Oral Streptococcal Endocarditis, Oral Hygiene Habits, and Recent Dental Procedures: A Case-Control Study
Xavier Duval, Sarah Millot, Catherine Chirouze, Christine Selton-Suty, Vanessa Moby, Pierre Tattevin, Christophe Strady, Edouard Euvrard, Nelly Agrinier, Daniel Thomas, Bruno Hoen, François Alla, EI-dents Association pour l'Etude et la Prévention de l'Endocardite Infectieuse (AEPEI) Study Group, X Duval, B Hoen, F Alla, A Bouvet, C Chirouze, T Doco-Lecompte, B Iung, C Selton-Suty, C Strady, P Tattevin, Catherine Chirouze, Elodie Curlier, Cécile Descottes-Genon, Edouard Euvrad, Bruno Hoen, C Meyer, Isabelle Patry, Lucie Vettoretti, Nejla Aissa, Aurelie Bannay, Thanh Doco-Lecompte, François Goehringer, Nathalie Keil, Lorraine Letranchant, Hepher Malela, Vanessa Moby, Christine Selton-Suty, N Benyounes Marie-Pierre Bretheaux, S Broda, Xavier Duval, C Fargou, Emila Ilic Habensus, Bernard Iung, Simone Imbert, Sarah Millot, Emmanuelle Cambau, Antoine Andremont, Clément Messeka, Catherine Leport, Daniel Thomas, François Bricaire, Jean Chastre, Jean-Louis Trouillet, Patrick Yeni, Michel Wolff, G Bourgeois, Pierre Nazeyrollas, Vernet Véronique, Christophe Strady, Gilbert De Mello, Caroline Piau, Audrey Brener, Hélène Martin-Thomé, Christian Michelet, Matthieu Revest, Pierre Tattevin, Elise Thébault, François Alla, Marie-Line Erpelding, Nelly Agrinier, Xavier Duval, Sarah Millot, Catherine Chirouze, Christine Selton-Suty, Vanessa Moby, Pierre Tattevin, Christophe Strady, Edouard Euvrard, Nelly Agrinier, Daniel Thomas, Bruno Hoen, François Alla, EI-dents Association pour l'Etude et la Prévention de l'Endocardite Infectieuse (AEPEI) Study Group, X Duval, B Hoen, F Alla, A Bouvet, C Chirouze, T Doco-Lecompte, B Iung, C Selton-Suty, C Strady, P Tattevin, Catherine Chirouze, Elodie Curlier, Cécile Descottes-Genon, Edouard Euvrad, Bruno Hoen, C Meyer, Isabelle Patry, Lucie Vettoretti, Nejla Aissa, Aurelie Bannay, Thanh Doco-Lecompte, François Goehringer, Nathalie Keil, Lorraine Letranchant, Hepher Malela, Vanessa Moby, Christine Selton-Suty, N Benyounes Marie-Pierre Bretheaux, S Broda, Xavier Duval, C Fargou, Emila Ilic Habensus, Bernard Iung, Simone Imbert, Sarah Millot, Emmanuelle Cambau, Antoine Andremont, Clément Messeka, Catherine Leport, Daniel Thomas, François Bricaire, Jean Chastre, Jean-Louis Trouillet, Patrick Yeni, Michel Wolff, G Bourgeois, Pierre Nazeyrollas, Vernet Véronique, Christophe Strady, Gilbert De Mello, Caroline Piau, Audrey Brener, Hélène Martin-Thomé, Christian Michelet, Matthieu Revest, Pierre Tattevin, Elise Thébault, François Alla, Marie-Line Erpelding, Nelly Agrinier
Abstract
Background.: We aimed to compare oral hygiene habits, orodental status, and dental procedures in patients with infective endocarditis (IE) according to whether the IE-causing microorganism originated in the oral cavity.
Methods.: We conducted an assessor-blinded case-control study in 6 French tertiary-care hospitals. Oral hygiene habits were recorded using a self-administered questionnaire. Orodental status was analyzed by trained dental practitioners blinded to the microorganism, using standardized clinical examination and dental panoramic tomography. History of dental procedures was obtained through patient and dentist interviews. Microorganisms were categorized as oral streptococci or nonoral pathogens using an expert-validated list kept confidential during the course of the study. Cases and controls had definite IE caused either by oral streptococci or nonoral pathogens, respectively. Participants were enrolled between May 2008 and January 2013.
Results.: Cases (n = 73) were more likely than controls (n = 192) to be aged <65 years (odds ratio [OR], 2.85; 95% CI, 1.41-5.76), to be female (OR, 2.62; 95% CI, 1.20-5.74), to have native valve disease (OR, 2.44; 95% CI, 1.16-5.13), to use toothpicks, dental water jet, interdental brush, and/or dental floss (OR, 3.48; 95% CI, 1.30-9.32), and to have had dental procedures during the prior 3 months (OR, 3.31; 95% CI, 1.18-9.29), whereas they were less likely to brush teeth after meals. The presence of gingival inflammation, calculus, and infectious dental diseases did not significantly differ between groups.
Conclusions.: Patients with IE caused by oral streptococci differ from patients with IE caused by nonoral pathogens regarding background characteristics, oral hygiene habits, and recent dental procedures, but not current orodental status.
Keywords: case-control study; dental status.; endocarditis; hygiene; prophylaxis.
Conflict of interest statement
Conflict of interest statement:
The authors have no commercial or other associations that might pose a conflict of interest
© The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com
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Source: PubMed