Therapeutics and Clinical Risk Management (Mar 2016)
Post-stroke bacteriuria among stroke patients attending a physiotherapy clinic in Ghana: a cross-sectional study
Abstract
Eric S Donkor,1,5 Amos Akumwena,1 Philip K Amoo,2 Mayowa O Owolabi,3 Thor Aspelund,4,5 Vilmundur Gudnason4,5 1Department of Medical Microbiology, College of Health Sciences, University of Ghana, Accra, Ghana; 2Public Health Unit, Korle-Bu Teaching Hospital, Accra, Ghana; 3Department of Medicine, University College Hospital, University of Ibadan, Ibadan, Nigeria; 4Icelandic Heart Association Research Institute, Kopavogur, Iceland; 5Centre for Public Health Sciences, University of Iceland, Reykjavik, Iceland Background: Infections are known to be a major complication of stroke patients. In this study, we evaluated the risk of community-acquired bacteriuria among stroke patients, the associated factors, and the causative organisms.Methods: This was a cross-sectional study involving 70 stroke patients and 83 age- and sex-matched, apparently healthy controls. Urine specimens were collected from all the study subjects and were analyzed by standard microbiological methods. Demographic and clinical information was also collected from the study subjects. For stroke patients, the information collected also included stroke parameters, such as stroke duration, frequency, and subtype.Results: Bacteriuria was significantly higher among stroke patients (24.3%, n=17) than among the control group (7.2%, n=6), with a relative risk of 3.36 (confidence interval [CI], 1.40–8.01, P=0.006). Among the control group, all six bacteriuria cases were asymptomatic, whereas the 17 stroke bacteriuria cases comprised 15 cases of asymptomatic bacteriuria and two cases of symptomatic bacteriuria. Female sex (OR, 3.40; CI, 1.12–10.30; P=0.03) and presence of stroke (OR, 0.24; CI, 0.08–0.70; P=0.009) were significantly associated with bacteriuria. The etiology of bacteriuria was similar in both study groups, and coagulase-negative Staphylococcus spp. were the most predominant organisms isolated from both stroke patients (12.9%) and the control group (2.4%).Conclusion: Stroke patients in the study region have a significantly higher risk of community-acquired bacteriuria, which in most cases is asymptomatic. Community-acquired bacteriuria in stroke patients appears to have little or no relationship with clinical parameters of stroke such as stroke subtype, duration and frequency. Keywords: stroke-related bacteriuria, asymptomatic, urinary tract infections, hypertension, coagulase-negative staphylococci, urine
