Dental Plaque Streptococci and Their Amoxicillin Resistance in Children with Congenital Heart Anomalies: Results of a Prospective Study

Aida Rexhepi, Raimonda Niko, Agim Begzati, Mergime Prekazi Loxha, Vjosa Krasniqi, Zana Agani, Blerta Xhemajli, Teuta Kutllovci, Urata Tahiri

Department of Maxillofacial Surgery, Clinical University Center of Kosova, Prishtina, Kosova.
Department of Oral Surgery, Clinical University Center of Kosova, Prishtina, Kosova.
Department of Pediatric Dentistry, Clinical University Center of Kosova, Prishtina, Kosova.
Pediatric Clinic, Faculty of Medicine, University of Tirana, Tirana, Albania.

DOI: 10.4236/ojst.2014.47048                

Abstract

Children with congenital heart diseases (CHD) are considered to be at higher risk of development of a Bacterial Endocarditic (BE) from infectious diseases of the oral cavity and following dental treatments. They represent the largest group of patients with special medical needs who appear in the daily dental practice. Maintenance of oral health and oral hygiene is suitable to reduce the incidence of bacteremia. Oral hygiene is more important in reducing the risk of BE than the administration of antibiotic-prophylaxis before dental procedures. The purpose of this study was to identify the strains of streptococci viridians group from dental plaque and their amoxicillin resistance at children with congenital heart disease. The study was carried out in University Dentistry Clinical Center of Kosova, Department of Pediatric Dentistry in cooperation with the Micro-biologic Department. Participants in this study (n = 90) were children between 6 - 15 years old, divided in the control group of healthy children (n = 30), and two study groups, first group, children with CHD who have not taken antibiotics within last three months (n = 30) and second group, children with CHD who have taken antibiotics within three months (n = 30). The gram positive cocci were identified using the automated system, VITEK 2 (BioMerux), while for determining amoxicillin resistance cocci the disc diffusion method was used. By analyzing the three groups of children regarding isolated dental plaque streptococci, in general the Viridans group of streptococci (VGS) has dominated our results, with a higher percentage of streptococcus Mitis group (37.2%). The highest resistance of VGS against amoxicilin was in the group of children with CHD, which have been using antibiotics within 3 months (23.3%). In the other two groups the resistance against amoxicillin was found in a lower percentage (3.3%). Based on the results of our study we can conclude that frequent use of amoxicillin may result in an increasing antimicrobial resistance of streptococci.

Keywords

Congenital Heart Anomalies, Bacterial Endocarditis, Dental Bacterial Plaque, Bakteremia, Streptococci, Antibiotics

Conflicts of Interest

The authors declare no conflicts of interest.

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