Prevention of infective endocarditis associated with dental interventions: South African Heart Association position statement, endorsed by the South African Dental Association

Jankelow, David; Cupido, Blanche; Zühlke, Liesl; Sliwa, Karen; Ntsekhe, Mpiko; Manga, Pravin; Doubell, Anton; Lawrenson, John; Essop, Mohammed R.

doi:10.24170/14-3-2716

Cited by 5 publications

(7 citation statements)

References 22 publications

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“…Data regarding the incidence in South Africa is lacking. It is well documented that the presence of rheumatic valvular heart disease significantly increases patient's risk of acquiring infective endocarditis (IE) (3). The fact that South Africa still has a high prevalence of rheumatic heart disease compared to the developed world, puts a significant part of the population at risk for developing IE.…”

Section: Patient Profilementioning

confidence: 99%

“…Streptococcal IE caused by the oral viridans group remains most common in low-income countries and is the most common cause in reported literature in South Africa (2)(3)(4). The fact that rheumatic valve disease is common in the developing world coupled with poor oral hygiene creates the perfect conditions for the development of IE.…”

Section: Microbiologymentioning

confidence: 99%

“…Zoonotic endocarditis is caused by Coxiella burnetii and Brucella (from livestock), Bartonella henselae (from cats) and Chlamydia psittaci (from parrots, pigeons). It is important to note that the prevalence of these groups were much lower in South African cohorts compared to developed countries (2)(3)(4). Fungal endocarditis due to Candida or Aspergillus, is rare but often fatal, arising in patients who are immunosuppressed or after cardiac surgery (4,11,12).…”

Section: Microbiologymentioning

confidence: 99%

“…The pathogenesis of Streptococcus viridans IE, especially in the RHD population, is well documented to be due to entry into the blood stream via the gingivae. Although low grade bacteraemia is common during normal dental activities e.g., tooth brushing, the levels of bacteraemia is much higher during invasive dental procedures (1,3). Recent observational studies from developed nations (Europe, USA and UK) after the restriction of antibiotic prophylaxis has yielded conflicting data.…”

Section: Recurrence and Preventionmentioning

confidence: 99%

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Infective endocarditis in South Africa

Pecoraro

Doubell

2020

Cardiovasc Diagn Ther

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Infective endocarditis (IE) is defined by infection of either a native or prosthetic heart valve, endocardial surface or any cardiac prosthetic device. It is a disease of both the developed and developing world, although IE has evolved in the developed world to a disease markedly different to the disease encountered in the developing world. IE in developed nations is mainly a disease of older patients with degenerative heart valve disease or cardiac prosthetic material, with virulent Staphylococci the most common causative organism. Data regarding the epidemiology of IE in South Africa, a developing country, is limited. The available data suggest it is still a disease of younger patients with rheumatic heart disease (RHD), associated with penicillin-sensitive Streptococcal infection. Although novel diagnostic techniques and improved therapeutic options has emerged, the 1-year mortality rate has remained high in both the developed and developing world at around 30%.

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Section: Patient Profilementioning

confidence: 99%

Section: Microbiologymentioning

confidence: 99%

Section: Microbiologymentioning

confidence: 99%

Section: Recurrence and Preventionmentioning

confidence: 99%

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Infective endocarditis in South Africa

Pecoraro

Doubell

2020

Cardiovasc Diagn Ther

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“…19 The effectiveness of such antibiotic prophylaxis in humans, however, remains unproven. 20 The more recent Cochrane review in 2013 concluded that there remains no evidence about whether antibiotic prophylaxis is effective or ineffective against bacterial endocarditis in people at risk who are about to undergo an invasive dental procedure. 21 However, the prophylaxis guidelines recommended by AHA, ESC and BSAC are applied in South Africa.…”

Section: < 523mentioning

confidence: 99%

Antibiotic prescribing practices of dentists at Medunsa Oral Health Centre

Mthethwa¹,

Matjila²

2018

S. Afr. dent. j.

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Infective endocarditis in infants and children in the Western Cape, South Africa: a retrospective analysis

et al. 2019

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Infective endocarditis is a microbial infection of the endothelial surface of the heart, predominantly the heart valves, that is associated with high mortality and morbidity. Few contemporary data exist regarding affected children in our context.Aims and Objectives:We aimed to describe the profile and treatment outcomes of infant and childhood endocarditis at our facilities.Methods:This is a retrospective analysis of infants and children with endocarditis at two public sector hospitals in the Western Cape Province of South Africa over a 5-year period. Patients with “definite” and “possible” endocarditis according to Modified Duke Criteria were included in the review.Results:Forty-nine patients were identified for inclusion; 29 had congenital heart disease as a predisposing condition; 64% of patients met “definite” and 36% “possible” criteria. The in-hospital mortality rate was 20%; 53% of patients underwent surgery with a post-operative mortality rate of 7.7%. The median interval from diagnosis to surgery was 20 days (interquartile range, 9–47 days). Valve replacement occurred in 28% and valve repair in 58%. There was a significant reduction in valvular dysfunction in patients undergoing surgery and only a marginal improvement in patients treated medically. Overall, 43% of patients had some degree of residual valvular dysfunction.Conclusion:Endocarditis is a serious disease with a high in-hospital mortality and presents challenges in making an accurate diagnosis. Despite a significant reduction in valvular dysfunction, a portion of patients had residual valvular dysfunction. Early surgery is associated with a lower mortality rate, but a higher rate of valve replacement compared with delayed surgery.

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Prevention of infective endocarditis associated with dental interventions: South African Heart Association position statement, endorsed by the South African Dental Association

Cited by 5 publications

References 22 publications

Infective endocarditis in South Africa

Infective endocarditis in South Africa

Antibiotic prescribing practices of dentists at Medunsa Oral Health Centre

Infective endocarditis in infants and children in the Western Cape, South Africa: a retrospective analysis

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