ArticleFrontiers in neurology2024
Stroke-associated pneumonia according to mCDC criteria: impact on prognosis and antibiotic therapy.
Article in Frontiers in neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- European stroke organisation guideline on stroke-associated pneumonia.European stroke journal · 2026Guideline
- Healthcare-Associated Infections in Deceased Stroke Patients in a Romanian Neurological ICU: A Retrospective Descriptive Study.Microorganisms · 2026Article
- Impact of Pneumonia on Rehabilitation Outcomes: A Large Observational Study.Archives of rehabilitation research and clinical translation · 2026Article
- Association between early ICU fever burden and 28-day mortality in patients with acute ischemic stroke: a retrospective cohort study based on the MIMIC-IV database.Frontiers in neurology · 2026Article
- Sex Modifies the Association Between Neutrophil Percentage-to-Albumin Ratio and Stroke-Associated Pneumonia in Acute Ischemic Stroke.Journal of inflammation research · 2026Article
- From disruption to remodeling: the evolution and therapeutic prospects of Neuroimmune Regulatory Circuitry after ischemic stroke.Frontiers in immunology · 2025Review
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Authors and funding
21 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: The modified Centers for Disease Control and Prevention (mCDC) criteria have been proposed for diagnosing and managing stroke-associated pneumonia (SAP). The objective was to investigate the impact of SAP on stroke outcome depending on whether or not it conforms to mCDC criteria. Our secondary objective was to identify the responsible factors for antibiotic initiation in stroke patients. Methods: We conducted a prospective, multicenter, observational study of ischemic stroke patients with moderate to severe stroke (NIHSS≥4) admitted within 24 h. For 7 days, mCDC criteria were assessed daily, and infections and antibiotics were recorded. Pneumonias were divided into those fulfilling mCDC criteria (mCDC-SAP) or not (other pneumonias, OPn). The effect of each type of pneumonia on 3-month outcome was evaluated in separated logistic regression models. Factors associated with antibiotic initiation were explored using a random forest analysis. Results: Of the 342 patients studied, infections were diagnosed in 72 (21.6%), including 39 (11.7%) cases of pneumonia. Of them, 25 (7.5%) fulfilled mCDC criteria. Antibiotics were used in 92% of mCDC-SAP and 64.3% of OPn. In logistic regression analysis, mCDC-SAP, but not OPn, was an independent predictor of poor outcome [OR, 4.939 (1.022-23.868)]. The random forest analysis revealed that fever had the highest importance for antibiotic initiation. Interpretation: The mCDC criteria might be useful for detecting clinically relevant SAP, which is associated with poor outcomes. Isolated signs of infection were more important for antibiotic initiation than compliance with pre-defined criteria. Therefore, adherence to mCDC criteria might result in antibiotic saving without compromising clinical outcome.
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