Diagnosis and treatment of stroke associated pneumonia: Qualitative exploration of clinicians’ practice

Zawiah, Mohammed; Khan, Amer Hayat; Farha, Rana Abu; Abubakar, Usman; Sha’aban, Abubakar; Hammour, Khawla Abu; Almuhsen, Zahraa

doi:10.29333/ejgm/12849

Cited by 3 publications

(4 citation statements)

References 31 publications

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“…13 Empirical antibiotic selection should be tailored to local microbial patterns and bacterial susceptibility to be more effective and less likely to induce bacterial resistance. 14,15 Resistance of pneumonia-causing bacteria to several antibiotics used in the first dosage reduce treatment effectiveness and increases morbidity and mortality. 14 However, data on microbiological etiology and drug susceptibility patterns of pneumonia are still being determined in Indonesia.…”

Section: Original Articlementioning

confidence: 99%

Antibiotic Susceptibility Patterns among Indonesian Adults Hospitalized with Pneumonia

Akhmad,

Ulfa,

Azuma

2024

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Introduction: Pneumonia continues to be a global issue with significant morbidity and mortality rates. Increased multidrug-resistant (MDR) bacterial pneumonia, aging populations, chronically ill patients, and inadequate initial antibiotic therapy increase hospitalized pneumonia patients' morbidity and mortality. This study aimed to analyze the microbiological pattern and choose a therapy based on local antibiotic susceptibility patterns. Methods: From January 2020 to December 2022, a retrospective cross-sectional study was conducted on hospitalized pneumonia patients at Haji General Hospital, Surabaya, Indonesia. Data from medical records were gathered to illustrate patient features, bacterial culture, and antimicrobial susceptibility tests. This study included 172 patients. In this study, no specific statistical analysis was performed. The data were reported as a percentage (%). Results: The patients were mostly 56-65 years old (36.6%) and male (55.2%). The most common comorbidities were cardiovascular disease (17.3%), and the others were diabetes mellitus (14.0%), cerebral vascular attack (CVA) (10.7%), and coronavirus infection (8.9%). Based on the sputum culture, the bacteria identified were Klebsiella pneumoniae (25.0%), Pseudomonas aeruginosa (20.9%), Acinetobacter baumannii (15.7%), and Escherichia coli (11.6%). The most common bacteria isolated from sputum cultures was Klebsiella pneumoniae, which was more susceptible to amikacin and meropenem. Conclusion: Only amikacin was an antibiotic susceptible to four primary pathogens. Rates of resistance to ciprofloxacin and ceftriaxone were high, and these empiric antibiotics should be used with caution in these patients.

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Section: Original Articlementioning

confidence: 99%

Antibiotic Susceptibility Patterns among Indonesian Adults Hospitalized with Pneumonia

Akhmad,

Ulfa,

Azuma

2024

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“…Definite SAP: ALL CDC criteria met, including diagnostic CXR changes (on at least one). To diagnose the SAP, it is recommended to check its compliance with the modified CDC criteria (Table 2) (25).…”

Section: Table 1 Recommended Diagnostic Criteria For a Definite And P...mentioning

confidence: 99%

“…Table 2. Modified CDC criteria 25 The presence of lower respiratory tract and pleural infection must meet at least one of the following criteria:…”

Section: Table 1 Recommended Diagnostic Criteria For a Definite And P...mentioning

confidence: 99%

Etiopathogenesis, diagnosis and treatment strategies for stroke-associated pneumonia

Kadyrov,

Mamytova,

Mamytova

et al. 2024

HVT

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The stroke-associated pneumonia (SAP) is considered an important risk factor for death following a stroke. It is important for clinicians to be able to recognize the causes of its occurrence, characteristic clinical and radiological signs and to be aware of treatment and prophylaxis in the early post-stroke period. This review article is devoted to the analysis and presentation of modern data on etiopathogenesis, modern strategies for early diagnosis and management of patients with stroke-associated pneumonia in the early post-stroke period. Design: Review of observational studies. Methods: We used following databases: PubMed, Web of Science, Scopus for the period of time 2019-2023 for studies search. Data from selected studies were extracted, including study design, data source, outcome definition, sample size, etiopathogenesis, diagnostic criteria and treatment strategies for stroke-associated pneumonia. Results: Totally 354 studies were reviewed, and after the selection process, 37 studies were included in this article. The incidence of stroke-associated pneumonia in patients with acute stroke ranged from 6.7 % to 37.98 %. Despite the abovementioned practical statements, there is currently no «gold standard» or generally accepted criteria for the diagnosis and treatment of SAP. As a rationale, detection of patients with the highest risk of SAP facilitates both prevention and treatment. The highest risks are associated with the age over 65, brain stem infarction with dysphagia, decreased throat and cough reflexes, impaired consciousness. Conclusion:The identification of high-risk patients requires knowledge of the modern criteria for diagnosing SAP. Since most SAP consists of aspiration pneumonia, hospital-acquired pneumonia, healthcare-associated pneumonia, pneumonia caused by artificial ventilation, partial diagnosis, treatment, rehabilitation, are related to the provision of medical care.

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“…Acute ischemic stroke (AIS) remains a substantial global health challenge, contributing to increased morbidity ( 1 , 2 ), disability ( 3 ), and mortality ( 4 , 5 ). While many cases of AIS can be efficiently treated in regular hospital environments or specialized stroke units, it is worth noting that approximately quarter of AIS patients require admission to an intensive care unit (ICU) ( 3 , 6 ).…”

Section: Introductionmentioning

confidence: 99%

Assessing the predictive value of neutrophil percentage to albumin ratio for ICU admission in ischemic stroke patients

Zawiah,

Khan,

Farha

et al. 2024

Front. Neurol.

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BackgroundAcute ischemic stroke (AIS) remains a substantial global health challenge, contributing to increased morbidity, disability, and mortality. This study aimed at investigating the predictive value of the neutrophil percentage to albumin ratio (NPAR) in determining intensive care unit (ICU) admission among AIS patients.MethodsA retrospective observational study was conducted, involving AIS cases admitted to a tertiary hospital in Jordan between 2015 and 2020. Lab data were collected upon admission, and the primary outcome was ICU admission during hospitalization. Descriptive and inferential analyses were performed using SPSS version 29.ResultsIn this study involving 364 AIS patients, a subset of 77 (21.2%) required admission to the ICU during their hospital stay, most frequently within the first week of admission. Univariable analysis revealed significantly higher NPAR levels in ICU-admitted ischemic stroke patients compared to those who were not admitted (23.3 vs. 15.7, p < 0.001), and multivariable regression models confirmed that higher NPAR (≥19.107) independently predicted ICU admission in ischemic stroke patients (adjusted odds ratio [aOR] = 4.85, 95% CI: 1.83–12.83). Additionally, lower GCS scores and higher neutrophil-to-lymphocyte ratio (NLR) were also associated with increased likelihood of ICU admission. In terms of predictive performance, NPAR showed the highest accuracy with an AUC of 0.885, sensitivity of 0.805, and specificity of 0.854, using a cutoff value of 19.107. NPAR exhibits an AUC of 0.058, significantly outperforming NLR (Z = 2.782, p = 0.005).ConclusionNPAR emerged as a robust independent predictor of ICU admission in ischemic stroke patients, surpassing the predictive performance of the NLR.

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Diagnosis and treatment of stroke associated pneumonia: Qualitative exploration of clinicians’ practice

Cited by 3 publications

References 31 publications

Antibiotic Susceptibility Patterns among Indonesian Adults Hospitalized with Pneumonia

Antibiotic Susceptibility Patterns among Indonesian Adults Hospitalized with Pneumonia

Etiopathogenesis, diagnosis and treatment strategies for stroke-associated pneumonia

Assessing the predictive value of neutrophil percentage to albumin ratio for ICU admission in ischemic stroke patients

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