title: Isolation of Raoultella planticola from refillable antimicrobial liquid soap dispensers in a dental setting.
abstract: BACKGROUND
  Liquid antimicrobial soaps are commonly used in the dental health care setting for hand washing to minimize the potential spread of infectious agents to health care workers and patients. The purpose of the current study was to evaluate possible bacterial contamination of antimicrobial liquid soap dispensers located in 2 institutional comprehensive dental care clinics.
  
  
  METHODS
  Fourteen soap dispensers and 16 original stock containers were sampled. A 1-milliliter aliquot was diluted in 10 mL of phosphate buffer (Tween-80; Acros). Serial dilutions were plated in duplicate on neutralizing agar and incubated for 7 days. Molecular identification was performed using 500 base pair comparisons of 16S ribosomal ribonucleic acid sequencing. Taq polymerase chain reaction was performed with sequence-specific primers for Raoultella species.
  
  
  RESULTS
  Bacterial growth was observed at 18 hours for 57% (8 of 14) of soap dispenser samples. Bacterial densities ranged from 4 × 10(2) to 6 × 10(9) colony-forming units per milliliter. Original commercial containers exhibited no growth. Isolates were identified as Raoultella (Klebsiella) planticola.
  
  
  CONCLUSIONS
  This is the first study to the authors' knowledge indicating recovery of R. planticola from antimicrobial liquid soap dispensers. R. planticola is a recognized environmental opportunistic pathogen that potentially poses a health concern.
  
  
  CONCLUSIONS
  These findings indicate compliance problems with infection prevention recommendations and support the US Centers for Disease Control and Prevention's recommendation that dispensers should not be topped off. High bacterial loads of R. planticola are inconsistent with infection control practices and are a concern because transmission and possible infection to the health care worker or the patient may occur.
authors.forename: Stephanie S
authors.initials: SS
authors.lastname: Momeni
authors.forename: Nancy
authors.initials: N
authors.lastname: Tomlin
authors.forename: John D
authors.initials: JD
authors.lastname: Ruby
mesh_terms: D000890:Anti-Infective Agents / Q000009:adverse effects*; D003770:Dental Offices; D004866:Equipment Contamination; D006235:Hand Disinfection; D006801:Humans; D007709:Klebsiella / Q000235:genetics / Q000302:isolation & purification*; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D012915:Soaps / Q000009:adverse effects*
chemical_list: D000890:Anti-Infective Agents; D012336:RNA, Ribosomal, 16S; D012915:Soaps
keywords: Bacterial contamination; Raoultella (Klebsiella) planticola; hand washing; liquid soap
references.citation: J Environ Health. 2011 Mar;73(7):26-9
references.pmid: 21413559
references.citation: Infect Control Hosp Epidemiol. 2000 Mar;21(3):196-9
references.pmid: 10738989
references.citation: Int J Syst Evol Microbiol. 2001 May;51(Pt 3):925-32
references.pmid: 11411716
references.citation: J Wound Care. 2010 Aug;19(8):329-32
references.pmid: 20852504
references.citation: Pediatr Infect Dis J. 2010 May;29(5):477-8
references.pmid: 20072080
references.citation: J Clin Microbiol. 2009 Dec;47(12):4129-30
references.pmid: 19812278
references.citation: J Clin Microbiol. 2009 Mar;47(3):868-9
references.pmid: 19144809
references.citation: J Med Microbiol. 2007 May;56(Pt 5):696-8
references.pmid: 17446297
references.citation: Zentralbl Bakteriol Mikrobiol Hyg B. 1988 May;186(2):166-79
references.pmid: 3138834
references.citation: J Environ Pathol Toxicol Oncol. 1984 Jul;5(4-5):1-14
references.pmid: 6394740
references.citation: Appl Environ Microbiol. 1984 Aug;48(2):338-41
references.pmid: 6486782
references.citation: Br Med J. 1977 Nov 19;2(6098):1315-7
references.pmid: 589166
references.citation: Antimicrob Agents Chemother. 2004 Jan;48(1):305-12
references.pmid: 14693555
references.citation: J Hosp Infect. 2014 Mar;86(3):219-20
references.pmid: 24559578
references.citation: Appl Environ Microbiol. 2011 May;77(9):2898-904
references.pmid: 21421792
references.citation: MMWR Recomm Rep. 2003 Dec 19;52(RR-17):1-61
references.pmid: 14685139
references.citation: Infect Control Hosp Epidemiol. 2002 Nov;23(11):692-5
references.pmid: 12452299
references.citation: Appl Environ Microbiol. 2002 Jul;68(7):3462-6
references.pmid: 12089029
references.citation: MMWR Recomm Rep. 2002 Oct 25;51(RR-16):1-45, quiz CE1-4
references.pmid: 12418624