IADR Abstract Archives
Bacteremia in Patients With Acute Coronary Syndrome After Periodontal Treatment
Objectives: Patients with recent acute coronary syndrome (ACS) have periodontal disease upon hospital admission to a cardiovascular rehabilitation program. However, periodontal treatment to control of the bacteremia and proinflammatory markers which increase cardiovascular risk, through the circulating oral microbiota is not usually implemented. This study aimed to compare the incidence of bacteremia using two periodontal treatment protocols in patients with ACS.
Methods: Methodology: This is an interim analysis of a double-blind controlled clinical trial evaluating two periodontal treatment schemes in patients with stage II and III periodontitis with recent ACS. After randomization seven patients were treated with Scheme A (scaling and root planning) and seven patients with Scheme B (ultrasonic scaling). Periodontal therapy was performed in two appointments accompanied by an antibiotic medication protocol with amoxicillin 2g 1 hour before the intervention followed by amoxicillin-metronidazole for one week. The incidence of bacteremia was evaluated previously to periodontal treatment (T0) and 30 minutes later (T1) in the second appointment, the same procedure was carried out with the following two quadrants (T3 y T4). Peripheral blood samples were taken from the samples bacteremia was evaluated by blood culture, qPCR, and next-generation sequencing (NGS).
Results: Results: Bacteremia with this protocol was low 2/14 (14.2%). The detection of genus and species against nine oral pathogens was carried out by qPCR and the following were detected: Porphyromonas gingivalis and Desulfobulbus oralis (14.2%), Filifactor alocis, Eubacterium saphenum, Eubacterium brachy (7.1%). When evaluated by NGS, identification was only achieved in a single patient at times T0 and T3; at time T0, greater bacterial diversity could be found than at T3, prevalent due to the action of antibiotic treatment. The highest abundance found was Proteobacteria and Bacteroidetes.
Conclusions: Conclusion: Periodontal therapy reduces bacteremia; however, despite antibiotic regimen there is bacteria in peripheral blood, which could be associated with antimicrobial resistance.
Methods: Methodology: This is an interim analysis of a double-blind controlled clinical trial evaluating two periodontal treatment schemes in patients with stage II and III periodontitis with recent ACS. After randomization seven patients were treated with Scheme A (scaling and root planning) and seven patients with Scheme B (ultrasonic scaling). Periodontal therapy was performed in two appointments accompanied by an antibiotic medication protocol with amoxicillin 2g 1 hour before the intervention followed by amoxicillin-metronidazole for one week. The incidence of bacteremia was evaluated previously to periodontal treatment (T0) and 30 minutes later (T1) in the second appointment, the same procedure was carried out with the following two quadrants (T3 y T4). Peripheral blood samples were taken from the samples bacteremia was evaluated by blood culture, qPCR, and next-generation sequencing (NGS).
Results: Results: Bacteremia with this protocol was low 2/14 (14.2%). The detection of genus and species against nine oral pathogens was carried out by qPCR and the following were detected: Porphyromonas gingivalis and Desulfobulbus oralis (14.2%), Filifactor alocis, Eubacterium saphenum, Eubacterium brachy (7.1%). When evaluated by NGS, identification was only achieved in a single patient at times T0 and T3; at time T0, greater bacterial diversity could be found than at T3, prevalent due to the action of antibiotic treatment. The highest abundance found was Proteobacteria and Bacteroidetes.
Conclusions: Conclusion: Periodontal therapy reduces bacteremia; however, despite antibiotic regimen there is bacteria in peripheral blood, which could be associated with antimicrobial resistance.