Eric S Donkor
University of Ghana
Title: Urinary tract infections after stroke: A longitudinal study among stroke outpatients and inpatients at the Korle-Bu Teaching Hospital in Ghana
Biography
Biography: Eric S Donkor
Abstract
Background: In Africa, little is known about urinary tract infection (UTI) in relation to stroke patients. The aim of the study was to investigate the epidemiology of UTI among stroke patients at the Korle-Bu Teaching Hospital (KBTH) in Ghana.
Methods: 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 analyzed every week or two for 6 months. Information on demographics and clinical history of the study participants were extracted from their clinical records.
Results: Prevalence of UTI among stroke outpatients and inpatients were 10.9% (6/55) and 18.8% (3/16), respectively (p=0.411). Incidence of UTI among stroke outpatients and inpatients were 1.8% (1/55) and 6.3% (1/16), respectively (p=0.125). Overall, 11% (1/9) of the UTI cases among the stroke patients were symptomatic. Severe stroke (OR=17.7, p=0.008) and pyuria (OR=38.7, p=0.002) were identified as predictors of UTI. Escherichia coli was the most common organism implicated in UTI and was susceptible to amikacin, but resistant to augmentin, ampicillin, cefuroxime, co-trimoxazole, meropenem, norfloxacin and tetracycline.
Conclusion: UTI is a common complication among both stroke inpatients and outpatients, though it appears to be more common among the former. Stroke severity appears to be the main stroke related determinant of UTI among stroke patients. UTI among stroke patients is mainly asymptomatic and E. coli is the most important aetiological agent.