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Surgery for bacterial endocarditis associated with bacteria of oral/dental origin – characteristics of the “typical host” and implications for prevention
© Borowski et al; licensee BioMed Central Ltd. 2013
Published: 23 October 2013
To characterize the “typical host” for bacterial endocarditis (BE) of oral/dental origin and to address possible implications for prevention.
104 patients who underwent surgery for BE were divided into two groups according to the presumable port of entry, Group A (n=14) with bacteria of oral flora (“oral entry port”), and for comparison, Group B (n=90) with bacteria of non-oral origin (“non-oral entry port”). Risk profile, clinical course and outcome were assessed.
Significant differences between the groups were found regarding poor oral health, metabolic syndrome and dental treatment with a higher incidence in Group A. In Group A, majority of cases had left-sided endocarditis (79%); in Group B, 63% of patients were diagnosed with left-sided-, 30% with left-and-right-sided-, and 7% with right-sided-endocarditis. The in-hospital mortality was 0% vs. 26% in Group A and Group B, respectively.
The findings of our study suggest that BE associated with pathogens of oral flora mainly affects left-sided native heart valves, and the typical host is a patient with metabolic syndrome and poor dental status. Dentists should be alert in dealing with these patients in terms of a continuous preventive and therapeutic measure to maintain their optimal oral health.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.