Pathogenic organism and risk factors of infection after acute ischemic stroke during the COVID-19 pandemic

Abstract

This study aims to determine the pathogen organisms’ profile and risk factors for infection after acute ischemic stroke (AIS) during the COVID-19 pandemic because of few studies. We conducted a retrospective cross-sectional study using the medical records of AIS inpatients at the National Brain Center Hospital Prof. Dr. dr. Mahar Mardjono, Jakarta, Indonesia, from 2020-2021. We found the species of pathogen organisms based on the positive growth of microbiological cultures of various specimens. Among 479 AIS patients, the infection prevalence was 12.3%. This study found the common pathogenic organisms were Gram-negative bacteria, and there were drug-resistant strains in <i>S. aureus, S. epidermidis, K. pneumoniae,</i> and <i>E. coli. </i>The risk factors for infection in COVID-19-infected patients were pneumonia (OR 6.89, 95% CI 1.49-31.79, <i>p </i>= 0.013) and intensive care stay (OR 0.13, 95% CI 0.05-0.36, <i>p </i>< 0.001); meanwhile, in non-COVID-19 patients were HIV comorbidity (OR 1.55, 95% CI 1.18-2.06, <i>p </i>= 0.002), leukocytosis (OR 0.07, 95% CI 0.01-0.43, <i>p </i>= 0.004), use of CVC (OR 0.29, 95% CI 0.12-0.68, <i>p </i>= 0.005), use of steroids (OR 0.21, 95% CI 0.06-0.70, <i>p </i>= 0.011), and tracheostomy (OR 0.17, 95% CI 0.05-0.62, <i>p </i>= 0.007). To sum up, the growth of pathogenic organisms indicated that the prevalence of infections after AIS during the COVID-19 pandemic did not increase. The risk factor for infections depends on the characteristics of patients, whether they have COVID-19 or have not been infected.