Bacteraemia and proinflammatory response after non-surgical periodontal therapy and adjunctive antibiotics in patients with recent acute coronary syndrome

Autores organización

• 

  Gloria Ines Lafaurie Villamil

  Autor

• 

  Diana Marcela Castillo Perdomo

  Autor

• 

  Nathaly Andrea Delgadillo Salgado

  Autor

• Yineth Neuta Poveda

  Autor

• Yormaris Castillo Romero

  Autor

• David Augusto Diaz Baez

  Autor

• Luz Amparo Gomez Peña

  Autor

Autores

• Vargas-Sánchez P.K.
• Moscoso S.
• Sarmiento J.M.
• Cortes F.
• Mendoza F.

Unidades de investigación

• Unidad de Investigación Básica Oral UIBO

  

  Investigador

  Gloria Ines Lafaurie Villamil

Resumen

Introduction: This study compares the incidence of bacteraemia and proinflammatory cytokines in short and long periods after non-surgical periodontal therapy involving premedication with amoxicillin (AMX) followed by AMX and metronidazole (MTZ) in patients with Acute Coronary Syndrome (ACS). Methods: This pilot study included twelve individuals with periodontitis and recent ACS. Six patients were treated with subgingival instrumentation (SI), and six with supragingival ultrasonic scaling (US). Amoxicillin 2 g was administered as premedication in the first visit, followed by AMX-MTZ for one week. The incidence of bacteraemia was evaluated using hemoculture, qPCR, and next-generation sequencing (NGS) before the treatment (t0) and 30 min later (t1) (quadrants 1 and 2), and after one-week, pre-post-treatment samples were taken from the re-maining quadrants (t3 and t4). Proinflammatory cytokines were evaluated in serum at baseline (t0), one week (t1), and six months (t5). Results: Bacteraemia was low in 16.6 %, similar in both treatment groups. Porphyromonas gingivalis and Desulfobulbus oralis (16.6 %), Filifactor alocis, Eubacterium saphenum, Eubacterium brachy (8.3 %) were identified with qPCR. NGS was only detected in a single patient; at time t0, bacteria were more diverse than at t3 and were associated with the phyla Bacteroidetes and Proteobacteria. Interestingly, many clones observed in blood were non-oral. After treatment, all cytokines were reduced significantly in the SI group in the long term (p < 0.05). Conclusions: Periodontal therapy reduced bacteremia: despite the antibiotic regimen, bacteria remained in peripheral blood, which could be associated with antimicrobial resistance. SI produced a more efficient reduction of proinflammatory cytokines after periodontal treatment in individuals with ACS. © 2024 Elsevier Inc.

Keywords

• Acute Coronary Syndrome; Adult; Aged; Amoxicillin; Anti-Bacterial Agents; Bacteremia; Cytokines; Female; Humans; Male; Metronidazole; Middle Aged; Periodontitis; Pilot Projects; amoxicillin; antibiotic agent; metronidazole; amoxicillin; antiinfective agent; cytokine; metronidazole; acute coronary syndrome; adult; antibiotic resistance; Article; bacteremia; bacterium; bleeding; clinical article; clinical protocol; controlled study; Desulfobulbus; Desulfobulbus oralis; disease severity; Eubacterium brachy; Eubacterium saphenum; Filifactor alocis; high throughput sequencing; human; incidence; invasive procedure; non invasive procedure; periodontal procedure; periodontitis; pilot study; polymerase chain reaction; Porphyromonas gingivalis; premedication; aged; bacteremia; blood; drug therapy; female; male; microbiology; middle aged; periodontitis; therapy