MRSA was confirmed by specific PCR on the species and on the genes. ESBL and VRE were isolated using specific CHROMagar and confirmed using antibiotic sensitivity tests. Of the 879 students who participated in this study (454 students which treated patients, 425 controls) a total of 50 students (5.7%) tested positive for a multi-drug resistant bacterium (MDRB); 13 (1.5%) students tested positive for MRSA, 26 (3.0%) for ESBL and 12 (1.4%) for VRE. No statistically significant differences were found between the students who treated patients compared to the control group for any of the MDRB and study centres, excluding MRSA carriage in the Italian student population. The use of antibiotics the year before sampling, was positively associated with the presence of an MDRB (OR 2.0; 95% Confidence Interval 1.10-3.68; p = 0.02). : The risk for MDRB carriage and sequential transmission of MDRB for dental health care students and their patients were acceptably low.

Keywords

References

  1. J Hosp Infect. 2014 Mar;86(3):216-8 [PMID: 24548405]
  2. J Glob Antimicrob Resist. 2014 Mar;2(1):27-33 [PMID: 27873634]
  3. Curr Oral Health Rep. 2018;5(4):221-228 [PMID: 30524929]
  4. Ned Tijdschr Tandheelkd. 2018 May;125(5):251-255 [PMID: 29754153]
  5. Int Dent J. 2018 Oct;68(5):359-366 [PMID: 29577266]
  6. Am J Infect Control. 2011 Oct;39(8):628-632 [PMID: 21962840]
  7. Int J Environ Res Public Health. 2019 Jun 04;16(11): [PMID: 31167449]
  8. Microb Drug Resist. 2020 Jun;26(6):661-669 [PMID: 31910349]
  9. Monogr Soc Res Child Dev. 2017 Jun;82(2):13-30 [PMID: 28475254]
  10. J Am Dent Assoc. 2016 May;147(5):348-53 [PMID: 26778005]
  11. BMC Infect Dis. 2014 Jul 03;14:363 [PMID: 24996225]
  12. Oral Dis. 2021 Apr;27 Suppl 3:674-683 [PMID: 32391651]
  13. Infect Control Hosp Epidemiol. 2011 Nov;32(11):1109-15 [PMID: 22011539]
  14. Br Dent J. 2003 Dec 20;195(12):701-3; discussion 694 [PMID: 14718964]
  15. Emerg (Tehran). 2017;5(1):e52 [PMID: 28286859]
  16. Saudi J Biol Sci. 2020 Apr;27(4):1003-1008 [PMID: 32256160]
  17. Epidemiol Infect. 2002 Oct;129(2):417-20 [PMID: 12403117]
  18. J Oral Microbiol. 2015 Apr 23;7:26250 [PMID: 25911151]
  19. Lancet Infect Dis. 2019 Jan;19(1):56-66 [PMID: 30409683]
  20. Am J Infect Control. 2015 Dec 1;43(12):e89-91 [PMID: 26384585]
  21. J Clin Microbiol. 1996 Aug;34(8):1880-4 [PMID: 8818874]
  22. PLoS One. 2015 Aug 11;10(8):e0135094 [PMID: 26262679]
  23. N Engl J Med. 2020 Apr 16;382(16):1564-1567 [PMID: 32182409]
  24. Clin Microbiol Infect. 2007 Jul;13(7):725-7 [PMID: 17403127]
  25. Int J Surg. 2014 Dec;12(12):1495-9 [PMID: 25046131]

Word Cloud

Created with Highcharts 10.0.0studentsstudyMRSApatientsMDRBESBLVREdentaltreatedgrouppresencepositive1prevalenceEuropecontroltestsconfirmedspecificusingtestedresistantcarriage:bacteriaassessedfourschoolshandtonguenostrilstreatsampledincubationTSBsubculturing4 µg/mloxacillinculturesidentifiedMannitolsaltagaragglutinationPCRspeciesgenesisolatedCHROMagarantibioticsensitivity879participated454425controlstotal5057%multi-drugbacterium135%2630%124%statisticallysignificantdifferencesfoundcomparedcentresexcludingItalianstudentpopulationuseantibioticsyearsamplingpositivelyassociatedOR2095%ConfidenceInterval10-368p= 002risksequentialtransmissionhealthcareacceptablylowLowmulti-resistantundergraduateobservationalcase-controlmulti-centreMeSH-termsMDR/multi-drugdentistryextendedSpectrumBeta-Lactamasemethicillin-ResistantStaphylococcusaureuspublicHealthvancomycinResistantEnterococci

Similar Articles

Cited By