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Profilaxia para prevenção da endocardite bacteriana: como, quando e porquê – revisão narrativa
| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 37907 | 1.06 MB | Adobe PDF |
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Abstract(s)
A endocardite bacteriana (EB) é a infeção de uma ou mais válvulas cardíacas, nativas ou protéticas, mais raramente do endocárdio parietal, por um microrganismo, na maioria das vezes bactérias, germes intracelulares ou leveduras. A incidência desta patologia permanece muito alta, apesar do progresso científico e médico, particularmente em termos de antibioticoterapia e assepsia, com uma taxa de mortalidade de cerca de 25%. A esfera oral é a principal e predominante porta de entrada de microrganismos que podem provocar endocardite bacteriana. São diversos os procedimentos dentários que favorecem a entrada de bactérias na corrente sanguínea, as denominadas bacteriemias. Na maioria das vezes, em indivíduos saudáveis, as próprias defesas do organismo são capazes de controlar esse processo, contudo, existem condições predisponentes, tais como a presença de cardiopatias valvulares que podem levar a complicações sistémicas, como a endocardite bacteriana.
Esta revisão narrativa tem como objetivo compreender a relação entre bactérias e cuidados dentários e adotar profilaxias e medidas preventivas necessárias para reduzir a incidência desta patologia.
Para isso foi desenvolvida uma pesquisa integrativa da literatura, com recurso à base de dados PubMed. Esta pesquisa foi submetida a critérios de inclusão e exclusão, em que apenas foram incluídos estudos que abordavam tanto a endocardite como as situações de utilização da profilaxia nos cuidados dentários. Os artigos foram selecionados primeiramente pelos títulos, seguidamente pela leitura dos abstracts e, finalmente, do artigo integralmente. Destes, foram selecionados 53 artigos, por serem os mais relacionados com o tema.
Verifica-se que as atuais guidelines para prevenir a endocardite são mais simples e objetivas das inicialmente propostas. No entanto, parece que o objetivo seja mesmo reduzir ou eliminar o uso da profilaxia nos procedimentos dentários.
Bacterial endocarditis (EB) is the infection of one or more heart valves, native or prosthetic, more rarely of the parietal endocardium, by a microorganism, most often bacteria, intracellular germs or yeasts. The incidence of this pathology remains very high, despite scientific and medical progress, particularly in terms of antibiotic therapy and asepsis, with a mortality rate of about 25%. The oral sphere is the main and predominant gateway of microorganisms that can provoke bacterial endocarditis. There are several dental procedures that allow the entry of bacteria into the bloodstream, called bacteriemias. In most instances, healthy individuals hold body defences able to control this process. However, there are predisposing conditions, such as the presence of valvular heart diseases that can lead to systemic complications, e.g. bacterial endocarditis. This narrative review aims to understand the relationship between bacteria and dental care and adopt prophylaxis and preventive measures necessary to reduce the incidence of this pathology. For this, an integrative literature search was developed, using the PubMed database. This research was submitted to inclusion and exclusion criteria, in which only studies that addressed both endocarditis and the situations of use of prophylaxis in dental care were included. The articles were selected first by their titles, then by reading the abstracts and, finally, by the full article. Of these, 53 articles were selected because they are the most related to the theme. It is verified that the current guidelines to prevent endocarditis are simpler and more objective than initially proposed. However, it seems that the goal is to reduce or eliminate the use of prophylaxis in dental procedures.
Bacterial endocarditis (EB) is the infection of one or more heart valves, native or prosthetic, more rarely of the parietal endocardium, by a microorganism, most often bacteria, intracellular germs or yeasts. The incidence of this pathology remains very high, despite scientific and medical progress, particularly in terms of antibiotic therapy and asepsis, with a mortality rate of about 25%. The oral sphere is the main and predominant gateway of microorganisms that can provoke bacterial endocarditis. There are several dental procedures that allow the entry of bacteria into the bloodstream, called bacteriemias. In most instances, healthy individuals hold body defences able to control this process. However, there are predisposing conditions, such as the presence of valvular heart diseases that can lead to systemic complications, e.g. bacterial endocarditis. This narrative review aims to understand the relationship between bacteria and dental care and adopt prophylaxis and preventive measures necessary to reduce the incidence of this pathology. For this, an integrative literature search was developed, using the PubMed database. This research was submitted to inclusion and exclusion criteria, in which only studies that addressed both endocarditis and the situations of use of prophylaxis in dental care were included. The articles were selected first by their titles, then by reading the abstracts and, finally, by the full article. Of these, 53 articles were selected because they are the most related to the theme. It is verified that the current guidelines to prevent endocarditis are simpler and more objective than initially proposed. However, it seems that the goal is to reduce or eliminate the use of prophylaxis in dental procedures.
Description
Keywords
Endocardite bacteriana Profilaxia Medidas preventivas Bacteriemia Antibioprofilaxia Cirurgia oral Paciente de risco Bacterial endocarditis Prophylaxis Preventive measures Bacteremia Antibioprophylaxis Oral surgery Patient at risk