Urinary tract infection and bacteriurua in stroke patients: frequencies, pathogen microorganisms, and risk factors

To investigate the frequencies, pathogen microorganisms involved, and possible risk factors of urinary tract infections, asymptomatic bacteriuria, and significant bacteriuria in subacute and chronic stroke patients. The frequencies were determined and compared for subgroups with respect to age, gender, level of education, type of lesion, side of lesion, bladder-emptying method, postvoid residual urine, ambulation-level class, and Brunnstrom recovery stage class of upper and lower extremities in 110 consecutive stroke patients. Frequencies were 27.3, 11.8, and 39.1% for urinary tract infections, asymptomatic bacteriuria, and significant bacteriuria, respectively. Bladder-emptying method (P < 0.05), presence of postvoid residual urine >50 ml (P < 0.04), and Brunnstrom recovery stage class of upper extremity (P < 0.02) were significant factors for the frequency of urinary tract infections. Bladder-emptying method, ambulation-level class, Brunnstrom recovery stage class of upper and lower extremities (P < 0.01), presence of postvoid residual urine >50 ml (P < 0.02), gender, and level of education (P < 0.05) were significant factors for the frequency of significant bacteriuria. Early treatment of urinary dysfunction for elimination of indwelling catheter use and high postvoid residue, early physical rehabilitation for better ambulation and hand function, patient education about prevention, and close monitoring of patients with unmodifiable risk factors may decrease the frequency of urinary tract infections and significant bacteriuria in stroke patients.