[The significance of amoebae and other protozoa in water conduit systems in dental units]

Abstract

In a longitudinal study over a period of ten weeks, the water conduit systems of seven dental surgeries with a total of 20 dental units in which legionellae had been detected in an earlier study (3) were investigated as a complement to extended microbiological tests (4) for the occurrence of free-living amebae and other protozoa. In 96% of all water samples, one or several ameba species were detected. These included 14 strains of the genus Naegleria, but no acanthamoebae. The naeglerias isolated were not thermophilic and thus belong to the N. gruberi complex, which does not contain any pathogenic strains. In two water samples, two different species of small freeliving nematodes were demonstrated. The simultaneous investigation of samples from the warm water supply in the individual dental surgeries revealed an ameba contamination in 24.9% of the samples. A nonpathogenic strain of the genus Protacanthamoeba was demonstrated once. The possible role of the trophozoites of various ameba species as hosts for an intracellular proliferation of the legionella strains demonstrated at the same time (cf. 4) is discussed. The occasional protective intracellular inclusion of legionellae in trophozoites of various species and in cysts of acanthamoebae might be an explanation for the resistance of legionellae to disinfection measures which has been repeatedly observed. This observation will have to be taken into consideration in sterilization and disinfection projects.