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Pathogen colonization in patients with acute cerebral stroke.
Kwang-Hwa Chang1, Tsan-Hon Liou, Chin-I Chen
1Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
Disability and Rehabilitation
|August 21, 2012
Summary
Acute stroke patients frequently develop bacterial infections, particularly Staphylococcus aureus and Gram-negative bacilli (GNB). Understanding infection timing aids in predicting pathogens and guiding treatment for stroke-associated infections.
Area of Science:
- Infectious Diseases
- Neurology
- Critical Care Medicine
Background:
- Stroke patients are susceptible to healthcare-associated infections.
- Bacterial colonization is common in acute stroke patients, increasing infection risk.
- Identifying common pathogens is crucial for effective management.
Purpose of the Study:
- To identify frequently occurring pathogens in acute stroke patients.
- To investigate the clinical features and risk factors associated with these infections.
- To determine the temporal patterns of pathogen isolation.
Main Methods:
- Retrospective review of medical records for 263 acute stroke patients and 351 controls (1999-2008).
- Analysis of bacterial cultures obtained within 30 days of admission.
- Assessment of cumulative bacteria-free probability and incidence of isolated pathogens, including Gram-negative bacilli (GNB).
Main Results:
- One-fourth of stroke patients exhibited positive bacterial cultures.
- High incidence of Staphylococcus aureus and various GNB detected in sputum.
- Urinary tract infections (UTIs) occurring >9 days post-admission were linked to glucose-nonfermenting bacilli, while earlier UTIs (<9 days) were associated with Enterobacteriaceae.
Conclusions:
- Stroke patients have a high incidence of pathogenic bacteria in sputum, increasing pneumonia risk.
- The timing of urinary tract infection onset post-admission is critical for predicting causative pathogens.
- This information aids in planning targeted antimicrobial therapy for stroke patients.
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