Post-stroke Urinary Tract Infections and Their Outcome: A Clinico-microbiological and Epidemiological Analysis based on A Stroke Registry
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Background
Urinary tract infections (UTIs) are common among hospitalized stroke patients, leading to increased hospital stays and patient discomfort. While it’s known that post-stroke infections generally worsen outcomes, specific factors contributing to UTIs after stroke remain unclear.
Methods
This study aimed to investigate the incidence of post-stroke UTI (PSUTI) in patients admitted to the Hospitals from September 2020 to June 2021. The study included patients with a suspected diagnosis of stroke at the time of initial visit by a specialist. The final diagnosis was approved by an experienced neurologist and radiologist according to their brain CT scan. Data was collected from patients’ files, including demographics, comorbidities, drug history, smoking history, admission unit, clinical manifestations, systolic and diastolic blood pressure, type of stroke, etiology, laboratory findings, admission unit, in-hospital stay duration, therapies, use of NG tubes, urinary catheters, CV lines, brain drain, intratracheal tube, chest tube, dialysis catheter, and their durations.
Results
A study involving 612 patients found that PSUTI-positive patients had worse conditions at admission, with ischemic stroke being more common. They had longer stays in the ward or ICU, and were more likely to have a death outcome. The most common pathogen was Escherichia coli, followed by Staphylococcus epidermidis, Enterococcus spp, and Pseudomonas aeruginosa. In-hospital complications were more prevalent in PSUTI-positive patients, except for hydrocephalus and pulmonary embolism. Positive history of diabetes, falling symptoms, urinary catheter, and intubation were independent risk factors for post-stroke UTI.
Conclusion
The study highlights the impact of urinary tract infections (UTIs) on stroke outcomes, revealing severe clinical profiles, comorbidities, longer hospital stays, and increased invasive interventions. Key risk factors like diabetes and urinary catheter use highlight the need for vigilant monitoring and tailored management strategies.
