Exodontia-associated bacteremia in horses characterized by next generation sequencing

Abstract

Bacteremia resulting from dental surgery is increasingly recognized as a health risk, especially in older and immunocompromised patients. Dentistry-associated bacteremic showering can lead to remote infections, as exemplified by valvular endocarditis. Emerging evidence points to a novel role played by uncultivable oral cavity commensals in the pathogenesis of diabetes, respiratory disease, cardiovascular disease, and adverse pregnancy outcomes. Whether dental extraction, a commonly-undertaken procedure in old horses, causes bacteremic showering has not been reported extensively. In a prospective clinical study using next generation sequencing (based on bacterial 16S rRNA), the circulating blood microbiome was characterized before and at 1 hour following extraction of incisor, canine or cheek teeth from 29 adult horses with dental disease. 16S rRNA sequencing results from the blood microbiome were compared with those from gingival swab samples obtained prior to extraction at the location of the diseased tooth. Bacteremic showering by translocated gingival commensals was demonstrated in horses undergoing exodontia and was, in some cases, still evident one hour post-operatively.