Oral microbiomes of patients with infective endocarditis (IE): a comparative pilot study of IE patients, patients at risk for IE and healthy controls

ABSTRACT

Background

Infective endocarditis (IE) is an uncommon disease with high morbidity and mortality rates, which often develops from oral bacterial species entering circulation.

Objective

We compared oral microbiome profiles of three groups: IE patients (N  9 patients; n = 27 samples), disease controls at risk for IE (N = 28; n = 84), and healthy controls (N = 37; n = 111). Bacterial species in IE patients’ blood cultures were identified for comparison with matched oral samples.

Design

Oral microbiome profiles were obtained from buccal mucosa, saliva, and tongue samples for all three groups and from sub- and supra-gingival plaque samples of the IE group (N = 9; n = 16) and disease controls (N = 28; n = 54). Alpha- and beta-diversities were determined based on relative abundance data. Discriminative species were identified by LEfSe, post hoc Mann-Whitney, and ROC analyses. Identity of the bacterial species in IE patients’ blood cultures was confirmed by 16S-rRNA gene Sanger sequencing.

Results

Alpha- and beta-diversities differed between groups. Discriminative IE-associated species were identified, e.g. Haemophilus parainfluenzae and Streptococcus sanguinis. Two blood isolates were Staphylococcus aureus, also identified in one matched saliva sample. Streptococcus mutans was present in one patient’s plaque samples and blood culture.

Conclusions

Oral microbiomes of IE, non-IE disease controls, and healthy controls differed significantly. A better understanding of IE-related bacterial-host interactions is warranted.

KEYWORDS:

• Infective endocarditis
• oral microbiome
• next-generation sequencing
• blood culture
• bacterial species

Acknowlegements

This study was funded by the NIDCR grant R01 DE023375-01A1 and Atrium Health Research Fund. We thank clinical and laboratory staff in Department of Oral Medicine and Sanger Heart & Vascular Institute for subjects’ clinical data and samples collection and handling.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authors’ contributions

Conceptualization: F. Bahrani Mougeot, P. B. Lockhart, J.-L. C. Mougeot, B.J. Paster.

Manuscript preparation: J-L. C. Mougeot, F. Bahrani Mougeot, M. F. Beckman, P. B. Lockhart. Data analysis: J-L. C. Mougeot, M. F. Beckman.

All authors read and approved the final submitted version of the manuscript.

Data availablity statement

All data are available via the Translational Research Lab Github repository (https://github.com/mbeckm01/IE_Project)

Ethics approval

This study was approved by Atrium Health IRB # 00019606.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/20002297.2022.2144614

Additional information

Funding

This study was supported by NIDCR 1R01DE023375-01A1 and the Atrium Health Research fund.