Bacteremia from Dental Extraction vs. Oral Hygiene

拔牙引起的菌血症与口腔卫生

• 批准号: 6748923
• 负责人: PETER B LOCKHART
• 金额: $ 56.27万
• 依托单位: CAROLINAS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-05-01 至 2006-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6748923
• 关键词: bacteria infection mechanism; bacterial disease; bacterial genetics; blood chemistry; blood toxicology; clinical research; clinical trials; dental disorder chemotherapy; disease /disorder proneness /risk; human subject; human therapy evaluation; nucleic acid sequence; oral bacteria; oral health; penicillins; polymerase chain reaction; statistics /biometry; tissue /cell culture; tooth extraction; toothbrushing

DESCRIPTION: (provided by applicant): The use of antibiotic prophylaxis to prevent distant site infections (DSI) from oral pathogens remains a controversial issue in clinical practice. Little is known about the incidence, nature, magnitude, and duration (INMD) of bacteremia from naturally occurring or invasive dental procedures, or the impact of prophylactic antibiotics on the INMD. The major purposes of this prospective, randomized, clinical study of 300 subjects is to: 1) determine and compare the true INMD of bacteremia resulting from a highly invasive dental office procedure (single tooth extraction) and a minimally invasive and naturally occurring source of bacteremia (tooth brushing), from 10 specific oral pathogens (S. mitis, S. sanguis. S. Oralis. S. intermedius, S. mutans, S. Salivarius. F. nucleatum, A. Actinomycetemcomitans, E. corrodens and P. gingivalis) that have been reported to cause DSI; and 2) measure the effect of the American Heart Association's guidelines for amoxicillin prophylaxis on the INMD of bacteremia resulting from a single tooth extraction. Subjects will be randomized into three equal into three equal groups: extraction with amoxicillin, extraction with placebo, and tooth brushing. Blood for aerobic and anaerobic bacterial cultures and PCR will be drawn at six time points before, during, and following these oral procedures. INMD will be determined as follows: 1) incidence figures for each blood draw will employ a highly sensitive, broth-based blood culturing system (BACTEC); 2) nature will be determined by conventional methods of speciating pathogens cultivated by BACTEC, and we will improve the specificity of the oral pathogens from BACTEC with the use of gene sequence analysis; 3) magnitude of bacteremia will be determined by PCR for each blood sample; and 4) bacteremia duration will correspond to the presence of oral pathogens in sequential blood draws following tooth brushing and extractions. This study will provide a more complete understanding of the impact of invasiveness (i.e., brushing vs. extraction) and the degree of oral disease on the INMD. Additionally, we will have unique and critical data for the development of both future research and evidence-based guidelines concerning antibiotic prophylaxis for individuals currently felt to be at risk for DSI.

描述：（由申请人提供）：使用抗生素预防 预防口腔病原体的远处部位感染（DSI）仍然是 临床实践中有争议的问题。关于发病率知之甚少 来自天然发生的菌血症的性质，幅度和持续时间（INMD） 或侵入性牙科程序，或预防性抗生素对 inmd。这项前瞻性，随机，临床研究的主要目的300 受试者是：1）确定并比较菌血症的真实INMD 从高度侵入性的牙科办公室程序（单牙提取）和 微创且自然存在的菌血症来源（牙齿 刷牙），从10种特定的口腔病原体（S. Mitis，S。Sanguis。S。Oralis。S。 Intermedius，S。Mutans，S。Salivarius。 F. nucleatum，A。放线菌， 据报道引起DSI的E.腐蚀和牙龈疟原虫）；和2） 衡量美国心脏协会指南的影响 单一牙齿引起的菌血症INMD的阿莫西林预防 萃取。受试者将被随机分为三等于三个相等 组：用阿莫西林提取，安慰剂提取和牙齿 刷牙。有氧和厌氧细菌培养和PCR的血液将是 在这些口头程序之前，之中和遵循六个时间点绘制。 INMD将确定如下：1）每次抽血的发病率数字 将采用高度敏感的基于肉汤的血液培养系统（BACTEC）； 2） 大自然将由常规的病原体指定方法来确定 由Bactec培养，我们将提高口腔病原体的特异性 从BACTEC使用基因序列分析； 3）菌血症的大小 每个血液样本将由PCR确定； 4）菌血症持续时间 将对应于顺序血液中口服病原体的存在 牙刷和萃取。这项研究将提供更多 完全了解侵入性的影响（即刷牙VS。 提取）和INMD上的口腔疾病程度。此外，我们会的 有独特的和关键的数据，用于发展未来的研究和 有关个体抗生素预防的循证指南 目前认为有DSI的风险。

项目成果

Concordance of HOMIM and HOMINGS technologies in the microbiome analysis of clinical samples.

• DOI: 10.3402/jom.v8.30379
• 发表时间: 2016
• 期刊: Journal of oral microbiology
• 影响因子: 4.5
• 作者: Mougeot JL;Stevens CB;Cotton SL;Morton DS;Krishnan K;Brennan MT;Lockhart PB;Paster BJ;Bahrani Mougeot FK
• 通讯作者: Bahrani Mougeot FK

Poor oral hygiene as a risk factor for infective endocarditis-related bacteremia.

• DOI: 10.14219/jada.archive.2009.0046
• 发表时间: 2009-10
• 期刊: Journal of the American Dental Association (1939)
• 作者: Lockhart PB;Brennan MT;Thornhill M;Michalowicz BS;Noll J;Bahrani-Mougeot FK;Sasser HC
• 通讯作者: Sasser HC