Risk factors for urinary tract infection and asymptomatic bacteriuria after stroke in patients with indwelling urinary catheter

[V. S. Janković]

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Urinarne infekcije javljaju se kod približno 19% pacijenata nakon moždanog udara. Dokazano je da urinarne infekcije nepovoljno utiču na kratkoročni i dugoročni ishod moždanog udara, produžavaju hospitalizaciju i povećavaju troškove lečenja. Cilj ove studije bio je da se utvrde faktori rizika za nastanak urinarne infekcije i asimptomatske bakteriurije. Ova retrospektivna studija tipa slučaj-kontrola sprovedena je u neurološkoj jedinici intenzivne nege, u tercijarnoj zdravstvenoj ustanovi, u periodu od jula 2018. do jula 2022. godine. Naše istraživanje je pokazalo da su stariji pacijenti, sa težim neurološkim statusom prilikom prijema, bili u većem riziku za nastanak urinarne infekcije. Ovaj faktor je takođe predisponirao pojavu asimptomatske bakteriurije. Pacijenti koji su primali ceftriakson i fluorohinolone imali su manji rizik za razvoj urinarne infekcije, dok je primena karbapenema i vankomicina mogla da potencira nastanak urinarne infekcije. Na osnovu ovih rezultata moguće je identifikovati pacijente koji su u većem riziku od razvoja urinarne infekcije i preduzeti mere prevencije, kao što su skraćenje trajanja kateterizacije ili češća zamena urinarnog katetera. Rezultati takođe omogućavaju identifikaciju pacijenata koji su u većem riziku od razvoja asimptomatske bakteriurije.

Urinary tract infections occur in approximately 19% of stroke patients. Urinary tract infections are proven to adversely affect the short-term and long-term outcomes of stroke, prolong hospitalization, and increase treatment costs. This study aimed to determine the risk factors for the occurrence of urinary tract infection and asymptomatic bacteriuria. This retrospective case-control study was conducted in the neurological intensive care unit, in a tertiary healthcare facility, from July 2018 to July 2022. Our study demonstrated that older patients with worse neurological status upon admission, were at a higher risk for the occurrence of urinary tract infection. This factor also predisposed the occurrence of asymptomatic bacteriuria. The patients who received ceftriaxone and fluoroquinolone were at a lower risk of developing a urinary tract infection, while carbapenem and vancomycin administration could potentiate the occurrence of a urinary tract infection. Based on these results, we can identify the patients who are at a higher risk of developing a urinary tract infection and take measures to prevent infection, such as decreasing the duration of catheterization or replacing the urinary catheter more frequently. The results also enable us to identify the patients who are at a higher risk of developing asymptomatic bacteriuria.

infekcije urinarnog trakta, asimptomatska bakteriurija, komlikacije moždanog udara, faktori rizika za nastanak urinarne infekcije

urinary tract infections, asymptomatic bacteriuria, stroke complications, risk factors for the occurrence of urinary tract infection

616.8

Neurologija

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