Oral Hygiene, Periodontal Disease, and Infective Endocarditis

口腔卫生、牙周病和感染性心内膜炎

• 批准号: 8693180
• 负责人: PETER B LOCKHART
• 金额: $ 76.63万
• 依托单位: CAROLINAS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-01 至 2019-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8693180
• 关键词: Address; Antibiotic Prophylaxis; Bacteremia; Bacteria; Blood; Cardiac; Cardiac Surgery procedures; Case-Control Studies; Catheters; Cessation of life; Clinical; Communities; Controlled Study; Data; Dental Care; Dental General Practice; Dental Hygiene; Development; Devices; Disease; Endocarditis; Future; Gingiva; Gingivitis; Health; Healthcare; Heart Valves; Incidence; Infective endocarditis; Knowledge; Medical; Methods; Microbial Biofilms; Morbidity - disease rate; Mouth Diseases; Odds Ratio; Oral; Oral cavity; Oral health; Patients; Periodontal Diseases; Periodontitis; Periodontium; Practice Guidelines; Prevention; Prevention Guidelines; Public Health; Research; Risk; Risk Factors; Source; Streptococcus; Testing; Tissues; Tooth structure; Work; cardiovascular risk factor; cost; design; disorder control; improved; mortality; oral bacteria; prevent; standardize measure

DESCRIPTION (provided by applicant): Infective endocarditis (IE) is a disease with a high degree of morbidity that can result in death. Healthcare- associated (HCA) IE is often due to non-oral staphylococcal bacteria and is associated with cardiac surgery, intravascular catheters, and cardiac devices. In contrast, community-acquired (CA) IE is typically due to streptococci in patients with pre-existing heart valve abnormalities. Prior studies provide some evidence that the periodontium and its biofilm may be a significant source of the bacteremia that results in CA-IE. However, no well-controlled studies have directly investigated the association of periodontal disease, periodontal bacteria, and CA-IE. Aim 1 of this multi-center case-control study is to determine if poor oral hygiene, gingivitis or periodontitis is associated with infective endocardits caused by any bacterial species. To address this aim, standardized measures of oral hygiene, gingivitis and periodontitis will be compared in 112 recently hospitalized patients with CA-IE (cases) and 224 healthy patients from the surrounding community who have cardiovascular risk factors for CA-IE but have not had the disease (controls). Aim 2 will determine if poor oral hygiene, gingivitis or periodontitis is associated with infective endocarditis caused by bacteria that ARE typically associated with poor oral hygiene or periodontal diseases. To address this aim, oral hygiene, gingivitis, and periodontitis will be compared among case patients with CA-IE who have positive blood cultures for oral bacteria that typically reside in the oral cavity and control patients from specific Aim 1. Aim 3 will determine if poor oral hygiene, gingivitis or periodontitis is associated with infective endocarditis caused by bacteria that ARE NOT typically associated with poor oral hygiene or periodontal disease. To address this aim, oral hygiene, gingivitis, and periodontitis will be compared among case patients with CA-IE who have positive blood cultures for non-oral bacteria and control patients from Specific Aim 1. If clinically and statistically significant associations are found between poor oral hygiene, gingivitis or periodontal disease and CA-IE, this study will transform our understanding of risk factors for CA-IE and will be a major step forward because it will provide supporting evidence that improving oral hygiene and maintaining periodontal health may reduce the risk for CA-IE. This has the potential to reduce the incidence of CA-IE and its associated morbidity, mortality, and cost. It would provide important information for future clinical guidelines for the prevention of endocarditis and be an important contribution to the public health in the U.S. and throughout the world for all people at risk for infective endocarditis.

描述（由申请人提供）：感染性心内膜炎（IE）是一种具有高度发病率的疾病，可能导致死亡。医疗保健相关（HCA）IE通常是由于非葡萄球菌细菌引起的，与心脏手术，血管内导管和心脏装置有关。相比之下，患有预先存在的心脏瓣膜异常的患者的链球菌通常是由于社区获得的（CA）IE。先前的研究提供了一些证据，表明牙周及其生物膜可能是导致CA-IE的菌血症的重要来源。然而，尚无控制的研究直接研究牙周疾病，牙周细菌和CA-IE的关联。这项多中心对照研究的目的1是确定口腔卫生，牙龈炎或牙周炎是否与任何细菌物种引起的感染性心内膜有关。为了解决这一目标，将在112例CA-IE（病例）住院的患者中，将比较口腔卫生，牙龈炎和牙周炎的标准化措施，以及来自周围有CA-IE心血管危险因素但没有疾病（对照组）的周围社区的224名健康患者。 AIM 2将确定口腔卫生，牙龈炎或牙周炎是否与通常与较差的口腔卫生或牙周疾病有关的细菌引起的感染性心内膜炎有关。为了解决这一目的，将比较口腔卫生，牙龈炎和牙周炎的CA-IE病例患者，这些患者的口腔细菌血液培养阳性，通常存在于口腔腹腔和特定目的1的患者中。IAM1 AIM 3将确定较差的口腔卫生，牙龈炎或牙周炎与细菌性疾病相关的较差或与细菌疾病相关。为了解决这一目标，将比较口腔卫生，牙龈炎和牙周炎的CA-IE病例患者，这些患者的血液培养为非口腔细菌和来自特定目标的非口腔细菌和对照患者的阳性。如果在临床上和统计上具有统计学意义的关联，则发现不良的口腔卫生，牙龈炎或牙周疾病或牙周疾病或CA-EIE的研究将是一定的研究，因为它的理解将是一定的。改善口腔卫生并维持牙周健康可能会降低CA-IE的风险。这有可能减少CA-IE的发病率及其相关的发病率，死亡率和成本。它将为预防心内膜炎的未来临床指南提供重要信息，并为美国公共卫生以及全世界的所有有感染性心内膜炎风险的人做出重要贡献。