An analysis of the frequency of bacteraemia of dental origin implicated in infective endocarditis in patients requiring valve surgery

Abstract Understanding the frequency of bacteraemia of dental origin implicated severe infective endocarditis (IE) will further our understanding of this disease’s pathoeatiology and therefore help us take steps to reduce its prevalence. 78 patients from Royal Papworth Hospital, Cambridge, who had valve surgery due to IE as confirmed by the Modified Duke Criteria were included. Case notes were retrospectively reviewed for microorganism implicated in the bacteraemia and IE. Associated factors were also recorded to determine if these were different if a dental pathogen or a non-dental pathogen was inoculated. Of the 78 cases included, 24 patients had a dental pathogen implicated in their IE, 20 patients had a non-dental pathogen and 34 patients were culture negative. This was not deemed statistically significant (P = 0.54). Of the associated factors, only smoking was deemed to be statistically significant with a greater proportion of non-smokers having a bacteraemia of dental origin (P = 0.03). No other associated factor was appreciably different based on aetiology of microorganism. Our results indicate that dental pathogens aren’t more likely to cause severe IE and therefore advocate the stance adopted by current national guidance on judicious prescribing for antibiotic prophylaxis for IE with regard to dental procedures.