Abstract

Purpose: To identify the pathogens that frequently cause infection and to explore their clinical features in acute stroke patients. Methods: From June 1, 1999 to December 31, 2008, we reviewed medical records of 263 patients with acute stroke and 351 controls. Within 30 days from admission, 109 and 107 patients had one or more bacterial cultures, respectively. The cumulative bacteria-free probability of all patients and the incidence of each isolated pathogen were assessed. We searched for the factors associated with isolation of different Gram-negative bacilli (GNB). Results: Patients with recent stroke were prone to healthcare-associated colonization within 2 weeks from admission. One-fourth of stroke patients had positive bacterial culture. Stroke patients had a high incidence of Staphylococcus aureus and various GNB in their sputum. When urinary tract infections (UTIs) began 9 days or more after admission, the contributory pathogens were most often glucose-nonfermenting bacilli. However, if UTIs occurred within 9 days after admission, the pathogens were likely to be Enterobacteriaceae bacilli. Conclusions: Stroke patients had high incidence of pathogenic bacteria in their sputum which might be prone to pneumonia. The time after admission of the onset of UTI is useful information for predicting contributory pathogens and planning for appropriate treatment. Implications for Rehabilitation Special care should be taken for reducing healthcare-associated pathogenic colonization within the first 2 weeks of hospitalization after stroke. Good oral hygiene to decrease the colonization of Staphylococcus aureus and various Gram-negative bacilli in sputum is important for pneumonia prevention in stroke patients. Stroke patients suspected of having urinary tract infections 9 days or more after admission are likely infected with glucose-nonfermenting bacilli, whereas many isolates from the earlier cultures are Enterobacteriaceae bacilli. Accordingly, physicians can start empirical treatment early.

Original languageEnglish
Pages (from-to)662-667
Number of pages6
JournalDisability and Rehabilitation
Volume35
Issue number8
DOIs
Publication statusPublished - Apr 2013

Fingerprint

Stroke
Bacillus
Urinary Tract Infections
Sputum
Enterobacteriaceae
Staphylococcus aureus
Incidence
Pneumonia
Bacteria
Delivery of Health Care
Glucose
Oral Hygiene
Medical Records
Hospitalization
Rehabilitation
Physicians
Therapeutics
Infection

Keywords

  • Bacteria
  • Pneumonia
  • Stroke
  • Urinary tract infections

ASJC Scopus subject areas

  • Rehabilitation

Cite this

Pathogen colonization in patients with acute cerebral stroke. / Chang, Kwang Hwa; Liou, Tsan Hon; Chen, Chin I.; Wu, Chien Hua; Hsu, Wen Yen; Ou, Tsong Yih.

In: Disability and Rehabilitation, Vol. 35, No. 8, 04.2013, p. 662-667.

Research output: Contribution to journalArticle

Chang, Kwang Hwa ; Liou, Tsan Hon ; Chen, Chin I. ; Wu, Chien Hua ; Hsu, Wen Yen ; Ou, Tsong Yih. / Pathogen colonization in patients with acute cerebral stroke. In: Disability and Rehabilitation. 2013 ; Vol. 35, No. 8. pp. 662-667.
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AU - Chen, Chin I.

AU - Wu, Chien Hua

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AU - Ou, Tsong Yih

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N2 - Purpose: To identify the pathogens that frequently cause infection and to explore their clinical features in acute stroke patients. Methods: From June 1, 1999 to December 31, 2008, we reviewed medical records of 263 patients with acute stroke and 351 controls. Within 30 days from admission, 109 and 107 patients had one or more bacterial cultures, respectively. The cumulative bacteria-free probability of all patients and the incidence of each isolated pathogen were assessed. We searched for the factors associated with isolation of different Gram-negative bacilli (GNB). Results: Patients with recent stroke were prone to healthcare-associated colonization within 2 weeks from admission. One-fourth of stroke patients had positive bacterial culture. Stroke patients had a high incidence of Staphylococcus aureus and various GNB in their sputum. When urinary tract infections (UTIs) began 9 days or more after admission, the contributory pathogens were most often glucose-nonfermenting bacilli. However, if UTIs occurred within 9 days after admission, the pathogens were likely to be Enterobacteriaceae bacilli. Conclusions: Stroke patients had high incidence of pathogenic bacteria in their sputum which might be prone to pneumonia. The time after admission of the onset of UTI is useful information for predicting contributory pathogens and planning for appropriate treatment. Implications for Rehabilitation Special care should be taken for reducing healthcare-associated pathogenic colonization within the first 2 weeks of hospitalization after stroke. Good oral hygiene to decrease the colonization of Staphylococcus aureus and various Gram-negative bacilli in sputum is important for pneumonia prevention in stroke patients. Stroke patients suspected of having urinary tract infections 9 days or more after admission are likely infected with glucose-nonfermenting bacilli, whereas many isolates from the earlier cultures are Enterobacteriaceae bacilli. Accordingly, physicians can start empirical treatment early.

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