Stroke Associated Infection: A Prospective Hospital-Based Study at Tertiary Care Institution of North India

BACKGROUND: Immune dysfunction is increasingly recognized to be contributing to stroke associated infections. OBJECTIVE: The present study was aimed to study the magnitude of the stroke associated infection in a mixed population of hemorrhagic and ischemic strokes and its predisposing f actors. MATERIAL &METHODS: The study population consisted of 173 consecutive stroke admissions at SKIMS Srinagar, a tertiary core hospital. The patients developing fever at admission or in hospital were included and underwent neuroimaging and workup for the source of infection. The follow up was done upto death or discharg e of the patient. A univariate and binary logistic regression analysis was done to find the patient characteristics associated with infection. RESULTS: The stroke subtypes in the study were 60.1% hemorrhagic and 39.9% ischemic strokes. The majority of hemorrhagic strokes (65A%) were located in putamina while as anterior circulation territory contributed about 80% of the ischemic strokes. Fifty eight (33.5%) patients developed stroke associated infection. Chest was the source of infection in 58.6% of the cases. The culture positivity rate was poor (18.9%) in the patient study. The presence of a comorbid illness {OR 3.4), volume of hematoma (OR 4,7). and ventricular extension  of the hemorrhoge (OR 4.9) significantly increased the odds ratio of stroke associated infection. CONCLUSIONS: The frequency of post stroke infection is around 33%, chest being the commonest source. Presence of a comorbid illness, volume of hemorrhage a nd ventricular extension increase the risk of infection . JMS 2012; 15(1):22-27