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Bacterial signature in retrieved thrombi of patients with acute ischemic stroke-a systematic review
Armin Zarrintan1,2, Sherief Ghozy3,2, Kasthuri Thirupathi2
1Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55902, USA.
Background:
Acute ischemic stroke (AIS) imposes a major healthcare burden. It is hypothesized that bacterial infection could influence atherosclerosis and thrombus formation, potentially contributing to AIS.
Objectives:
We aim to systematically review all studies that have investigated the presence of bacterial signatures within thrombi retrieved following mechanical thrombectomy (MT) procedures in patients with AIS.
Design:
This systematic review is designed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 checklist.
Data Sources And Methods:
A comprehensive search was conducted in the Web of Sciences, PubMed, Scopus, and Embase databases to identify relevant studies.
Results:
The literature search and screening included 11 studies involving 674 patients, with 414 (61.4%) being male and 260 (38.6%) females. Among all the patients, 393 (58.3%) were positive for bacterial presence in their retrieved thrombi. The most utilized technique for bacterial signature detection was bacterial DNA extraction followed by polymerase chain reaction amplification of the 16S rRNA gene sequence. Staphylococcus aureus was the most studied bacteria among the studies analyzed.
Conclusion:
Bacterial infections and the presence of bacteria within thrombi may significantly contribute to AIS by initiating or exacerbating atherosclerosis or thrombosis. Understanding the mechanisms by which bacteria affect vascular health is crucial for developing effective preventive and therapeutic strategies for stroke patients.
Insights
Bacterial presence in thrombi is common in acute ischemic stroke (AIS) patients undergoing mechanical thrombectomy (MT). This systematic review highlights bacteria
Area of Science:
- Neurology
- Microbiology
- Cardiovascular Research
Background:
- Acute ischemic stroke (AIS) presents a significant global health challenge.
- Bacterial infections are hypothesized to play a role in atherosclerosis and thrombus formation, contributing to AIS.
- Investigating bacterial presence in AIS thrombi is crucial for understanding stroke pathogenesis.
Purpose of the Study:
- To systematically review studies on bacterial signatures in thrombi from AIS patients treated with mechanical thrombectomy (MT).
- To synthesize current evidence on the prevalence and detection methods of bacteria in AIS-related thrombi.
Main Methods:
- Systematic literature search across major databases (Web of Science, PubMed, Scopus, Embase).
- Adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines.
- Analysis of 11 studies involving 674 AIS patients undergoing MT.
Main Results:
- Bacterial DNA was detected in the thrombi of 58.3% of analyzed AIS patients.
- Bacterial DNA extraction and 16S rRNA gene sequencing via PCR were the primary detection methods.
- Staphylococcus aureus was the most frequently identified bacterium across the included studies.
Conclusions:
- Bacterial presence within thrombi may significantly contribute to AIS pathogenesis, potentially by promoting atherosclerosis and thrombosis.
- Further research into the mechanisms of bacterial involvement in vascular health is essential for developing novel stroke prevention and treatment strategies.
