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Increased susceptibility to gingival colonization by specific HACEK microbes in children with congenital heart disease

  • Robert Steelman1,*,
  • Stanley Einzig1
  • Arpy Balian1
  • John Thomas2
  • David Rosen3
  • Robert Gustafson4
  • Lori Gochenour5

1Department of Pediatrics, Division of Pediatric Cardiology, WVU School of Medicine, Morgantown, WV 26506

2Departments of Pathology and Periodontics, WVU School of Medicine, Morgantown, WV 26506

3Departments of Anesthesiology and Pediatrics, Division of Cardiothoracic Anesthesia, WVU School of Medicine, Morgantown, WV 26506

4Department of Surgery and Pediatrics, Division of Cardiothoracic Surgery, WVU School of Medicine, Morgantown, WV 26506

5Department of Dental Hygiene, WVU School of Dentistry, Morgantown, WV 26506.

DOI: 10.17796/jcpd.25.1.kv5218kw3ql67r67 Vol.25,Issue 1,January 2001 pp.91-94

Published: 01 January 2001

*Corresponding Author(s): Robert Steelman E-mail: Rsteehnan@wvu.edu

Abstract

It is well established that infective endocarditis (IE) involving the HACEK (Hemophilus, Actinobaccillus, Cardiobacter, Eikenella, Kingella) group of microbes occurs in patients with congenital heart defects (CHD) and in those with prosthetic grafts. Dental caries and gingival disease have been presumed to be the focus of microbial shedding. The purpose of this study was to determine if children with CHD had a more severe gingival inflammatory condition and harbored the HACEK group of microbes to a greater extent than normal children. Two groups of 12 age and sex matched children were selected for this study. The experimental group consisted of twelve children with CHD, 1-1/2 to 8 years of age. The control group consisted of 12 healthy children 2 to 8 years of age. Each child had a gingival index score recorded as described by Massler. Subgingival cultures were obtained. Gingival samples were cultured for HACEK microbes and total Streptococcus (spp) using standard techniques. Fisher’s exact test was performed with significance defined at P<0.05. Children with CHD had more severe gingival inflammatory index than the control group (P<0.05). 8/12 CHD patient had Actinobacillus actinomycetemcomitans (A.a.) as compared with 2/12 controls (P<0.05). Furthermore, all cyanotic CHD patients (4/4) had A.a. whereas, only 2/12 controls did (P<0.05). 4/12 CHD patients harbored Eikenella corrodens (E.c.) compared to 1/12 controls (N.S.). There was no significant difference in colonization with E.c. or A.a. between cyanotic and acyanotic patients. No significant difference in total Streptococcus (spp) was found between the two groups. This study suggests that children with CHD have a more severe gingival inflammatory index and are colonized with specific HACEK microbes more so than normal children.

Cite and Share

Robert Steelman, Stanley Einzig,Arpy Balian,John Thomas,David Rosen,Robert Gustafson,Lori Gochenour. Increased susceptibility to gingival colonization by specific HACEK microbes in children with congenital heart disease. Journal of Clinical Pediatric Dentistry. 2001. 25(1);91-94.

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