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Bacterial stroke-associated pneumonia: microbiological analysis and mortality outcome
Alshaimaa M Aboulfotooh1, Heba Sherif Abdel Aziz2, Marwa M Zein3
1Department of Neurology, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt.
Stroke-associated pneumonia (SAP) affects one-third of acute ischemic stroke patients, increasing mortality. Key predictors include bulbar dysfunction, mechanical ventilation, and prior TIA/stroke history.
Area of Science:
- Neurology
- Infectious Diseases
- Critical Care Medicine
Background:
- Stroke-associated pneumonia (SAP) presents a significant healthcare burden.
- Identifying SAP predictors in acute ischemic stroke (AIS) patients is crucial for management.
Purpose of the Study:
- To determine predictors of SAP development in AIS patients.
- To investigate microbiological causes and 30-day mortality impact of SAP.
Main Methods:
- Retrospective cohort study of AIS patients admitted to Manial Specialized Hospital Stroke Unit (February 2021 - August 2023).
- Patients were categorized into SAP and non-SAP groups.
- Clinical data and microbiological results were analyzed.
Main Results:
- 32.4% of 522 AIS patients developed SAP.
- Klebsiella pneumoniae (40.2%) and Pseudomonas aeruginosa (20.7%) were common pathogens.
- Bulbar dysfunction (OR=200.46), mechanical ventilation (OR=4.88), and prior TIA/stroke (OR=3.01) independently predicted SAP.
- All 11 deaths occurred in the SAP group (P < 0.001).
Conclusions:
- SAP significantly increases mortality in AIS patients.
- Bulbar dysfunction, mechanical ventilation, and prior TIA/stroke are key SAP predictors.
- Targeted attention to high-risk patients is essential to reduce SAP-related mortality.
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