Assessment of periodontitis and its role in viridans streptococcal bacteremia and infective endocarditis

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Abstract

Objectives

To evaluate the role of periodontitis in viridans group streptococci (VGS) bacteremia and infective endocarditis (IE).

Methods

A total of 200 subjects including two groups. Group A- 34 subjects undergoing tooth extraction with periodontitis, 46 subjects undergoing tooth extraction without periodontitis and 40 healthy controls. Group B: 40 confirmed cases of IE (17 with and 23 without periodontitis) and 40 healthy controls. Subgingival plaque and blood samples were obtained and processed by standard procedures.

Results

A total of 53 blood samples (66.25%) yielded positive cultures after tooth extraction. The relationship between the presence of periodontitis and a positive blood culture was significantly higher (p = 0.05) for tooth extraction cases with periodontitis (79.40%) than tooth extraction cases without periodontitis (56.50%). Periodontitis was observed in 42.5% of IE cases. Out of the 40 patients of IE, the blood samples yielded 40 different isolates, majority were viridans streptococci 15 (37.5%) and staphylococci nine (22.5%). No statistically significant difference was observed between the subgingival plaque and blood isolates of periodontitis in both the groups, indicating similarity of biotypes of viridans streptococci isolated from the blood and the subgingival plaque. Similarity was also observed between the antibiogram profiles of viridans streptococci from both the groups.

Conclusions

Periodontitis enhances viridans streptococcal bacteremia and may be a potential risk factor for IE.

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Most cited references 33

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What happened to the streptococci: overview of taxonomic and nomenclature changes.

Richard Facklam (2002)

Since the division of the Streptococcus genus into enterococci, lactococci, and streptococci in 1984, many changes in the nomenclature and taxonomy of the Streptococcus genus have taken place. The application of genetic comparisons has improved the proper classification of the different species. The Lancefield system of serogrouping the streptococci by the expression of beta-hemolysis on blood agar plates is still very useful for the identification of streptococci for patient management. The Lancefield grouping system cannot be used in itself for accurate identification of specific beta-hemolytic species, but it can be a useful part of the identification procedure. Except for identification of the "Streptococcus bovis group" of species and Streptococcus suis, Lancefield grouping is of little value in identification of the non-beta-hemolytic streptococci and related genera. In fact, identification of the non-beta-hemolytic species is problematic for conventional as well as commercially available identification procedures. A combination of conventional tests and specific chromogenic tests suggested by several investigators is presented and discussed. Tables are included that suggest tests and procedures to guide investigators attempting to identify all the species.

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Relationship between periodontal infections and systemic disease.

G Seymour, P J Ford, M Cullinan … (2007)

Oral conditions such as gingivitis and chronic periodontitis are found worldwide and are among the most prevalent microbial diseases of mankind. The cause of these common inflammatory conditions is the complex microbiota found as dental plaque, a complex microbial biofilm. Despite 3000 years of history demonstrating the influence of oral status on general health, it is only in recent decades that the association between periodontal diseases and systemic conditions such as coronary heart disease and stroke, and a higher risk of preterm low birth-weight babies, has been realised. Similarly, recognition of the threats posed by periodontal diseases to individuals with chronic diseases such as diabetes, respiratory diseases and osteoporosis is relatively recent. Despite these epidemiological associations, the mechanisms for the various relationships remain unknown. Nevertheless, a number of hypotheses have been postulated, including common susceptibility, systemic inflammation with increased circulating cytokines and mediators, direct infection and cross-reactivity or molecular mimicry between bacterial antigens and self-antigens. With respect to the latter, cross-reactive antibodies and T-cells between self heat-shock proteins (HSPs) and Porphyromonas gingivalis GroEL have been demonstrated in the peripheral blood of patients with atherosclerosis as well as in the atherosclerotic plaques themselves. In addition, P. gingivalis infection has been shown to enhance the development and progression of atherosclerosis in apoE-deficient mice. From these data, it is clear that oral infection may represent a significant risk-factor for systemic diseases, and hence the control of oral disease is essential in the prevention and management of these systemic conditions.

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Gingival recession, gingival bleeding, and dental calculus in adults 30 years of age and older in the United States, 1988-1994.

T Kingman, J Albandar (1998)

The aim of this study was to assess the prevalence and extent of gingival recession, gingival bleeding, and dental calculus in United States adults, using data collected in the third National Health and Nutrition Examination Survey (NHANES III). The study group consisted of 9,689 persons 30 to 90 years of age obtained by a stratified, multi-stage probability sampling method in 1988 to 1994. The weighted sample is representative of U.S. adults 30 years or older and represents approximately 105.8 million civilian, non-institutionalized Americans. Gingival recession, gingival bleeding, and dental calculus were assessed at the mesio-buccal and mid-buccal surfaces in 2 randomly selected quadrants, one maxillary and one mandibular. Data analysis accounted for the complex sampling design used. We estimate that 23.8 million persons have one or more tooth surfaces with > or = 3 mm gingival recession; 53.2 million have gingival bleeding; 97.1 million have calculus; and 58.3 million have subgingival calculus; and the corresponding percentages are 22.5%, 50.3%, 91.8%, and 55.1% of persons, respectively. The prevalence, extent, and severity of gingival recession increased with age, as did the prevalence of subgingival calculus and the extent of teeth with calculus and gingival bleeding. Males had significantly more gingival recession, gingival bleeding, subgingival calculus, and more teeth with total calculus than females. Of the 3 race/ethnic groups studied, non-Hispanic blacks had the highest prevalence and extent of gingival recession and dental calculus, whereas Mexican Americans had the highest prevalence and extent of gingival bleeding. Mexican Americans had similar prevalence and extent of gingival recession compared with non-Hispanic whites. Gingival recession was much more prevalent and also more severe at the buccal than the mesial surfaces of teeth. Gingival bleeding also was more prevalent at the buccal than mesial surfaces, whereas calculus was most often present at the mesial than buccal surfaces. Dental calculus, gingival bleeding, and gingival recession are common in the U.S. adult population. In addition to their unfavorable effect on esthetics and self-esteem, these conditions also are associated with destructive periodontal diseases and root caries. Appropriate measures to prevent or control these conditions are desirable, and this may also be effective in improving the oral health of the U.S. adult population.

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Author and article information

Contributors

Basavraj Nagoba

Journal

Journal ID (nlm-ta): Indian Heart J

Journal ID (iso-abbrev): Indian Heart J

Title: Indian Heart Journal

Publisher: Elsevier

ISSN (Print): 0019-4832

Publication date (Print): Mar-Apr 2018

Publication date (Electronic): 01 July 2017

Volume: 70

Issue: 2

Pages: 225-232

Affiliations

[a ]Department of Microbiology, M.M. Patel Public Charitable Trust’s, Ashwini Medical College & Hospital, Kumbhari, Solapur, Maharashtra, India

[b ]Govt. Medical College, Miraj, Maharashtra, India

[c ]Maharashtra Institute of Medical Sciences & Research, Latur, 413 531, Maharashtra, India

[d ]Department of PSM, M.M. Patel Public Charitable Trust’s, Ashwini Medical College & Hospital, Kumbhari, Solapur, Maharashtra, India

Author notes

[* ]Corresponding author at: Assistant Dean Research & Development, Maharashtra Institute of Medical Sciences & Research, Latur, 413 531, Maharashtra, India. dr_bsnagoba@ 123456yahoo.com bsnagoba@ 123456gmail.com

Article

Publisher ID: S0019-4832(16)30109-2

DOI: 10.1016/j.ihj.2017.06.019

PMC ID: 5993913

PubMed ID: 29716699

SO-VID: 8bbf9953-797e-4426-a4fe-fb99fa64d378

License:

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

History

Date received : 6 May 2016

Date accepted : 29 June 2017

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Assessment of periodontitis and its role in viridans streptococcal bacteremia and infective endocarditis

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Abstract

Objectives

Methods

Results

Conclusions

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Metrics and Research Assessment

Most cited references 33

What happened to the streptococci: overview of taxonomic and nomenclature changes.

Relationship between periodontal infections and systemic disease.

Gingival recession, gingival bleeding, and dental calculus in adults 30 years of age and older in the United States, 1988-1994.

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Cited by 19

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