Urinary tract infections among post-stroke patients – correlation with the rehabilitation process, prevention
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Fitness Club Olimpia Lublin
Państwowa Szkoła Wyższa im. Papieża Jana Pawła II w Białej Podlaskiej
Milena Socha   

Fitness Club Olimpia Lublin, Jana Skrzetuskiego 6/79, 20-628 Lublin, Polska
Med Og Nauk Zdr. 2017;23(4):221–224
Urinary tract infections are the second most common cause of infectious complications following stroke, with the incidence ranging from 2% to even 44%.The post-stroke infections in the urinary tracts, as different research suggest, forfeit worse results in improving and increased mortality. A proper diagnosis of the predictors of such complications allows one to apply proper prophylaxis and, at the moment of getting the disease, better treatment and preventing the negative outcomes of the infection. This allows to conduct proper rehabilitation, according to plan.

The goal of this paper is to determine the predicators of the infection of the urinary tract among the post-stroke patients and the influence of the infection on the patients’ condition as well as the applied rehabilitation.

The infection causes extending of the hospitalization and the necessity of antibiotics treatment, which in turn adds more treatment costs. The neurological rehabilitation is delayed and consequently the patients get worse functional results, compared to the patients without the infection. This increases their dependence on third parties and significantly lowers the quality of life. The conclusions suggest searching for new standards of actions in preventing the infection as well as in the moment of its occurring, so that the patients can acquire as good functionality as possible

Westendorp WF, Nederkoorn PJ, Vermeij JD, Dijkgraaf MG, van de Beek D. Post-stroke infection: A systematic review and meta-analysis. BMC Neurology 2011, 11: 110.
Stott DJ, Falconer A, Miller H, Tilston JC, Lamghorne P. Urinary tract infection after stroke. Q J Med 2009; 102: 243–249.
Indredavik B, Rohweder G, Naalsund E, Lydersen S. Medicalcomplica¬tions in a comprehensive stroke unit and an Elary supported discharge service. Stroke 2008; 39: 414–20.
Aslanyan S, Weir CJ, Diener HC, Kaste M, Lees KR. GAIN International Steering Committee and Investigators. Pneumonia and urinary tract infection after acute ischemic stroke: a tertiary analysis of the GAIN International trial. Eur J Neurol 2004; 11: 49–53.
Matz K, Keresztes K, Tatschl C, Nowotny M, Dachenhausenm A, Brainin M et al. Disorders of glucose metabolism in acute stroke patients: an underrecognized problem. Diabetes Care 2006; 29: 792–7.
Aljohi AA, Hassan HE, Gupta RK.The efficacy of noble metal alloy uri¬nary catheters in reducing catheter-associated urinary tract infection. Urol Ann. 2016 Oct–Dec; 8(4): 423–429.
Poisson S, Johnston SC, Josephson SA. Urinary tract infections com¬plicating stroke: mechanisms, consequecses, and possible solutions. Stroke 2010; 41(4): 180–184.
Wodzińska ME, Doryńska A, Stach B, Bober A, Kurzydło W, Hopek A, Pająk A. Zakażenia układu moczowego u pacjentów po udarze mózgu – doniesienie wstępne. Rehabilitacja Medyczna 2013, tom 17, nr 1, XX–XX.
Pizzi A, Falsini C, Martini M, Rossetti MA, Verdesca S, Tosto A. Urinary incontinence after ischemic stroke: clinical and urodynamic studies. Neurourol Urodyn. 2014 Apr; 33(4): 420–5.
Pietrucha-Dilanchian P, Hooton TM. Diagnosis, Treatment, and Pre¬vention of Urinary Tract Infection. Microbiol Spectr. 2016 Dec; 4(6).
Kizilbash QF, Petersen NJ, Chen GJ, Naik AD, Trautner BW. Bactere¬mia and mortality with urinary catheter-associated bacteriuria. Infect Control Hosp Epidemiol. 2013 Nov; 34(11): 1153–9. Infect Control Hosp Epidemiol. 2013 Nov; 34(11): 1153–9.
Lucas SM, Rothwell NJ, Gibson RM. The role of inflammation in CNS injury and disease. Br J Pharmacol 2006; 147(Suppl. 1): S232–40.
Welsh P, Barber M, Langhorne P, Rumley A, Lowe GDO, Stott DJ. Associations of inflammatory and haemostatic biomarkers with poor outcome in acute ischaemic stroke. Cerebrovasc Dis 2009; 27: 247–253.
Kwolek A. Rehabilitacja neurologiczna, Schorzenia i urazy mózgowia. W: Rehabilitacja medyczna, Urban & Partner, Wrocław 2003.
Piskorz J, Wójcki G, Iłzecka J, Kozak-Putowska D. Wczesna rehabilita¬cja pacjentów po udarze niedokrwiennym mózgu. Medycyna Ogólna i Nauki o Zdrowiu, 2014, tom 20, nr 4, 351–355.
European Stroke Initiative Recommendations for Stroke Management – Update 2003. Cerebrovasc Dis 2003; 16: 311–337.
Spetruk P, Opala G. Wieloaspektowy charakter depresji występującej po udarze mózgu. Udar Mózgu 2005, tom 7, nr 1, 25–30.
Zembaty A. Kinezyterapia, t. 2, Wyd. Kasper, Kraków 2003.
Ratuszek-Sadowska D, Kowalski M, Woźniak K, Kochański B, Hagner W. Rehabilitacja neurologiczna pacjentki po udarze mózgu – opis przypadku. Journal of Education, Health and Sport. 2016; 6(8): 28–40.
Wolny T, Saulicz E, Gnat R. Wykorzystanie metody PNF u chorych po udarze mózgu. Rehabilitacja Praktyczna, 2008 (3).
Mikołajewska E, Radziszewski K. Metoda NDT – Bobath w rehabili¬tacji pacjentów dorosłych. Valetudinaria – Post. Med. Klin. Wojsk.; 2007: 12(1).
Czarkowska-Pączek B. Wpływ wysiłku fizycznego na mięśnie po¬przecznie prążkowane. W: B Czarkowska-Pączek, J Przybylski (red.). Zarys fizjologii wysiłku fizycznego. Urban & Partner, Wrocław 2006.
Freeman RM. The role of pelvic floor muscle training in urinaryin¬continence. International Journal of Obstetrics and Gynecology 2004; 111: 37–40.
Dumoulin C, Korner-Bitensky N, Tannenbaum C. Urinary incontinence after stroke: identification, assessment, and intervention by rehabilita-tion professionals in Canada. Stroke. 2007 Oct; 38(10): 2745–51.
Halski T, Taradaj J, Pasternok M, Pasternok M, Halska U. Zastosowanie elektrostymulacji w przypadkach NTM u kobiet, cz. I. Rehabilitacja w praktyce 2007; 4: 24–26.
Borowicz AM, Wieczorkowska-Tobis K. Metody fizjoterapeutyczne w leczeniu nietrzymania moczu. Gerontol. Pol. 2010; 18, 3: 114–119.
Liu Y, Xu G, Luo M, Teng HF. Effects of Transcutaneous Electrical Nerve Stimulation at Two Frequencies on Urinary Incontinence in Poststroke Patients: A Randomized Controlled Trial. Am J Phys Med Rehabil. 2016 Mar; 95(3): 183–93.
Sun Z, Yu N, Yue J, Zhang Q. Acupuncture for urinary incontinence after stroke: a protocol for systematic review. BMJ Open. 2016 Feb 23; 6(2).:e008062. doi: 10.1136/bmjopen-2015–008062.
Polskie Towarzystwo Neurologiczne. Postępowanie w udarze mózgu. Wytyczne Grupy Ekspertów Sekcji Chorób Naczyniowych Polskiego Towarzystwa Neurologicznego. Neurologia i Neurochirurgia Polska 2012; 46, 1(supl. 1): 1–114.
Wang Q, Sun F, Liu Y, Xiong L, Xie L, Xia P. Enhancement of bio¬film formation by subinhibitory concentrations of macrolides in ica ADBC-positive and -negative clinical isolates of Staphylococcus epider¬midis. Antimicrob. Agents Chemother. 2010, 54, 2707–2711.
Hannan S, Ready D, Jasni AS, Rogers M, Pratten J, Roberts AP. Trans¬fer of antibiotic resistance by transformation with eDNA within oral biofilms. FEMS Immunol. Med. Microbiol. 2010, 59, 345–349.
Pop CS, Hussien MD, Popa M, Mares A, Grumezescu AM, Grigore R, Lazar V, Chifiriuc MC, Sakizlian M, Bezirtzoglou E et al. Metallic¬-Based, Micro and Nanostructures with Antimicrobial Activity. Curr. Top. Med. Chem. 2015, 15, 1577–1582.
Bilcu M, Grumezescu AM, Oprea AE, Popescu RC, Mogosanu GD, Hristu R, Stanciu GA, Mihailescu DF, Lazar V, Bezirtzoglou E et al. Efficiency of Vanilla, Patchouli and Ylang Ylang Essential Oils Stabilized by Iron Oxide@C-14 Nanostructures against Bacterial Adherence and Biofilms Formed by Staphylococcus aureus and Klebsiella pneumonia. Molecules 2014, 19, 17943–17956.
Chifiriuc MC, Di¸tu LM, Oprea E, Li¸tescu S, Bucur M, M˘aru¸tescu L, Enache G, Saviuc C, Burliba¸sa M, Tr˘aistaru T. In vitro study of the inhibitory activity of usnic acid on dental plaque biofilm. Roum. Arch. Microbiol. Immunol. 2009, 68, 215–222.
Roshni Amalaradjou MA, Venkitanarayanan K. Recent Advances in the Field of Urinary Tract Infections. In Role of Bacterial Biofilms in Catheter-Associted Urinary Tract Infections (CAUTI) and Strategies for Their Control; T Nelius (Ed.). INTECH: Vienna, Austria, 2013; p. 184.
Cotar A, Ionescu B, Pelinescu D, Voidarou C, Lazar V, Bezirtzoglou E, Chifiriuc MC. Current Solutions for the Interception of Quorum Sensing in Staphylococcus aureus. Curr. Org. Chem. 2013, 17, 97–104.
Grumezescu AM, Chifiriuc CM. Prevention of Microbial Biofilms – The Contribution of Micro and Nanostructured Materials. Curr. Med. Chem. 2014, 21, 3311.
Choong S, Whitfield H. Biofilms and their role in infections in urology. BJU Int. 2000, 86, 935–941.
Tenke P, Kovacs B, Jackel M, Nagy E. The role of biofilm infection in urology. World J. Urol. 2006, 24, 13–20.