Microbiota present in combined endodontic-periodontal diseases and its risks for endocarditis

Gomes, Brenda Paula Figueiredo de Almeida; Berber, Vanessa Bellocchio; Chiarelli‐Neto, Vito M.; Aveiro, Emelly de; Chapola, Rafaela C.; Passini, Maicon Ricardo Zieberg; Lopes, Érica Mendes; Chen, Tsute; Paster, Bruce J.

doi:10.1007/s00784-023-05104-0

Cited by 2 publications

(1 citation statement)

References 52 publications

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“…Rothia bacteria are part of the normal human microbiota in the skin [6,7,8], intestine [9,10,11], and oral cavity [12,13,14,15,16]. Considered opportunistic pathogens with low virulence [17], Rothia spp.…”

Section: Rothia Mucilaginosa Initially Classified Asmentioning

confidence: 99%

Microbiological and Epidemiological Aspects of Endocarditis Caused by Rothia spp.: A Systematic Review

Norberg,

Manhães

et al. 2023

JAMMR

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Background and Aim: Rothia, a genus comprising pleomorphic Gram-positive bacteria found in the human oral, intestinal, and skin microbiota, is recognized as an opportunistic pathogen. Case reports of Rothia spp. endocarditis in the scientific literature are scarce, with limited knowledge of relevant data on Rothia endocarditis and clinical aspects of its treatment. The objective of this literature review is to compile clinical aspects of endocarditis caused by Rothia species, analyzing results and clinical practices to elucidate the most important risk factors, comorbidities, prognostic factors, and appropriate antibiotic treatment options. Methods: Employing the PRISMA model, a systematic review was conducted utilizing PubMed, SciELO, and Google Scholar databases, encompassing articles published from 1978 to November 2023. Pertinent aspects were systematically recorded and summarized for subsequent analysis. Results: Rothia dentocariosa (48.69%), Rothia mucilaginosa (22.37%), Rothia aeria (14.47%), and Rothia kristinae (14.47%) were recognized as the agents of endocarditis cases. Patients exhibited an average age of 48.5 years, with a notable male preponderance (71.6%). Clinical manifestations of Rothia spp. endocarditis presented similar features compared to other Gram-positive bacterial endocarditis cases. The mortality rate was notably lower than observed in other infectious endocarditis instances (11.84%). Predominant risk factors included preexisting cardiovascular diseases (50%), followed by odontological procedures, caries, and precarious oral hygiene (17.1%), immunocompromised status (14.47%), injectable illicit drug use (11.84%), and diabetes (9.21%). Embolic events were documented in 35.53% of patients, predominantly in Central Nervous System (28.95%). Mycotic aneurysms were identified in 6.58% of cases. Resistance to antibiotics was identified in only 13.16% of strains causing endocarditis, although certain strains displayed characteristics indicative of multidrug resistance. Conclusion: Despite its rarity, Rothia spp. endocarditis exhibits clinical parallels with endocarditis caused by other Gram-positive bacteria, but with a comparatively lower mortality rate. Challenges in identifying Rothia spp. species based on cultural and microscopic characteristics, associated to early resolution in antibiotic therapy, seems to contribute to the underreporting of endocarditis caused by these bacteria.

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Section: Rothia Mucilaginosa Initially Classified Asmentioning

confidence: 99%

Microbiological and Epidemiological Aspects of Endocarditis Caused by Rothia spp.: A Systematic Review

Norberg,

Manhães

et al. 2023

JAMMR

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Does Endodontic Treatment Influence Human Endocarditis? Systematic Review

Pereira,

Leutz,

Gomes

et al. 2024

Hearts

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Endocarditis is a severe infection affecting the heart’s inner layer, the endocardium. Its pathophysiology may involve heart valve damage, bacteria adhesion and biofilm formation, potentially leading to fatal complications. Bacteria from various sources, including from endodontic diseases and its treatments may enter the bloodstream provoking this condition. This systematic review aimed to explore the influence of endodontic factors on endocarditis. Searches across PubMed, Embase, Cochrane Library and manual sources yielded 14 relevant articles from 1562 screened studies. Assessment platforms from JBI Critical Appraisal Tools evaluated studies biases. Findings mainly focused on transient bacteraemia as a key indicator of risk correlating bacterial virulence and counts with endocarditis development. Worryingly, multi-species bacteraemia post-endodontic treatment was noted including the genera Enterococcus, Parvimonas, Streptococcus and Staphylococcus. Conclusive validation of the incidence and association between endodontic patients and endocarditis was limited due to a lack of robust longitudinal investigations, such as randomized controlled trials. This emphasizes the need for further research with well-designed methodologies to provide a full understanding of the causative bacterial population and its pathological mechanisms. A current guideline (2023 European Society of Cardiology) was developed to support healthcare professionals in diagnosing and managing infective endocarditis; this 2023 version is introducing a new diagnostic algorithm to aid in patient classification aiming to improve outcomes for this challenging disease. The study was a priori registered on PROSPERO (CRD42023407736).

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Microbiota present in combined endodontic-periodontal diseases and its risks for endocarditis

Cited by 2 publications

References 52 publications

Microbiological and Epidemiological Aspects of Endocarditis Caused by Rothia spp.: A Systematic Review

Microbiological and Epidemiological Aspects of Endocarditis Caused by Rothia spp.: A Systematic Review

Does Endodontic Treatment Influence Human Endocarditis? Systematic Review

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