The epidemiological and clinical features of odontogenic infective endocarditis

Scientific paper - Original scientific paper

• Author: Ivana Šutej
• Author: Kristina Peroš
• Author: Vladimir Trkulja
• Author: Igor Rudež
• Author: Davor Barić
• Author: Ivan Alajbeg
• Author: Hrvoje Pintarić
• Author: Ranko Stevanović
• Author: Dragan Lepur
• Author's institution: University of Zagreb; School of Medicine; (Department of Pharmacology)
• Author's institution: University of Zagreb; School of Medicine; (Department of Surgery)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Basic Medical Sciences; Pharmacology

Abstract (english)

Antibiotic prophylaxis (AP) of infective endocarditis (IE) in dental practice is a controversial topic. We evaluated the characteristics of the odontogenic IE and assessed the practice and sources of information pertaining to the topic utilized by the Croatian dentists. We conducted a retrospective review of consecutive medical charts of adult patients with IE, admitted to the University Hospital for Infectious Diseases in Zagreb, Croatia, between January 2007 and December 2017. In addition, a cross-sectional, self-reporting questionnaire survey was conducted with participation of 348 Croatian dentists. Of the 811 admissions for suspected IE (40.3% of all Croatian and 92.1% of all Zagreb hospitals), 386 patients were confirmed as definite IE: 68 with odontogenic IE and 318 with IE of other origin. Their first hospital admissions were analyzed. Definite odontogenic IE was defined as a positive echocardiographic result in conjunction with two separate positive blood cultures showing exclusive oral cavity pathogen or Streptococcus viridans associated with current or recent (< 1 month) dental, periodontal, or oral cavity infection. The annual number of new odontogenic IE patients appeared constant over time. In 91.2% of the cases, odontogenic IE was not preceded by a dental procedure; poor oral health was found in 51.5% of patients, and 47.1% had no cardiac condition that increases the IE risk. In-hospital mortality was 5.1% with conservative treatment and 4.5% with cardiac surgery and was much lower for odontogenic IE than in non-odontogenic IE (14.6% and 34.4%, respectively). An increasing number of admissions for non-odontogenic IE were observed in parallel with an increasing number of staphylococcal IE. Surveyed dentists (500 invited, 69.6% responded) were aware of the AP recommendations, but were largely reluctant to treat patients at risk. In people with poor oral health, AP should be considered regardless of cardiac risk factors. Improvement of oral health should be the cornerstone of odontogenic IE prevention.

• Keywords (english): Aged; Antibiotic Prophylaxis; Croatia / epidemiology; Cross-Sectional Studies; Dental Care / adverse effects; Endocarditis / epidemiology; Endocarditis / etiology; Endocarditis / prevention & control; Female; Hospitals, University; Humans; Male; Middle Aged; Odontogenesis; Retrospective Studies; Risk Factors; Streptococcal Infections / complications; Streptococcal Infections / epidemiology; Streptococcal Infections / etiology; Surveys and Questionnaires; Viridans Streptococci / isolation & purification; Viridans Streptococci / pathogenicity
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Accepted version
• Journal title: European Journal of Clinical Microbiology & Infectious Diseases
• Numbering: vol. 39, no. 4, pp. 637-645
• p-ISSN: 0934-9723
• e-ISSN: 1435-4373
• DOI: https://doi.org/10.1007/s10096-019-03766-x
• URN:NBN: urn:nbn:hr:105:749746
• Publication: 2020-04
• Document URL: http://link.springer.com/10.1007/s10096-019-03766-x
• Type of resource: Text
• Access conditions: Open access; Embargo expiration date: 2021-04-30
• Created on: 2021-01-14 11:13:31