Abstract:
BACKGROUND
Infections are known to be a major complication of stroke patients. The relationship between stroke and bacteriuria has rarely been studied in sub-Saharan Africa, though this information could be relevant in the management of stroke in the sub-region.
AIM :The aim of the study was to investigate the epidemiology of post stroke bacteriuria at the Korle-Bu Teaching Hospital including the prevalence, incidence, risk factors and causative organisms.
METHODS :This was a longitudinal study involving 55 stroke out-patients and 16 in-patients recruited at the Korle-Bu Teaching Hospital. Stroke out-patients were followed up at the Physiotherapy Clinic of the hospital weekly for three months and urine specimens were collected on each occasion for analysis. Urine specimens were collected from the stroke in-patients daily during admission until discharged from the hospital ward. Demographic and clinical information were also collected from all the study subjects.
RESULTS :Stroke in-patients had a higher prevalence of bacteriuria (18.8%) than stroke out-patients (10.9%) with a relative risk of 1.72 (p=0.411). Similarly, stroke in-patients had a higher incidence of bacteriuria (6.3%) than stroke out-patients (1.8%) with a relative risk of 3.5 (p=0.125). Three risk factors of bacteriuria and UTI were identified among the stroke patients and included stroke severity (p<0.001), diabetes (p<0.001) and pyuria (p=0.09). Nine bacteria organisms were identified from the urine cultures of the stroke patients but the most common was Escherichia coli (33.3%). All the Escherichia coli isolates were susceptible to chloramphenicol and amikacin, with the highest resistance observed with cotrimoxazole, ampicillin, norfloxacin and cefuroxime.
CONCLUSION :The incidence of bacteriuria observed at Korle-Bu Teaching Hospital was low among both stroke out-patients and in-patients, though the prevalence was quite high. Escherichia coli is the main cause of bacteriuria among the stroke patients at this hospital and the infection could be managed with chloramphenicol and amikacin. The study identified several risk factors of post stroke bacteriuria such as stroke severity and diabetes which is useful in the prevention and management of bacteriuria.
