Objectives: There is a bidirectional relationship between stroke and infection, with stroke increasing susceptibility to infections and contributing to poorer clinical outcomes and higher mortality rates. Stroke-induced dysmotility, impaired gut barrier integrity, and systemic dissemination of resident gut microbiota have recently been implicated in the pathogenesis of poststroke infections. We hypothesize that early modulation of the gut microbiota within the first week of acute stroke may help prevent or mitigate post-stroke infections, mortality, and morbidity. Methods: This prospective study was conducted between 2020 and 2024 and included patients with moderate-to-severe acute stroke who were monitored in the intensive care unit (ICU) for at least 4 weeks. Probiotic agents containing Saccharomyces Boulardii were administered to the study group either orally or through a nasogastric tube. National Institutes of Health Stroke Scale (NIHSS) scores, patient survival rates, and poststroke infections were recorded during the first month and compared with those of the control group, who were not given probiotics. Results: The study group had significantly lower rates of poststroke infection and mortality ( P= 0.010 and P= 0.023, respectively). In addition, NIHSS scores were significantly higher in the control group ( P =0.032). Laboratory analyses revealed significantly higher neutrophil and platelet counts, C-reactive protein (CRP), and total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) levels were also significantly higher in the control group ( P <0.05). Conclusion: This study demonstrated that probiotic administration may reduce the risk of poststroke infections, improve functional outcomes, and decrease both mortality and morbidity in patients with acute ischemic stroke.
Arslan et al. (Tue,) studied this question.