Stroke-associated pneumonia: Major advances and obstacles

Cerebrovascular Diseases

Volumn 35, Issue 5, 2013, Pages 430-443

  Hannawi, Yousef ^a   Hannawi, Bashar ^b   Rao, Chethan P Venkatasubba ^a   Suarez, Jose I ^a   Bershad, Eric M ^a  

^a BAYLOR COLLEGE OF MEDICINE   (United States)

^b HOUSTON METHODIST HOSPITAL   (United States)

Author keywords

Acute ischemic stroke; Post stroke pneumonia; Stroke associated pneumonia; Stroke induced immunodepression; Ventilator associated pneumonia

Indexed keywords

CEFTRIAXONE; ANTIBIOTIC AGENT; CILOSTAZOL; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; DOPAMINE; SUBSTANCE P;

ARTIFICIAL VENTILATION; ASPIRATION; CEREBROVASCULAR ACCIDENT; CLINICAL TRIAL; DISEASE ASSOCIATION; HUMAN; HYPOTHALAMUS HYPOPHYSIS ADRENAL SYSTEM; IMMUNE DEFICIENCY; INTENSIVE CARE UNIT; MICROBIOLOGY; MORTALITY; NEUROLOGIC DISEASE; OUTCOME ASSESSMENT; PATHOPHYSIOLOGY; PNEUMONIA; PRIORITY JOURNAL; PROGNOSIS; REVIEW; RISK FACTOR; STROKE ASSOCIATED PNEUMONIA; ANTIBIOTIC PROPHYLAXIS; ANTIBIOTIC THERAPY; ASPIRATION PNEUMONIA; DISEASE SEVERITY; FOLLOW UP; INCIDENCE; INFECTIOUS PNEUMONIA; MEDICAL SUBJECT HEADINGS; META ANALYSIS (TOPIC); NATIONAL INSTITUTES OF HEALTH STROKE SCALE; NERVE TRACT; PATHOGENESIS; RANDOMIZED CONTROLLED TRIAL (TOPIC); REHABILITATION CARE; STROKE INDUCED IMMUNODEPRESSION; STROKE PATIENT; STROKE UNIT; SYSTEMATIC REVIEW;

CROSS INFECTION; DEGLUTITION DISORDERS; HOSPITAL MORTALITY; HUMANS; HYPOTHALAMO-HYPOPHYSEAL SYSTEM; IMMUNOCOMPROMISED HOST; INCIDENCE; INTENSIVE CARE UNITS; LUNG DISEASES, FUNGAL; PARASYMPATHETIC NERVOUS SYSTEM; PITUITARY-ADRENAL SYSTEM; PNEUMONIA, ASPIRATION; PNEUMONIA, BACTERIAL; PNEUMONIA, VENTILATOR-ASSOCIATED; PROGNOSIS; RISK FACTORS; STROKE; SYMPATHETIC NERVOUS SYSTEM;

EID: 84878375856     PISSN: 10159770     EISSN: 14219786     Source Type: Journal    
DOI: 10.1159/000350199     Document Type: Review

References (101)

1. Vermeij FH, Scholte op Reimer WJ, de Man P, et al: Stroke-associated infection is an independent risk factor for poor outcome after acute ischemic stroke: Data from the Netherlands Stroke Survey. Cerebrovasc Dis 2009; 27: 465-471
2. Roger VL, Go AS, Lloyd-Jones DM, et al: Heart disease and stroke statistics - 2012 update: A report from the American Heart Association. Circulation 2012; 125:e2-e220
3. Koennecke HC, Belz W, Berfelde D, et al: Factors influencing in-hospital mortality and morbidity in patients treated on a stroke unit. Neurology 2011; 77: 965-972
4. Katzan IL, Dawson NV, Thomas CL, Votruba ME, Cebul RD: The cost of pneumonia after acute stroke. Neurology 2007; 68: 1938- 1943
5. Wilson RD: Mortality and cost of pneumonia after stroke for different risk groups. J Stroke Cerebrovasc Dis 2012; 21: 61-67
6. Chamorro A, Meisel A, Planas AM, Urra X, van de Beek D, Veltkamp R: The immunology of acute stroke. Nat Rev Neurol 2012; 8: 401- 410
7. Dirnagl U, Klehmet J, Braun JS, et al: Strokeinduced immunodepression: Experimental evidence and clinical relevance. Stroke 2007; 38: 770-773
8. Bershad EM, Feen ES, Hernandez OH, Suri MF, Suarez JI: Impact of a specialized neurointensive care team on outcomes of critically ill acute ischemic stroke patients. Neurocrit Care 2008; 9: 287-292
9. Kwon HM, Jeong SW, Lee SH, Yoon BW: The pneumonia score: A simple grading scale for prediction of pneumonia after acute stroke. Am J Infect Control 2006; 34: 64-68
10. Teramoto S: Novel preventive and therapuetic strategy for post-stroke pneumonia. Expert Rev Neurother 2009; 9: 1187-1200
11. Hilker R, Poetter C, Findeisen N, et al: Nosocomial pneumonia after acute stroke: Implications for neurological intensive care medicine. Stroke 2003; 34: 975-981
12. Kasuya Y, Hargett JL, Lenhardt R, et al: Ventilator- associated pneumonia in critically ill stroke patients: Frequency, risk factors, and outcomes. J Crit Care 2011; 26: 273-279
13. Horan TC, Andrus M, Dudeck MA: CDC/ NHSN surveillance definition of health careassociated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2008; 36: 309-332
14. Josephson SA, Moheet AM, Gropper MA, Nichols AD, Smith WS: Ventilator-associated pneumonia in a neurologic intensive care unit does not lead to increased mortality. Neurocrit Care 2010; 12: 155-158
15. Walter U, Knoblich R, Steinhagen V, Donat M, Benecke R, Kloth A: Predictors of pneumonia in acute stroke patients admitted to a neurological intensive care unit. J Neurol 2007; 254: 1323-1329
16. Huang JY, Zhang DY, Yao Y, Xia QX, Fan QQ: Training in swallowing prevents aspiration pneumonia in stroke patients with dysphagia. J Int Med Res 2006; 34: 303-306
17. Lim SH, Lieu PK, Phua SY, et al: Accuracy of bedside clinical methods compared with fiberoptic endoscopic examination of swallowing (FEES) in determining the risk of aspiration in acute stroke patients. Dysphagia 2001; 16: 1-6
18. Lakshminarayan K, Tsai AW, Tong X, et al: Utility of dysphagia screening results in predicting poststroke pneumonia. Stroke 2010; 41: 2849-2854
19. Jia YX, Sekizawa K, Ohrui T, Nakayama K, Sasaki H: Dopamine D 1 receptor antagonist inhibits swallowing reflex in guinea pigs. Am J Physiol 1998; 274:R76-R80
20. Nakagawa T, Ohrui T, Sekizawa K, Sasaki H: Sputum substance P in aspiration pneumonia. Lancet 1995; 345: 1447
21. Arai T, Yoshimi N, Fujiwara H, Sekizawa K: Serum substance P concentrations and silent aspiration in elderly patients with stroke. Neurology 2003; 61: 1625-1626
22. Chastre J, Fagon JY: Ventilator-associated pneumonia. Am J Respir Crit Care Med 2002; 165: 867-903
23. Upadya A, Thorevska N, Sena KN, Manthous C, Amoateng-Adjepong Y: Predictors and consequences of pneumonia in critically ill patients with stroke. J Crit Care 2004; 19: 16-22
24. Weimar C, Roth MP, Zillessen G, et al: Complications following acute ischemic stroke. Eur Neurol 2002; 48: 133-140
25. Dziewas R, Ritter M, Schilling M, et al: Pneumonia in acute stroke patients fed by nasogastric tube. J Neurol Neurosurg Psychiatry 2004; 75: 852-856
26. Chamorro A, Urra X, Planas AM: Infection after acute ischemic stroke: A manifestation of brain-induced immunodepression. Stroke 2007; 38: 1097-1103
27. Howard RJ, Simmons RL: Acquired immunologic deficiencies after trauma and surgical procedures. Surg Gynecol Obstet 1974; 139: 771-782
28. Meisel C, Schwab JM, Prass K, Meisel A, Dirnagl U: Central nervous system injury-induced immune deficiency syndrome. Nat Rev Neurosci 2005; 6: 775-786
29. Prass K, Meisel C, Hoflich C, et al: Stroke-induced immunodeficiency promotes spontaneous bacterial infections and is mediated by sympathetic activation reversal by poststroke T helper cell type 1-like immunostimulation. J Exp Med 2003; 198: 725-736
30. Prass K, Braun JS, Dirnagl U, Meisel C, Meisel A: Stroke propagates bacterial aspiration to pneumonia in a model of cerebral ischemia. Stroke 2006; 37: 2607-2612
31. Haeusler KG, Schmidt WU, Fohring F, et al: Cellular immunodepression preceding infectious complications after acute ischemic stroke in humans. Cerebrovasc Dis 2008; 25: 50-58
32. Liesz A, Hagmann S, Zschoche C, et al: The spectrum of systemic immune alterations after murine focal ischemia: Immunodepression versus immunomodulation. Stroke 2009; 40: 2849-2858
33. Schulte-Herbruggen O, Quarcoo D, Meisel A, Meisel C: Differential affection of intestinal immune cell populations after cerebral ischemia in mice. Neuroimmunomodulation 2009; 16: 213-218
34. Vogelgesang A, Grunwald U, Langner S, et al: Analysis of lymphocyte subsets in patients with stroke and their influence on infection after stroke. Stroke 2008; 39: 237-241
35. Walter U, Kolbaske S, Patejdl R, et al: Insular stroke is associated with acute sympathetic hyperactivation and immunodepression. Eur J Neurol 2013; 20: 153-159
36. Marklund N, Peltonen M, Nilsson TK, Olsson T: Low and high circulating cortisol levels predict mortality and cognitive dysfunction early after stroke. J Intern Med 2004; 256: 15-21
37. Bernik TR, Friedman SG, Ochani M, et al: Pharmacological stimulation of the cholinergic antiinflammatory pathway. J Exp Med 2002; 195: 781-788
38. Tuosto L, Cundari E, Gilardini Montani MS, Piccolella E: Analysis of susceptibility of mature human T lymphocytes to dexamethasone- induced apoptosis. Eur J Immunol 1994; 24: 1061-1065
39. Whalen MJ, Carlos TM, Clark RS, et al: The relationship between brain temperature and neutrophil accumulation after traumatic brain injury in rats. Acta Neurochir Suppl 1997; 70: 260-261
40. Dietrich WD, Chatzipanteli K, Vitarbo E, Wada K, Kinoshita K: The role of inflammatory processes in the pathophysiology and treatment of brain and spinal cord trauma. Acta Neurochir Suppl 2004; 89: 69-74
41. Takagi K, Ginsberg MD, Globus MY, Martinez E, Busto R: Effect of hyperthermia on glutamate release in ischemic penumbra after middle cerebral artery occlusion in rats. Am J Physiol 1994; 267:H1770-H1776
42. Hajat C, Hajat S, Sharma P: Effects of poststroke pyrexia on stroke outcome: A metaanalysis of studies in patients. Stroke 2000; 31: 410-414
43. Wright WL: Sodium and fluid management in acute brain injury. Curr Neurol Neurosci Rep 2012; 12: 466-473
44. Huang WY, Weng WC, Peng TI, et al: Association of hyponatremia in acute stroke stage with three-year mortality in patients with firstever ischemic stroke. Cerebrovasc Dis 2012; 34: 55-62
45. Martinez MA, Pena JM, Fernandez A, et al: Time course and prognostic significance of hemostatic changes in sepsis: Relation to tumor necrosis factor-alpha. Crit Care Med 1999; 27: 1303-1308
46. Millns B, Gosney M, Jack CI, Martin MV, Wright AE: Acute stroke predisposes to oral gram-negative bacilli - A cause of aspiration pneumoniä Gerontology 2003; 49: 173-176
47. Gosney MA, Martin MV, Wright AE, Gallagher M: Enterobacter sakazakii in the mouths of stroke patients and its association with aspiration pneumonia. Eur J Intern Med 2006; 17: 185-188
48. Hassan A, Khealani BA, Shafqat S, et al: Stroke-associated pneumonia: Microbiological data and outcome. Singapore Med J 2006; 47: 204-207
49. Kostadima E, Kaditis AG, Alexopoulos EI, Zakynthinos E, Sfyras D: Early gastrostomy reduces the rate of ventilator-associated pneumonia in stroke or head injury patients. Eur Respir J 2005; 26: 106-111
50. Yilmaz GR, Cevik MA, Erdinc FS, Ucler S, Tulek N: The risk factors for infections acquired by cerebral hemorrhage and cerebral infarct patients in a neurology intensive care unit in Turkey. Jpn J Infect Dis 2007; 60: 87- 91
51. Dettenkofer M, Ebner W, Els T, et al: Surveillance of nosocomial infections in a neurology intensive care unit. J Neurol 2001; 248: 959- 964
52. Westendorp WF, Nederkoorn PJ, Vermeij JD, Dijkgraaf MG, van de Beek D: Post-stroke infection: A systematic review and meta-analysis. BMC Neurol 2011; 11: 110
53. Sui R, Zhang L: Risk factors of stroke-associated pneumonia in Chinese patients. Neurol Res 2011; 33: 508-513
54. Yeh SJ, Huang KY, Wang TG, et al: Dysphagia screening decreases pneumonia in acute stroke patients admitted to the stroke intensive care unit. J Neurol Sci 2011; 306: 38-41
55. Commichau C, Scarmeas N, Mayer SA: Risk factors for fever in the neurologic intensive care unit. Neurology 2003; 60: 837-841
56. Yan F, Zhang D, Xu H, Guo H: Risk factors for fever in critically ill patients with acute newonset stroke. Neurol Res 2008; 30: 394-399
57. Hassan AE, Chaudhry SA, Zacharatos H, et al: Increased rate of aspiration pneumonia and poor discharge outcome among acute ischemic stroke patients following intubation for endovascular treatment. Neurocrit Care 2012; 16: 246-250
58. Yang CC, Shih NC, Chang WC, Huang SK, Chien CW: Long-term medical utilization following ventilator-associated pneumonia in acute stroke and traumatic brain injury patients: A case-control study. BMC Health Serv Res 2011; 11: 289
59. Broadley S, Croser D, Cottrell J, et al: Predictors of prolonged dysphagia following acute stroke. J Clin Neurosci 2003; 10: 300-305
60. Dziedzic T, Pera J, Klimkowicz A, et al: Serum albumin level and nosocomial pneumonia in stroke patients. Eur J Neurol 2006; 13: 299-301
61. Dziedzic T, Slowik A, Pera J, Szczudlik A: Association between hyperglycemia, heart failure and mortality in stroke patients. Eur J Neurol 2009; 16: 251-256
62. Gosney M, Martin MV, Wright AE: The role of selective decontamination of the digestive tract in acute stroke. Age Ageing 2006; 35: 42-47
63. Ickenstein GW, Riecker A, Hohlig C, et al: Pneumonia and in-hospital mortality in the context of neurogenic oropharyngeal dysphagia (NOD) in stroke and a new NOD stepwise concept. J Neurol 2010; 257: 1492-1499
64. Ifejika-Jones NL, Arun N, Peng H, Elizabeth A, Grotta JC, Francisco GE: The interaction of aspiration pneumonia with demographic and cerebrovascular disease risk factors is predictive of discharge level of care in acute stroke patient. Am J Phys Med Rehabil 2012; 91: 141-147
65. Ingeman A, Andersen G, Hundborg HH, Svendsen ML, Johnsen SP: Processes of care and medical complications in patients with stroke. Stroke 2011; 42: 167-172
66. Minnerup J, Wersching H, Brokinkel B, et al: The impact of lesion location and lesion size on poststroke infection frequency. J Neurol Neurosurg Psychiatry 2010; 81: 198-202
67. Saposnik G, Black SE, Hakim A, et al: Age disparities in stroke quality of care and delivery of health services. Stroke 2009; 40: 3328-3335
68. Aslanyan S, Weir CJ, Diener HC, Kaste M, Lees KR: Pneumonia and urinary tract infection after acute ischaemic stroke: A tertiary analysis of the GAIN International trial. Eur J Neurol 2004; 11: 49-53
69. Chen CM, Hsu HC, Tsai WS, Chang CH, Chen KH, Hong CZ: Infections in acute older stroke inpatients undergoing rehabilitation. Am J Phys Med Rehabil 2012; 91: 211-219
70. Chumbler NR, Williams LS, Wells CK, et al: Derivation and validation of a clinical system for predicting pneumonia in acute stroke. Neuroepidemiology 2010; 34: 193-199
71. Cuesy PG, Sotomayor PL, Pina JO: Reduction in the incidence of poststroke nosocomial pneumonia by using the 'turn-mob' program. J Stroke Cerebrovasc Dis 2010; 19: 23-28
72. Field TS, Green TL, Roy K, Pedersen J, Hill MD: Trends in hospital admission for stroke in Calgary. Can J Neurol Sci 2004; 31: 387-393
73. Finlayson O, Kapral M, Hall R, et al: Risk factors, inpatient care, and outcomes of pneumonia after ischemic stroke. Neurology 2011; 77: 1338-1345
74. Grau AJ, Buggle F, Schnitzler P, Spiel M, Lichy C, Hacke W: Fever and infection early after ischemic stroke. J Neurol Sci 1999; 171: 115-120
75. Hamidon BB, Raymond AA, Norlinah MI, Jefferelli SB: The predictors of early infection after an acute ischaemic stroke. Singapore Med J 2003; 44: 344-346
76. Hinchey JA, Shephard T, Furie K, Smith D, Wang D, Tonn S: Formal dysphagia screening protocols prevent pneumonia. Stroke 2005; 36: 1972-1976
77. Hong KS, Kang DW, Koo JS, et al: Impact of neurological and medical complications on 3-month outcomes in acute ischaemic stroke. Eur J Neurol 2008; 15: 1324-1331
78. Johnston KC, Li JY, Lyden PD, et al: Medical and neurological complications of ischemic stroke: Experience from the RANTTAS trial. RANTTAS Investigators. Stroke 1998; 29: 447-453
79. Jones EM, Albright KC, Fossati-Bellani M, Siegler JE, Martin-Schild S: Emergency department shift change is associated with pneumonia in patients with acute ischemic stroke. Stroke 2011; 42: 3226-3230
80. Katzan IL, Cebul RD, Husak SH, Dawson NV, Baker DW: The effect of pneumonia on mortality among patients hospitalized for acute stroke. Neurology 2003; 60: 620-625
81. Ota K, Saitoh E, Baba M, Sonoda S: The secretion severity rating scale: A potentially useful tool for management of acute-phase fasting stroke patients. J Stroke Cerebrovasc Dis 2011; 20: 183-187
82. Sellars C, Bowie L, Bagg J, et al: Risk factors for chest infection in acute stroke: A prospective cohort study. Stroke 2007; 38: 2284-2291
83. Hanchaiphiboolkul S: Risk factors for early infection after an acute cerebral infarction. J Med Assoc of Thai 2005; 88: 150-155
84. Kolb G, Broker M: State of the art in aspiration assessment and the idea of a new non invasive predictive test for the risk of aspiration in stroke. J Nutrition Health Aging 2009; 13: 429-433
85. Falsetti P, Acciai C, Palilla R, et al: Oropharyngeal dysphagia after stroke: Incidence, diagnosis, and clinical predictors in patients admitted to a neurorehabilitation unit. J Stroke Cerebrovasc Dis 2009; 18: 329-335
86. Lipson DM, Sangha H, Foley NC, Bhogal S, Pohani G, Teasell RW: Recovery from stroke: Differences between subtypes. Int J Rehabil Res 2005; 28: 303-308
87. Teasell R, Foley N, Doherty T, Finestone H: Clinical characteristics of patients with brainstem strokes admitted to a rehabilitation unit. Arch Phys Med Rehabil 2002; 83: 1013-1016
88. Seo WK, Yu SW, Kim JH, Park KW, Koh SB: The impact of hyperthermia and infection on acute ischemic stroke patients in the intensive care unit. Neurocrit Care 2008; 9: 183-188
89. Adams HP Jr, del Zoppo G, Alberts MJ, et al: Guidelines for the early management of adults with ischemic stroke: A guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Circulation 2007; 115:e478-e534
90. Gomes CA Jr, Lustosa SA, Matos D, Andriolo RB, Waisberg DR, Waisberg J: Percutaneous endoscopic gastrostomy versus nasogastric tube feeding for adults with swallowing disturbances. Cochrane Database Syst Rev 2012; 3:CD008096
91. Meisel C, Prass K, Braun J, et al: Preventive antibacterial treatment improves the general medical and neurological outcome in a mouse model of stroke. Stroke 2004; 35: 2-6
92. Harms H, Prass K, Meisel C, et al: Preventive antibacterial therapy in acute ischemic stroke: A randomized controlled trial. PLoS One 2008; 3:e2158
93. Chamorro A, Horcajada JP, Obach V, et al: The Early Systemic Prophylaxis of Infection After Stroke study: A randomized clinical trial. Stroke 2005; 36: 1495-1500
94. Schwarz S, Al-Shajlawi F, Sick C, Meairs S, Hennerici MG: Effects of prophylactic antibiotic therapy with mezlocillin plus sulbactam on the incidence and height of fever after severe acute ischemic stroke: The Mannheim infection in stroke study (MISS). Stroke 2008; 39: 1220-1227
95. Westendorp WF, Vermeij JD, Vermeij F, et al: Antibiotic therapy for preventing infections in patients with acute stroke. Cochrane Database Syst Rev 2012; 1:CD008530
96. Nederkoorn PJ, Westendorp WF, Hooijenga IJ, et al: Preventive antibiotics in stroke study: Rationale and protocol for a randomised trial. Int J Stroke 2011; 6: 159-163
97. Braun JS, Prass K, Dirnagl U, Meisel A, Meisel C: Protection from brain damage and bacterial infection in murine stroke by the novel caspase-inhibitor Q-VD-OPH. Exp Neurol 2007; 206: 183-191
98. Shinohara Y: Antiplatelet cilostazol is effective in the prevention of pneumonia in ischemic stroke patients in the chronic stage. Cerebrovasc Dis 2006; 22: 57-60
99. Ohkubo T, Chapman N, Neal B, et al: Effects of an angiotensin-converting enzyme inhibitor-based regimen on pneumonia risk. Am J Respir Crit Care Med 2004; 169: 1041-1045
100. Shinohara Y, Origasa H: Post-stroke pneumonia prevention by angiotensin-converting enz yme inhibitors: Results of a meta-analysis of five studies in Asians. Adv Ther 2012; 29: 900-912
101. Torres A, Ferrer M, Badia JR: Treatment guidelines and outcomes of hospital-acquired and ventilator-associated pneumonia. Clin Infect Dis 2010; 51(suppl 1):S48- S53