Urinary tract infection after stroke: A narrative review

Abstract

Background: Urinary tract infection (UTI) is one of the most common infections seen in patients hospitalized for acute stroke, resulting in greater utilization of hospital resources in addition to patient discomfort. Although post-stroke infections (PSIs) are commonly referenced for interference with stroke recovery as well as associations with worse clinical outcome, factors associated specifically with UTI after stroke remain unclear.

Aim: To provide a comprehensive narrative synthesis covering literature published with results specific to the topic of UTI in stroke patients.

Methods: Literature review was performed searching the keywords "stroke" and "urinary tract infection" in Pubmed. All manuscripts published in English were appraised for information relevant to UTI in stroke patients. Applicable content was obtained, synthesized, and summarized.

Results: Post-stroke UTI is found to be associated with prolongation of hospital length of stay (LOS), discharge to a Care Home, and increased medical care costs. This process possibly reflects the consequences of greater stroke severity and clinical courses requiring urinary catheterization in hospitalized patients. However, UTI does not share an independent association with long-term clinical outcomes including morbidities and mortality.

Conclusions: A narrative review was performed, including the following topics: classifications and epidemiology, pathogenesis, clinical features, and future directions. The heterogeneous nature of reports on UTI in stroke patients remains as a major limitation in literature.

Keywords: Clinical features; Epidemiology; Pathophysiology; Post-stroke infection; Stroke; Urinary tract infection.