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Meta-Analysis
. 2024 Dec 18;24(1):479.
doi: 10.1186/s12883-024-03968-7.

A systematic review and meta-analysis show a decreasing prevalence of post-stroke infections

Aaron Awere-Duodu  1 , Samuel Darkwah  1 , Abdul-Halim Osman  1 , Eric S Donkor  2
Affiliations
Meta-Analysis

A systematic review and meta-analysis show a decreasing prevalence of post-stroke infections

Aaron Awere-Duodu et al. BMC Neurol. .

Abstract

Background: Infection is a common complication in the acute phase after stroke; a systematic review in 2011 reported a post-stroke infection prevalence of 30%. Despite the plethora of primary data on post-stroke infections in recent times, a systematic review that synthesizes the data to provide comprehensive information to guide preventive, control, and management efforts is yet to be undertaken. This systematic review, therefore, aimed at bridging this gap by describing the epidemiology of post-stroke infections including the global prevalence and the associated mortality rates.

Methodology: A comprehensive search was conducted in PubMed, SCOPUS, and Web of Science resulting in 2210 studies, of which 73 studies covering 32,109,574 stoke patients were included in the systematic review. Prevalence data on defined post-stroke infections were extracted for analysis in RStudio version 4.3.3.

Results: The pooled prevalence of post-stroke infections and mortality rates were 9.14% and 15.91% respectively. The prevalence of post-stroke infections was highest for pneumonia (12.4%), followed by urinary tract infection (8.31%). Geographically, the prevalence of post-stroke infections for the various continents were Europe (10.41%), Africa (10.22%), South America (8.83%), North America (8.15%), Asia (8.09%), and Australia (7.88%). Common etiological agents of post-stroke infections included multidrug-resistant organisms particularly, Carbapenem-resistant Klebsiella pneumoniae (15.4-31.8%), Methicillin-resistant Staphylococcus aureus (9.8-15.4%), and Carbapenem-resistant Acinetobacter baumannii (38.5%).

Conclusion: This systematic review indicates about a 3-fold decline in the global prevalence of post-stroke infections in the last decade. Pneumonia is the most common post-stroke infection. Europe and Africa have the highest prevalence of post-stroke infections.

Keywords: BSI; Epidemiology; Pneumonia; Post-stroke infections; Sepsis; UTI.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study required no ethical approval or consent from patients. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flowchart of study selection process
Fig. 2
Fig. 2
Global prevalence of post-stroke infections
Fig. 3
Fig. 3
Prevalence of post-stroke infections according to type of strokes
Fig. 4
Fig. 4
Mortality rate of post-stroke infections
See this image and copyright information in PMC

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