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Following in Real Time the Impact of Pneumococcal Virulence Factors in an Acute Mouse Pneumonia Model Using Bioluminescent Bacteria

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Stroke-associated pneumonia: major advances and obstacles.

Yousef Hannawi¹, Bashar Hannawi, Chethan P Venkatasubba Rao

¹Department of Neurology, Baylor College of Medicine, Houston, TX, USA. yousefhannawi @ yahoo.com

Cerebrovascular Diseases (Basel, Switzerland)

|June 6, 2013

Summary

Stroke-associated pneumonia (SAP) is a significant complication after acute ischemic stroke, particularly in intensive care units (ICUs). Further research is needed to clarify its incidence and prognosis in these critical care settings.

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Published on: September 21, 2019

Area of Science:

Neurology
Critical Care Medicine
Infectious Diseases

Background:

Stroke-associated pneumonia (SAP) significantly increases morbidity, mortality, and healthcare costs following acute ischemic stroke.
The annual hospitalization cost for SAP in the US is approximately $459 million.
The incidence and prognosis of SAP specifically within intensive care unit (ICU) populations remain under-investigated.

Purpose of the Study:

To review the pathophysiology, microbiology, incidence, risk factors, outcomes, and prophylaxis of SAP.
To focus on studies conducted in intensive care units (ICUs).

Main Methods:

A comprehensive literature search was conducted on PubMed using terms 'pneumonia', 'neurology intensive unit', 'stroke', and 'pneumonia'.
Studies were excluded if they were non-English, case reports, or focused on chronic SAP.
Research articles were categorized based on their study setting: NICUs, MICUs, stroke units, mixed settings, or rehabilitation.

Main Results:

SAP incidence varied widely across settings: NICUs (4.1-56.6%), MICUs (17-50%), stroke units (3.9-44%), mixed studies (3.9-23.8%), and rehabilitation (3.2-11%).
Higher SAP incidence in ICUs is linked to mechanical ventilation, stroke severity, aspiration, and stroke-induced immunosuppression.
SAP was associated with increased short-term mortality (10.1-37.3% in mixed/stroke units) and worse functional outcomes, though mortality consistency varied in ICU studies due to heterogeneity and confounding factors.

Conclusions:

A unified definition and strict inclusion criteria are necessary for future prospective studies on SAP.
Long-term follow-up is crucial for accurately determining SAP incidence and prognosis, especially in ICU patients.
Standardized research approaches will improve understanding of SAP's impact and management in critical care.