Donkor Eric S, Darkwah Samuel, Akpalu Albert
Department of Medical Microbiology, School of Biomedical and Allied Health Sciences University of Ghana, Accra, Ghana.
Department of Medicine, School of Medicine and Dentistry, University of Ghana, Accra, Ghana.
Med Sci (Basel). 2017 Jun 2;5(2):11. doi: 10.3390/medsci5020011.
Infections of the urinary tract constitute an important post-stroke complication but in Africa, little is known about such infections in relation to stroke patients. The aim of the study was to investigate the epidemiology of bacteriuria among stroke patients at the Korle-Bu Teaching Hospital (KBTH) in Ghana including the prevalence, incidence, risk factors and aetiological agents. This was a longitudinal study involving 55 outpatients and 16 inpatients of stroke from the physiotherapy clinic and stroke admission ward of KBTH respectively. Urine cultures for inpatient subjects were done each day until the patient was discharged. With outpatients, urine specimens were analysed every week or two for 6 months. Information on demographics and clinical history of the study participants were extracted from their clinical records. The results showed that the prevalence of bacteriuria among stroke outpatients and inpatients were 10.9% (6/55) and 18.8% (3/16) respectively ( = 0.411). Among both the outpatients and inpatients, there was one new case of bacteriuria each during the period of follow-up. Overall, 1/9 (11%) of the bacteriuria cases among the stroke patients was symptomatic. Severe stroke (OR = 17.7, = 0.008) and pyuria (OR = 38.7, = 0.002) were identified as predictors of bacteriuria. was the most common organism implicated in bacteriuria and was susceptible to amikacin, but resistant to augmentin, ampicillin, cefuroxime, cotrimoxazole, meropenem, norfloxacin and tetracycline. Overall, bacteriuria is a common complication among both stroke inpatients and outpatients at KBTH, though it appears to be more common among the former. Stroke severity appears to be the main stroke-related determinant of bacteriuria among stroke patients. Bacteriuria among stroke patients is mainly asymptomatic and is the most important aetiological agent.
尿路感染是中风后的一种重要并发症，但在非洲，对于中风患者的此类感染情况知之甚少。本研究的目的是调查加纳科勒-布教学医院（KBTH）中风患者的菌尿症流行病学，包括患病率、发病率、危险因素和病原体。这是一项纵向研究，分别纳入了KBTH物理治疗诊所和中风病房的55名门诊中风患者和16名住院中风患者。住院患者每天进行尿培养，直至出院。门诊患者每1至2周分析一次尿标本，持续6个月。从研究参与者的临床记录中提取人口统计学和临床病史信息。结果显示，中风门诊患者和住院患者的菌尿症患病率分别为10.9%（6/55）和18.8%（3/16）（P = 0.411）。在门诊患者和住院患者中，随访期间各有1例新的菌尿症病例。总体而言，中风患者中1/9（11%）的菌尿症病例有症状。严重中风（OR = 17.7，P = 0.008）和脓尿（OR = 38.7，P = 0.002）被确定为菌尿症的预测因素。大肠埃希菌是菌尿症中最常见的病原体，对阿米卡星敏感，但对奥格门汀、氨苄西林、头孢呋辛、复方新诺明、美罗培南、诺氟沙星和四环素耐药。总体而言，菌尿症是KBTH中风住院患者和门诊患者的常见并发症，尽管在前者中似乎更常见。中风严重程度似乎是中风患者菌尿症的主要中风相关决定因素。中风患者的菌尿症主要无症状，大肠埃希菌是最重要的病原体。
