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 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 Assessment of Knowledge of Dental Staff at a Saudi Arabian University Regarding the Prophylaxis for Infective Endocarditis

2013 ◽  
Vol 7 (1) ◽  
pp. 82-87 ◽  
Author(s):  
Ahmed Bhayat ◽  
Fadi Jarab ◽  
Samir Mansuri ◽  
Mohammad Sami Ahmad ◽  
Mohamed Saad Mahrous
Keyword(s):  
Infective Endocarditis ◽  
Heart Association ◽  
Cross Sectional ◽  
Staff Members ◽  
Drug Of Choice ◽  
Dental Procedures ◽  
Dental Practitioners ◽  
Dental Staff ◽  
Almost All ◽  
Self Administered Questionnaire

The use of prophylactic antibiotics for the prevention of infective endocarditis following dental procedures has long been debated and there is still confusion regarding its efficacy. As a result, the prophylactic treatment varies considerably amongst different countries across the world and amongst different dental practitioners.Aim:To evaluate the knowledge of dental staff regarding the guidelines for the prevention of infective endocarditis.Methods:This was a cross sectional analytical study which included all staff members. A self administered questionnaire was used and responses were “graded” according to the American Heart Association (AHA) guidelines.Results:The response rate was 87% (N=39) and 97% reported to use the AHA guidelines; 66% reported their knowledge was based on previous training and scientific journals. Of those cardiac conditions and dental procedures which required prophylaxis; 47% and 65% chose the correct option, respectively. Penicillin was prescribed as the drug of choice by the majority of respondents.Conclusions:Although almost all staff reported the use of the AHA guidelines, many were not following them. The study emphasizes the need for continuous education and evaluation of this critical aspect of dentistry.

scholarly journals KNOWLEDGE AND AWARENESS REGARDING ANTIBIOTIC PROPHYLAXIS FOR INFECTIVE ENDOCARDITIS AMONG UNDERGRADUATE DENTAL STUDENTS

2016 ◽  
pp. 154 ◽  
Author(s):  
Santhosh Kumar ◽  
Sneha S
Keyword(s):  
Infective Endocarditis ◽  
Antibiotic Prophylaxis ◽  
American Heart ◽  
Heart Association ◽  
Dental Students ◽  
Basic Knowledge ◽  
First Line ◽  
Validated Questionnaire ◽  
Dental Procedures ◽  
Teaching Curriculum

<p>ABSTRACT<br />Objective: To evaluate the knowledge and awareness regarding antibiotic prophylaxis for infective endocarditis (IE) among undergraduate dental<br />students.<br />Methods: A validated questionnaire of 16 questions, regarding the basic knowledge and awareness about antibiotic prophylaxis for the prevention<br />of IE, was distributed among 100 students randomly belonging to final year and internship (5<br /> year trainee) of the undergraduate dental program in<br />Saveetha Dental College and Hospital, Saveetha University, Chennai. The data extracted were tabulated, statistically analyzed, and results obtained.<br />Results were calculated on the basis of frequency and percentages using SPSS Version 20.0.<br />th<br />Results: About 73% of the students were aware of IE prophylaxis, and 40% of dental students were exposed to treating patients susceptible to IE.<br />56% of participants answered that amoxicillin is the first line of antibiotic for IE prophylaxis and 59% replied 2 g PO 1 hr before the appointment is<br />the recommended regimen. 36% said that erythromycin is no longer recommended by American Heart Association for IE prophylaxis. However, only<br />one-third of the participants knew about the cardiac conditions and dental procedures that require antibiotic prophylaxis for the prevention of IE.<br />Furthermore, only 16% knew about the recommended dosage of clindamycin.<br />Conclusion: This study revealed a reasonable knowledge and awareness about IE prophylaxis among undergraduate dental students but was<br />inadequate. Hence, this study emphasizes the need for improved education in the teaching curriculum for dental students regarding IE prophylaxis.<br />A standard protocol regarding the training as well as preventive measures for IE should be formulated for the dental students and the knowledge<br />acquired must be transferred into practice.<br />Keywords: Infective endocarditis, Prophylaxis, Antibiotics, Dental students, Knowledge.</p>

scholarly journals Evaluation of the Current Knowledge About Bacterial Endocarditis Prevention Among General Dentists in the City of Santo Domingo, Dominican Republic

2020 ◽  
Vol 8 ◽  
Author(s):  
Juan Manuel Aragoneses ◽  
Javier Aragoneses ◽  
Vanessa Arlette Brugal ◽  
Juan Algar ◽  
Ana Suarez
Keyword(s):  
Dominican Republic ◽  
Current Knowledge ◽  
Heart Association ◽  
Bacterial Endocarditis ◽  
Santo Domingo ◽  
Prosthetic Valves ◽  
Dental Procedures ◽  
Life Threatening ◽  
History Of ◽  
General Dentists

Infective endocarditis (IE) is a life-threatening disease caused by bacterial adherence to the lining of the heart and heart valve, and it can be caused by bacterial contamination of the bloodstream during invasive dental procedures. The American Heart Association (AHA) recommended guidelines for antibiotic prophylaxis in 2008 before invasive dental procedures; however, in the Dominican Republic, no official guidelines or regulations on this topic have been yet established. This study aimed to evaluate the current knowledge about bacterial endocarditis prevention among dentists in Santo Domingo. The study participants were dentists who attended a conference organized by Universidad Federico Henríquez y Carvajal (n = 95), of which 74 responded to the questionnaire survey. Seventy-eight percentage of the participants responded that an indication of antibiotics is recommended in cases of prophylaxis for IE. The prescription of antibiotics was applied to patients with prosthetic valves (78.4%), presented a history of previous IE (77%) among others. Among all the interventions in which the respondents would prescribe antibiotics, tooth extraction (70.7%) was the most frequent. Amoxicillin was the preferred drug choice (63.5%) and clindamycin was the antibiotic of choice in allergic patients (55.4%). Even though the choice of antibiotics were according to AHA guidelines (2008), majority of the dentists (58.82 and 55.4%) were not aware of the correct dosage and timing of administration of azithromycin and clindamycin in drugs in patients allergic to penicillin.

scholarly journals Antibiotic Prophylaxis of Infective Endocarditis: From the History of the Concept to Modern Recommendations (Review)

2020 ◽  
Vol 10 (2) ◽  
pp. 119-130
Author(s):  
G. G. Taradin ◽  
E. Yu. Ponomareva ◽  
G. A. Ignatenko ◽  
N. T. Vatutin ◽  
B. D. Prendergast
Keyword(s):  
Infective Endocarditis ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
Clinical Excellence ◽  
Concept Development ◽  
Antibacterial Prophylaxis ◽  
Fatality Rate ◽  
History Of ◽  
European Society Of Cardiology

The presented review highlights current understandings of prophylaxis for infective endocarditis (IE). The historic aspects of the concept development of antibacterial prophylaxis (ABP) for IE, the main approaches and the rationale for changing the principles of ABP in recent years are described. There are detailed clarifications of published international and national recommendations, in particular, of European Society of Cardiology, National Institute for Health and Clinical Excellence, American Heart Association/American College of Cardiology and Japanese Circulation Society. The critical estimation of earlier adopted international guidelines with analysis of influence of partial or absolute ABP restrictions on the incidence of IE and its complications including fatality rate are presented.

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 Infective Endocarditis Prophylaxis in Patients Undergoing Oral Surgery

2016 ◽  
Vol 20 (1) ◽  
pp. 5-14 ◽  
Author(s):  
M. Zoumpoulakis ◽  
F. Anagnostou ◽  
S. Dalampiras ◽  
L. Zouloumis ◽  
C. Pliakos
Keyword(s):  
Infective Endocarditis ◽  
Oral Surgery ◽  
Heart Association ◽  
Clinical Excellence ◽  
British Society ◽  
Prophylactic Measures ◽  
Adjacent Structures ◽  
Management Of Complications ◽  
Bacteria And Fungi ◽  
European Society Of Cardiology

SummaryInfective endocarditis (IE), an infection of the endocardium that usually involves the valves and adjacent structures, may be caused by a wide variety of bacteria and fungi that entered the bloodstream and settled in the heart lining, a heart valve or a blood vessel. The IE is uncommon, but people with some heart conditions have a greater risk of developing it. Despite advances in medical, surgical, and critical care interventions, the IE remains a disease that is associated with considerable morbidity and mortality. Hence, in order to minimize the risk of adverse outcome and achieve a yet better management of complications, it is crucial to increase the awareness of all the prophylactic measures of the IE.For the past 50 years, the guidelines for the IE prophylaxis have been under constant changes. The purpose of this paper is to review current dental and medical literature considering the IE prophylaxis, including the new and updated guidelines from the American Heart Association (AHA, 2007 and 2015), the National Institute for Health and Clinical Excellence (NICE, 2015), the European Society of Cardiology (ESC, 2009 and 2015) and the British Society for Antimicrobial Chemotherapy (BSAC, 2006).

scholarly journals Knowledge of Moroccan Dentists Towards the Prophylaxis of Infective Endocarditis

2018 ◽  
Vol 5 ◽  
Author(s):  
Hajar Ben Mohimd ◽  
Fatima Zaoui ◽  
Bassima Chami ◽  
Wafae El Wady
Keyword(s):  
Heart Disease ◽  
Infective Endocarditis ◽  
Antibiotic Prophylaxis ◽  
Analytical Study ◽  
Heart Association ◽  
Cross Sectional ◽  
Dental Procedures ◽  
Level Of Knowledge ◽  
General Dentists ◽  
The City

Background: The involvement of oral bacterias in the occurrence of infective endocarditis (IE) has prompted the adoption of antibiotic prophylaxis prior to dental procedures for patients at high-risk. The aim of this paper was to assess the knowledge of Moroccan dentists regarding the management of patients with heart disease at risk of infective endocarditis.Methods: This was a cross-sectional descriptive analytical study which targeted 200 dentists in the city of Rabat- Morocco. A questionnaire with 16 questions was distributed randomly. The level of knowledge of dentists was established based on the number of correct answers for each section and responses were assessed according to the American Heart Association (AHA) 2007 guidelines.Results: Only 133 practitioners have agreed to participate in our study with a response rate of 66,5%. 87% of dentists reported contacting the cardiologist before starting treatment, 33% of practitioners weren’t aware of any guidelines and 20% knew AHA 2007, 52% reported not following guidelines in the management of patients with heart disease. Among the cardiac conditions and dental procedures proposed in the questionnaire which required prophylaxis; 8% and 2% respectively chose the correct answer according to the AHA’s 2007 guidelines. 31% of dentists answered correctly on the prescription of antibiotic prophylaxis protocol according to the latest recommendations.Conclusion: According to our results, the knowledge of Moroccan private general dentists towards endocarditis prophylaxis was in a low level. The study highlights the need for continuous education.

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