Dental Bacteremia in Children

Roberts, Graham; Holzel, Helen; Sury, Michael R. J.; Simmons, N.A.; Gardner, P; Longhurst, P

doi:10.1007/s002469900103

Cited by 173 publications

(172 citation statements)

References 10 publications

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“…[9][10][11][12][13][14][15] It was also noted to undertake a de novo analysis. A very endocarditis and when to seek that cases of infective endocarditis have simple model was developed to explore expert advice…”

Section: Recommendationsmentioning

confidence: 99%

Prophylaxis against infective endocarditis for dental procedures – summary of the NICE guideline

Wray¹,

Ruiz

Richey

et al. 2008

Br Dent J

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Section: Recommendationsmentioning

confidence: 99%

Prophylaxis against infective endocarditis for dental procedures – summary of the NICE guideline

Wray¹,

Ruiz

Richey

et al. 2008

Br Dent J

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“…P. acnes are commonly found in hair follicles in the skin and in the oral cavity. They frequently invade the circulatory system during tooth brushing where they do not present an immediate health risk due to the aerobic environment of the blood stream [12][13][14]. When an intervertebral disc is herniated, nuclear material extrudes into the spinal canal.…”

Section: Introductionmentioning

confidence: 99%

Does nuclear tissue infected with bacteria following disc herniations lead to Modic changes in the adjacent vertebrae?

et al. 2013

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Purpose To investigate the prevalence of infected herniated nucleus material in lumbar disc herniations and to determine if patients with an anaerobic infected disc are more likely to develop Modic change (MC) (bone oedema) in the adjacent vertebrae after the disc herniation. MCs (bone oedema) in vertebrae are observed in 6 % of the general population and in 35-40 % of people with low back pain. These changes are strongly associated with low back pain. There are probably a mechanical cause and an infective cause that causes MC. Several studies on nuclear tissue from herniated discs have demonstrated the presence of low virulent anaerobic microorganisms, predominantly Propionibacterium acnes, in 7-53 % of patients. At the time of a herniation these low virulent anaerobic bacteria may enter the disc and give rise to an insidious infection. Local inflammation in the adjacent bone may be a secondary effect due to cytokine and propionic acid production. Methods Patients undergoing primary surgery at a single spinal level for lumbar disc herniation with an MRI-confirmed lumbar disc herniation, where the annular fibres were penetrated by visible nuclear tissue, had the nucleus material removed. Stringent antiseptic sterile protocols were followed. Results Sixty-one patients were included, mean age 46.4 years (SD 9.7), 27 % female. All patients were immunocompetent. No patient had received a previous epidural steroid injection or undergone previous back surgery. In total, microbiological cultures were positive in 28 (46 %) patients. Anaerobic cultures were positive in 26 (43 %) patients, and of these 4 (7 %) had dual microbial infections, containing both one aerobic and one anaerobic culture. No tissue specimens had more than two types of bacteria identified. Two (3 %) cultures only had aerobic bacteria isolated. In the discs with a nucleus with anaerobic bacteria, 80 % developed new MC in the vertebrae adjacent to the previous disc herniation. In contrast, none of those with aerobic bacteria and only 44 % of patients with negative cultures developed new MC. The association between an anaerobic culture and new MCs is highly statistically significant (P = 0.0038), with an odds ratio of 5.60 (95 % CI 1.51-21.95). Conclusion These findings support the theory that the occurrence of MCs Type 1 in the vertebrae adjacent to a previously herniated disc may be due to oedema surrounding an infected disc. The discs infected with anaerobic bacteria were more likely (P \ 0.0038) to develop MCs in the adjacent vertebrae than those in which no bacteria were found or those in which aerobic bacteria were found.

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“…6 The data on intensity of bacteraemia are novel as are the data on plaque and gingivitis indices. The data on percentage prevalence are reproduced here to aid analysis and interpretation of the new data.…”

Section: Researchmentioning

confidence: 99%

Intensity of bacteraemia associated with conservative dental procedures in children

et al. 2000

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Dental Bacteremia in Children

Cited by 173 publications

References 10 publications

Prophylaxis against infective endocarditis for dental procedures – summary of the NICE guideline

Prophylaxis against infective endocarditis for dental procedures – summary of the NICE guideline

Does nuclear tissue infected with bacteria following disc herniations lead to Modic changes in the adjacent vertebrae?

Intensity of bacteraemia associated with conservative dental procedures in children

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