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龈上洁治和拔牙术后菌血症:培养和分子分析。

Bacteremia after supragingival scaling and dental extraction: Culture and molecular analyses.

机构信息

National Institute of Cardiology, Rio de Janeiro, Brazil.

Department of Endodontics, Estácio de Sá University, Rio de Janeiro, Brazil.

出版信息

Oral Dis. 2018 May;24(4):657-663. doi: 10.1111/odi.12792. Epub 2018 Feb 8.

Abstract

OBJECTIVE

To study the incidence and magnitude of bacteremia after dental extraction and supragingival scaling.

SUBJECTS AND METHODS

Blood samples were taken before and 5 and 30 min after dental extraction and supragingival scaling from individuals at high (n = 44) or negligible risk (n = 51) for infective endocarditis. The former received prophylactic antibiotic therapy. Samples were subjected to aerobic and anaerobic culture and quantitative real-time polymerase chain reaction to determine the incidence of bacteremia and total bacterial levels.

RESULTS

Patients who did not receive prophylactic antibiotic therapy had a higher incidence of positive blood cultures (30% 5 min after extraction) than patients who received prophylactic antibiotic therapy (0% 5 min after extraction; p < .01). Molecular analysis did not reveal significant differences in the incidence or magnitude of bacteremia between the two patient groups either 5 or 30 min after each of the procedures evaluated. Extraction was associated with higher incidence of bacteremia than supragingival scaling by blood culture (p = .03) and molecular analysis (p = .05).

CONCLUSIONS

Molecular methods revealed that dental extraction and supragingival scaling were associated with similar incidence of bacteremia in groups receiving or not prophylactic antibiotic therapy. However, blood culture revealed that antibiotic therapy reduced viable cultivable bacteria in the bloodstream in the extraction group.

摘要

目的

研究拔牙和龈上洁治术后菌血症的发生率和严重程度。

对象和方法

从感染性心内膜炎高危(n=44)和低危(n=51)个体中采集拔牙和龈上洁治术前、后 5 分钟和 30 分钟的血样。前者接受预防性抗生素治疗。对样本进行需氧和厌氧培养及定量实时聚合酶链反应,以确定菌血症的发生率和总细菌水平。

结果

未接受预防性抗生素治疗的患者,其血培养阳性的发生率高于接受预防性抗生素治疗的患者(拔牙后 5 分钟时分别为 30%和 0%;p<.01)。分子分析显示,在评估的每个操作后 5 分钟或 30 分钟,两组患者的菌血症发生率或严重程度均无显著差异。与龈上洁治相比,拔牙后血培养(p=.03)和分子分析(p=.05)的菌血症发生率更高。

结论

分子方法显示,接受或不接受预防性抗生素治疗的两组患者,拔牙和龈上洁治术菌血症的发生率相似。然而,血培养显示,在拔牙组中,抗生素治疗降低了血流中可培养活菌的数量。

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