How does urinary tract infection affect the prognosis middle cerebral artery (MCA) stroke?

Updated: Aug 09, 2021
  • Author: Daniel I Slater, MD; Chief Editor: Stephen Kishner, MD, MHA  more...
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Because acute stroke patients are entering rehabilitation programs earlier than ever before, it is important to understand the impact of urinary tract infections on this specific population. Patients with a diagnosis of acute stroke are more than twice as likely to develop urinary tract infections as other hospitalized patients, regardless of the use of urinary catheters. [53]

Urinary tract infections in poststroke patients also independently predict poor outcomes, including death, prolonged hospitalization, and poorer neurological outcomes. [54] Acute stroke patients with hospital-acquired symptomatic urinary tract infections are less likely to be discharged home. [55] Additionally, acute stroke patients with symptomatic urinary tract infections are more likely to perform at a lower functional level while participating in an acute inpatient rehabilitation program.

A Cochrane summary completed in 2013 found some evidence, albeit limited, for the benefit of prophylactic antibiotics in nonsurgical patients who undergo bladder drainage. [56] More research is clearly needed to evaluate the potential benefit to stroke patients with urinary incontinence and/or neurogenic retention in the acute and postacute setting.

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