scholarly journals Prevention of the infective endocarditis during the dental procedures

2005 ◽  
Vol 52 (3) ◽  
pp. 152-154
Author(s):  
Tatjana Puskar ◽  
S. Puskar ◽  
Z. Nikolic
Keyword(s):  
Infective Endocarditis ◽  
Heart Valves ◽  
Wide Spectrum ◽  
Prosthetic Heart Valves ◽  
Heart Defect ◽  
Dental Procedures ◽  
Dental Intervention ◽  
Infective Disease ◽  
Risk Patients ◽  
Circulation Of The Blood

Endocarditis is endovascular infective disease of intracardiac structures, which are in contact with blood. The most common cause is Staphylococcus aureus and Streptococcus viridans, which inhabit oral cavity. During dental intervention, which includes gingival trauma (risky dental intervention) microorganisms that cause infective endocarditis could penetrate into circulation of the blood. The group of high risk patients consists of patients which have already had infective endocarditis, patients with prosthetic heart valves or other foreign endovascular bodies, patients with congenital heart defect, patients with acquired heart defect, prolapse of mitral valve with registered mitral regurgitation and hyphertrophic cardiomiopathy. Those groups of patients should have prevention from infective endocarditis before any risky dental intervention with bactericidal dosage of wide spectrum antibiotics at least an hour before the procedure. .

scholarly journals Streptococcus oralis MitraClip endocarditis following a dental procedure: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Aikaterini Papamanoli ◽  
Tahmid Rahman ◽  
Andreas P. Kalogeropoulos ◽  
Zeena Lobo ◽  
Paul Diggs ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Mitral Valve ◽  
Hemodynamic Instability ◽  
Blood Cultures ◽  
Causative Organism ◽  
Surgical Risk ◽  
Continue Medical ◽  
Streptococcus Oralis ◽  
Dental Procedures ◽  
Risk Patients

Abstract Background Transcatheter edge-to-edge mitral valve repair using the MitraClip device is increasingly used for high surgical risk patients with severe mitral regurgitation (MR). Previous guidelines for infective endocarditis prophylaxis prior to dental procedures focused on high-risk patients, but without explicit recommendation for MitraClip recipients. We believe this could be the first reported case to identify Streptococcus oralis as the causative organism. Case presentation An 87-year-old male with severe MR treated with two MitraClip devices three months prior to index admission, presented with worsening malaise and intermittent chills on a background of multiple comorbid conditions. The patient had dental work a month prior to presentation, including a root canal procedure, without antibiotic prophylaxis. Vitals were significant for fever and hypotension. On physical examination, there was a holosystolic murmur at the apex radiating to the axilla, bilateral pitting edema in the lower extremities, and elevated jugular venous pulsation. A transthoracic echocardiogram showed severe MR with a possible echodensity on the mitral valve, prompting a transesophageal echocardiogram, which demonstrated a pedunculated, mobile mass on the posterior leaflet of the mitral valve. Five blood cultures grew gram positive cocci in pairs and chains, later identified as Streptococcus oralis, with minimum inhibitory concentration to penicillin 0.06 mg/L. Initial empiric antibiotics were switched to ceftriaxone 2 gr daily and subsequent blood cultures remained negative. However, the patient developed pulmonary edema and worsening hemodynamic instability requiring vasopressors. As surgical risk for re-operation was considered prohibitive, the decision was made to continue medical management and comfort-directed care. The patient died a week later. Conclusions Despite low incidence, infective endocarditis should be included in the differential among MitraClip recipients. The explicit inclusion of this growing patient population in the group requiring prophylaxis prior to dental procedures in the 2020 ACC/AHA valvular heart disease guidelines is an important step forward.

scholarly journals Anti-biofilm Approach in Infective Endocarditis Exposes New Treatment Strategies for Improved Outcome

2021 ◽  
Vol 9 ◽  
Author(s):  
Christian Johann Lerche ◽  
Franziska Schwartz ◽  
Marie Theut ◽  
Emil Loldrup Fosbøl ◽  
Kasper Iversen ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Antibiotic Therapy ◽  
Biofilm Formation ◽  
Heart Valves ◽  
Treatment Strategies ◽  
High Dose ◽  
Special Focus ◽  
Infective Disease ◽  
New Treatment ◽  
Improved Outcome

Infective endocarditis (IE) is a life-threatening infective disease with increasing incidence worldwide. From early on, in the antibiotic era, it was recognized that high-dose and long-term antibiotic therapy was correlated to improved outcome. In addition, for several of the common microbial IE etiologies, the use of combination antibiotic therapy further improves outcome. IE vegetations on affected heart valves from patients and experimental animal models resemble biofilm infections. Besides the recalcitrant nature of IE, the microorganisms often present in an aggregated form, and gradients of bacterial activity in the vegetations can be observed. Even after appropriate antibiotic therapy, such microbial formations can often be identified in surgically removed, infected heart valves. Therefore, persistent or recurrent cases of IE, after apparent initial infection control, can be related to biofilm formation in the heart valve vegetations. On this background, the present review will describe potentially novel non-antibiotic, antimicrobial approaches in IE, with special focus on anti-thrombotic strategies and hyperbaric oxygen therapy targeting the biofilm formation of the infected heart valves caused by Staphylococcus aureus. The format is translational from preclinical models to actual clinical treatment strategies.

Simple and Safe Method to Prepare Patients With Prosthetic Heart Valves for Surgical Dental Procedures

2000 ◽  
Vol 6 (2) ◽  
pp. 90-93 ◽  
Author(s):  
Giulia Russo ◽  
Lorenza Dal Corso ◽  
Alessandra Biasiolo ◽  
Mario Berengo ◽  
Vittorio Pengo
Keyword(s):  
Heart Valves ◽  
Prosthetic Heart Valves ◽  
Safe Method ◽  
Dental Procedures

scholarly journals Infective Endocarditis: A Focus on Oral Microbiota

2021 ◽  
Vol 9 (6) ◽  
pp. 1218
Author(s):  
Carmela Del Giudice ◽  
Emanuele Vaia ◽  
Daniela Liccardo ◽  
Federica Marzano ◽  
Alessandra Valletta ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Oral Hygiene ◽  
Current Knowledge ◽  
Significant Risk ◽  
Heart Association ◽  
Resistant Mutant ◽  
Oral Microbiota ◽  
Dental Procedures ◽  
Risk Patients ◽  
European Society Of Cardiology

Infective endocarditis (IE) is an inflammatory disease usually caused by bacteria entering the bloodstream and settling in the heart lining valves or blood vessels. Despite modern antimicrobial and surgical treatments, IE continues to cause substantial morbidity and mortality. Thus, primary prevention and enhanced diagnosis remain the most important strategies to fight this disease. In this regard, it is worth noting that for over 50 years, oral microbiota has been considered one of the significant risk factors for IE. Indeed, among the disparate recommendations from the American heart association and the European Society of Cardiology, there are good oral hygiene and prophylaxis for high-risk patients undergoing dental procedures. Thus, significant interest has grown in the role of oral microbiota and it continues to be a subject of research interest, especially if we consider that antimicrobial treatments can generate drug-resistant mutant bacteria, becoming a severe social problem. This review will describe the current knowledge about the relationship between oral microbiota, dental procedures, and IE. Further, it will discuss current methods used to prevent IE cases that originate from oral pathogens and how these should be focused on improving oral hygiene, which remains the significant persuasible way to prevent bacteremia and systemic disorders.

scholarly journals ANTIBIOTIC PROPHYLAXIS OF INFECTIVE ENDOCARDITIS IN DENTISTRY

2019 ◽  
Vol 15 (2) ◽  
pp. 4-10
Author(s):  
Елена Гайсина ◽  
Elena Gaysina ◽  
Татьяна Еловикова ◽  
Tat'yana Elovicova ◽  
Надежда Изможерова ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Antibiotic Prophylaxis ◽  
Heart Valves ◽  
Heart Defects ◽  
Prosthetic Heart Valves ◽  
Targeted Prevention ◽  
Drug Of Choice ◽  
The World ◽  
High Risk Factor ◽  
Serious Disease

Background. Infective endocarditis is a serious disease and has the risk of disability and high mortality. This disease can be a terrible complication of both general surgical and dental invasive procedures. The problem of infective endocarditis is relevant in most countries of the world, which determine the need for targeted prevention of dental interventions. The most important pathogenetic component of this disease is transient bacteremia, which develops when the skin and mucous membrane of the oral cavity are damaged under the influence of various traumatic agents. Antibiotic prophylaxis prevents of infective endocarditis and helps to reduce the risk. Objectives ― to identify and analyze the most effective methods of antibiotic prophylaxis of IE at the dental admission. Methodology. A review of literature - publications of domestic and foreign studies using the scientific search library databases PubMed, Medline, Cochrane, Elibrary. Total found 38 publications from Russia, USA, Germany, Jordan, Saudi Arabia, Singapore, Japan and other countries. Results. The review examines studies - questioning people, clinical studies with "double glare", publication of patents, revealing the attitude to antibiotic prophylaxis of infective endocarditis at a dental reception in the world, and also analyzed the choice of drugs and their use. Conclusions. The most preferred option is to carry out antibiotic prophylaxis of the disease in people with a high risk factor, which include patients with prosthetic heart valves, congenital heart defects and patients with a history of infectious endocarditis. The drug of choice among antibacterial agents is the use of amoxicillin / clavulanic acid combination.

scholarly journals The knowledge of undergraduate dental students and dentists about antibiotic prophylaxis in patients at risk for infective endocarditis

2020 ◽  
Vol 68 ◽  
Author(s):  
Ana Paula Silva GANGÁ ◽  
Natália Bermond ARPINI ◽  
Tatiany Pimentel FERREIRA ◽  
Arlinda Lúcia Zocatelli CALENZANI ◽  
Paula Sampaio de Mello ASSIS
Keyword(s):  
Infective Endocarditis ◽  
High Risk ◽  
Heart Association ◽  
Dental Students ◽  
Mortality And Morbidity ◽  
High Risk Patients ◽  
Dental Procedures ◽  
Patients At Risk ◽  
Risk Patients ◽  
Definition Of

ABSTRACT Infective Endocarditis (IE) is an infection of the endocardial surface of the heart that is caused by fungi, bacteria or viruses. The high mortality and morbidity rates of IE have encouraged the adoption of preventive strategies. This study investigated the knowledge on the prevention of IE among 2nd, 3rd and 4th-year undergraduate dental students at the Escola Superior São Francisco de Assis (ESFA) and among dentists working in the municipality of Santa Teresa, ES, Brazil. Objective: The rationale for this study was to identify the gaps in their knowledge and raise awareness on the topic. Methods: The study was previously approved by the Research Ethics Committee. The sample consisted of dental students who had completed the Pharmacology for Dentistry course at the ESFA, totaling 35 2nd-year students, 29 3rd-year students, and 36 4th-year students. Thirty dentists registered in the Regional Council of Dentistry of Espírito Santo state, who were working in the municipality of Santa Teresa, ES, Brazil, were also included. All participants were given a questionnaire containing six objective and four subjective questions to assess their knowledge regarding the definition of IE, high-risk patients, dental procedures known to cause bacteremia, recommended dosage regimens for high risk patients, and additional care in the assistance of these patients. The questionnaires’ responses were reviewed following the American Heart Association (AHA) guidelines for disease prevention published in 2007. Results: The analysis of the results revealed a low rate of correct responses among students and dentists. The questions with the lowest rate of correct responses were those addressing the identification of patients at high risk for heart conditions and the dental procedures known to cause bacteremia, with no significant differences between the four groups analyzed (P > 0.05). Third-year dental students presented a frequency of correct responses significantly lower than that of the other groups (P < 0.001), which did not differ from each other. To conclude, all participants demonstrated poor knowledge about the topic, particularly 3rd-year dental students. Conclusion: These results reinforce the need for informative measures to raise awareness and improve the quality of dental care provided to the population.

scholarly journals Infective Endocarditis in Children — New Approach in Antimicrobial Prophylaxis

2016 ◽  
Vol 1 (1) ◽  
pp. 9-11
Author(s):  
Rodica Togănel
Keyword(s):  
Infective Endocarditis ◽  
Heart Valves ◽  
Task Force ◽  
Antimicrobial Prophylaxis ◽  
Bacterial Endocarditis ◽  
New Approach ◽  
Secondary Damage ◽  
Risk Patients ◽  
European Society Of Cardiology ◽  
Significant Mortality

Abstract Infective endocarditis (IE) is an infection of the endocardium and/or heart valves with the formation of a thrombus and secondary damage of the involved tissue, with significant mortality and severe complications. The prevention of bacterial endocarditis is of great controversy. Antimicrobial prophylaxis is usable in the prevention of endocarditis by killing bacteria before or after their extension to the damaged endocardium. No human studies offer strong evidence to support the efficacy of antibiotic prophylaxis so far, thus it could be potentially dangerous. Therefore, the European Society of Cardiology (ESC) may need to reconsider and update the previous guidelines with the proposal of reducing the prophylactic approach of IE. The 2015 Task Force recommends prophylaxis for highest risk patients undergoing highest risk procedures, focused on prevention rather than prophylaxis of IE, especially in nosocomial endocarditis.

scholarly journals Bacillus cereus Subacute Native Valve Infective Endocarditis and Its Multiple Complications

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Jemimah Nallarajah ◽  
M. I. Mujahieth
Keyword(s):  
Infective Endocarditis ◽  
Bacillus Cereus ◽  
Heart Valves ◽  
Rare Event ◽  
Antineutrophil Cytoplasmic Antibody ◽  
Prosthetic Heart Valves ◽  
Drug Abusers ◽  
Sri Lankan ◽  
Native Valve ◽  
Glomerular Nephritis

Bacillus cereus causing infective endocarditis (IE) in a native valve is an extremely rare event, but it is reported mostly in intravenous drug abusers and other risk factors as immunosuppression, malignancy, and valvular heart disease including prosthetic heart valves. We report a case of B.cereus native mitral valve infective endocarditis in a 58-year-old Sri Lankan male who is not a drug abuser who presented with painless hematuria with reduced urine output. During hospital stay, he developed frequent episodes of brief focal seizures. He had undergone multiple investigations that revealed splenic abscesses, cerebral vasculitis, and glomerular nephritis with positive rheumatoid factor, cytoplasmic antineutrophil cytoplasmic antibody (C-ANCA), and cryoglobulin. The appropriate antibiotic was the prime therapeutic intervention which carried an excellent prognosis. This case highlights an unusual organism in the blood culture that caused IE warranting thorough physical examination and investigations.

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