Abstract：
This review aimed to evaluate the contamination rate of dental unit waterlines (DUWL) with Pseudomonas aeruginosa and Legionella pneumophila in several countries in the Middle East.Literature search was conducted in databases such as PubMed, Scopus, Web of Science, and Google Scholar to gather studies published from the beginning of 2000 to 30th April 2020. Medical Subject Headings (MeSH) terms were; \"Legionellosis\"; \"Legionnaire\", \"Legionellosis\", \"L. pneumophila\", \"dent\", \"dental\", \"dentistry\", \"Dental Unit Waterlines\", \"dental water\", \"DUWL\", \"Middle East\", \"P. aeruginosa\", \"Iran\", \"Turkey\", \"Iraq\", and \"Jordan\". The search was independently conducted by two of the authors. Data was analyzed using Comprehensive Meta-Analysis software.Almost all studies included in this review reported a high rate of bacterial contamination of DUWL, which exceeded the current standard bacterial contamination level of <200 (CFU) mL-1 recommended by the American Dental Association (ADA). The combined prevalence of L. pneumophila from four countries (Iran, Jordan, Turkey, and Iraq) was 23.5% (95% Cl: 6.5-57.7), and the combined prevalence of P. aeruginosa was reported 21.7% (95% Cl: 7.1-50.1%).This study showed a high bacterial contamination rate of DUWL with opportunistic pathogens. So, it is recommended to prevent biofilm formation in DUWL, some measures should be extended by practical approaches allowing for water quality control and improvement on-site in the dental practices such as mobile filtration units, chlorination and disinfection chemicals.
摘要：
这篇综述旨在评估中东几个国家的铜绿假单胞菌和嗜肺军团菌对牙科单位水线（DUWL）的污染率。文献检索在PubMed等数据库中进行，Scopus,WebofScience,和谷歌学者收集2000年初至2020年4月30日发表的研究报告。医学主题词（MeSH）术语为；\“军团病\”；\“军团病\”，“军团菌病”，\"L.肺炎\“，\"凹陷\",\"牙科\",\"牙科\",“牙科单位水线”，“牙科水”，\"DUWL\",\"中东\",\"P.铜绿假单胞菌“，\"伊朗\",\"土耳其\",\"伊拉克\",和“乔丹”。搜索由两名作者独立进行。采用综合Meta分析软件对数据进行分析。这篇综述中几乎所有的研究都报道了DUWL的细菌污染率很高，超过了美国牙科协会（ADA）推荐的当前标准细菌污染水平<200（CFU）mL-1。来自四个国家(伊朗，乔丹,土耳其,和伊拉克)为23.5%(95%Cl:6.5-57.7)，铜绿假单胞菌的合并患病率为21.7％（95％Cl：7.1-50.1％）。这项研究表明，机会性病原体对DUWL的细菌污染率高。所以,建议在DUWL中防止生物膜形成，一些措施应通过切实可行的方法加以扩展，以便在牙科实践中进行水质控制和现场改善，例如移动过滤装置，氯化和消毒化学品。
