Dhotre Shree, Jahagirdar Vilas, Suryawanshi Namdev, Davane Milind, Patil Ramesh, Nagoba Basavraj
Department of Microbiology, M.M. Patel Public Charitable Trust's, Ashwini Medical College & Hospital, Kumbhari, Solapur, Maharashtra, India.
Govt. Medical College, Miraj, Maharashtra, India.
Indian Heart J. 2018 Mar-Apr;70(2):225-232. doi: 10.1016/j.ihj.2017.06.019. Epub 2017 Jul 1.
To evaluate the role of periodontitis in viridans group streptococci (VGS) bacteremia and infective endocarditis (IE).
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.
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.
Periodontitis enhances viridans streptococcal bacteremia and may be a potential risk factor for IE.
评估牙周炎在草绿色链球菌（VGS）菌血症和感染性心内膜炎（IE）中的作用。
共200名受试者，分为两组。A组：34名患有牙周炎的拔牙受试者、46名未患牙周炎的拔牙受试者和40名健康对照者。B组：40例确诊的IE病例（17例伴有牙周炎，23例不伴有牙周炎）和40名健康对照者。通过标准程序获取龈下菌斑和血液样本并进行处理。
拔牙后共53份血样（66.25%）培养结果呈阳性。患有牙周炎的拔牙病例（79.40%）血培养阳性与牙周炎存在之间的关系显著高于未患牙周炎的拔牙病例（56.50%）（p = 0.05）。42.5%的IE病例观察到牙周炎。在40例IE患者中，血样产生了40种不同的分离株，大多数是草绿色链球菌15株（37.5%）和葡萄球菌9株（22.5%）。两组中牙周炎的龈下菌斑和血液分离株之间未观察到统计学上的显著差异，表明从血液和龈下菌斑分离出的草绿色链球菌生物型相似。两组草绿色链球菌的抗菌谱也观察到相似性。
牙周炎会增加草绿色链球菌菌血症，可能是IE的一个潜在危险因素。
