Experimental Bacterial Endocarditis After Dental Extractions in Rats with Periodontitis

Overholser, C. Daniel; Moreillon, P.; Mp, Glauser

doi:10.1093/infdis/155.1.107

Cited by 45 publications

(26 citation statements)

References 26 publications

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“…This confirms our previous findings in a preparation that mimics human endocarditis more closely than the preparation produced by intravenous bacterial challenge. 11 In our current preparation, dental extractions produced endocarditis that was caused by organisms that were found in dental plaque before extractions and were recovered from the blood cultures after extractions, thus demonstrating a direct relationship between dental extractions, bacteremia, and the subsequent development of bacterial endocarditis.…”

Section: Discussionmentioning

confidence: 75%

Antibiotic prophylaxis of experimental endocarditis after dental extractions.

et al. 1988

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In rats with catheter-induced sterile aortic valve vegetations we studied the efficacy of single-dose amoxicillin and single-dose erythromycin prophylaxis for the prevention of bacterial endocarditis after extractions of periodontally diseased teeth. Endocarditis after extractions occurred in 89% of control animals and was due to group G streptococci, to Staphylococcus aureus, or to both organisms. A single-dose of amoxicillin or erythromycin successfully prevented endocarditis due to these bacterial species. The analysis of the bacteremia (by culturing blood drawn 1 min after extraction on penicillinase-containing blood agar plates) indicated that amoxicillin did not influence the incidence or the magnitude of circulating group G streptococci and S. aureus, while erythromycin apparently suppressed them. However, when care was taken to eliminate blood erythromycin by a lysis-centrifugation process, the incidence and magnitude of bacteremia after erythromycin prophylaxis was similar to that in control rats. We conclude that single doses of amoxicillin and erythromycin successfully prevent experimental endocarditis after dental extractions. Since this prophylaxis was operative by mechanisms other than the prevention of the circulation of bacteria before seeding the valvular vegetations, it suggests that recommendations for prevention of bacterial endocarditis should not be aimed only at providing adequate antibiotic blood levels to suppress the bacteremia produced by the invasive procedure.

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Section: Discussionmentioning

confidence: 75%

Antibiotic prophylaxis of experimental endocarditis after dental extractions.

et al. 1988

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“…Samples were taken just before inoculation, 1 min and 2 h (for bolus injection) or 2 and 6 h (for continuous infusion) after inoculation onset. The 1-min time point for bolus injection corresponded to the timing of blood cultures in previous human and animal studies (31,33). The 2-and 6-h time points for continuous infusion were chosen on the basis of numerous pilot experiments, which showed that the continuous-infusion technique yielded stable bacteremia levels over time.…”

Section: Methodsmentioning

confidence: 99%

Induction of Experimental Endocarditis by Continuous Low-Grade Bacteremia Mimicking Spontaneous Bacteremia in Humans

et al. 2011

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Transient high-grade bacteremia following invasive procedures carries a risk of infective endocarditis (IE).This is supported by experimental endocarditis. On the other hand, case-control studies showed that IE could be caused by cumulative exposure to low-grade bacteremia occurring during daily activities. However, no experimental demonstration of this latter possibility exists. This study investigated the infectivity in animals of continuous low-grade bacteremia compared to that of brief high-grade bacteremia. Rats with aortic vegetations were inoculated with Streptococcus intermedius, Streptococcus gordonii or Staphylococcus aureus (strains Newman and P8). Animals were challenged with 10 3 to 10 6 CFU. Identical bacterial numbers were given by bolus (1 ml in 1 min) or continuous infusion (0.0017 ml/min over 10 h). Bacteremia was 50 to 1,000 times greater after bolus than during continuous inoculation. Streptococcal bolus inoculation of 10 5 CFU infected 63 to 100% vegetations compared to 30 to 71% infection after continuous infusion (P > 0.05). When increasing the inoculum to 10 6 CFU, bolus inoculation infected 100% vegetations and continuous infusion 70 to 100% (P > 0.05). S. aureus bolus injection of 10 3 CFU infected 46 to 57% valves. This was similar to the 53 to 57% infection rates produced by continuous infusion (P > 0.05). Inoculation of 10 4 CFU of S. aureus infected 80 to 100% vegetations after bolus and 60 to 75% after continuous infusion (P > 0.05). These results show that high-level bacteremia is not required to induce experimental endocarditis and support the hypothesis that cumulative exposure to low-grade bacteremia represents a genuine risk of IE in humans.

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“…7 Thus, in animal models, endocarditis subsequent to bacteraemia is 48% in rats with periodontal diseases versus 6% in healthy rats. 8 In humans, bacteraemia subsequent to invasive procedures is around 51-55%. 9 …”

Section: Complications To Avoidmentioning

confidence: 99%

Documento de consenso sobre la utilización de profilaxis antibiótica en cirugía y procedimientos dentales

Pérez¹,

Sebastián²,

Martínez³

et al. 2006

Av Odontoestomatol

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SUMMARYThe goal of antibiotic prophylaxis in Odontology is to prevent the onset of infections through the entrance way provided by the therapeutic action, therefore it is indicated provided there is a considerable risk of infection, either because of the characteristics of the operation itself or the patient's local or general condition. Nonetheless, clinical trials with antibiotics in dental pathologies scarcely adhere to the required methodological criteria and, in addition, are not sufficiently numerous. This text presents the results of an expert conference comprising the Presidents of the most representative Scientific Societies in Spain who have analyzed the existing literature and have drawn on their valuable professional experience. It describes the technical circumstances, analyzes the biological and pharmacological foundations and their application to the most representative medical situations. It is concluded that antibiotic prophylaxis in Odontology has certain well-founded, precise indications and offers the international scientific community a practical protocol for action.

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Experimental Bacterial Endocarditis After Dental Extractions in Rats with Periodontitis

Cited by 45 publications

References 26 publications

Antibiotic prophylaxis of experimental endocarditis after dental extractions.

Antibiotic prophylaxis of experimental endocarditis after dental extractions.

Induction of Experimental Endocarditis by Continuous Low-Grade Bacteremia Mimicking Spontaneous Bacteremia in Humans

Documento de consenso sobre la utilización de profilaxis antibiótica en cirugía y procedimientos dentales

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