Prevalence in Dental Personnel

Prevalence of Legionella-specific IgG and IgM antibody in a dental clinic population

P. G. Fotos, H. N. Westfall, I. S. Snyder, R. W. Miller and B. M. Mutchler

This study was undertaken to determine the frequency of Legionella infection in a dental clinic setting. Serum samples from 270 dental clinic personnel were evaluated using an enzyme-linked immunosorbent assay to detect Legionella-specific IgM and IgG antibodies. The pooled-species whole-cell-antigen preparation used in these assays was derived from six Legionella pneumophila strains and one strain each from Legionella bozemanii and Legionella micdadei. Significant levels of IgG and IgM antibodies were found in 20% and 16%, respectively, of the samples. This compares with 8% and 10%, respectively, for a randomly selected non-clinical group from the region (P less than 0.005). Samples from clinic personnel with significant IgG titers (greater than 1:128) were also evaluated for activity to each of the eight single-species antigens, with the following results: L. pneumophila, 45% (combined six strains); L. micdadei, 37%; and L. bozemanii, 18%. Comparing individuals' "years spent in the clinic environment" with the incidence of significant antibody levels strongly suggests that the risk of Legionella infection increases proportionately with increased clinic exposure time (P less than 0.05). Analysis of these data implies that Legionella may be present in the dental clinic environment, thus creating an increased risk for clinical personnel or patients.

Serological examinations for antibodies against Legionella species in dental personnel

F. F. Reinthaler, F. Mascher and D. Stunzner
Hygiene Institute, University of Graz, Austria.

Serum samples from 107 dentists, dental assistants, and dental technicians were examined with an indirect immunofluorescence test for antibodies to Legionella pneumophila SG1-SG6, L. micdadei, L. bozemanii, L. dumoffii, L. gormanii, L. jordanis, and L. longbeachae SG1 + 2. Thirty-six (34%) employees from dental personnel from 13 practices showed a positive reaction for antibodies to Legionella pneumophila. Only five samples (5%) from a control group (non-medical workers) were positive. Of the 36 positive serum samples, 13 (36%) reacted with Serogroup 6, 12 with SG 1 (33%), 12 with SG 5 (33%), and three with SG 4 (8%), and eight samples were positive for antibodies to other Legionella species. Dentists had the highest prevalence (50%) of L. pneumophila antibodies, followed by assistants (38%) and technicians (20%). These results indicate that dental personnel are at an increased risk of legionella infection.