Although a growing attention is being paid to
acute ischemic stroke patients, the correlation between clinical outcome and infectious events in this population has been poorly investigated. 749
ischemic stroke (mean age 71 years old, males 56%) patients were enrolled in this prospective case-control study by 11 Italian
Stroke Units. Demographic data, vascular risk factors, previous
infections and post-
stroke infections (PSIs) were recorded. Blood samples were collected and the
enzyme-linked immunoassay was chosen to measure Chlamydia pneumoniae
IgG and
IgA plasma
antibodies (antibody titers were classified with specific cut-off levels:
IgA > 1:16 and
IgG > 1:64). Early poor outcome was defined as mRS score >2 at discharge, while poor outcome at 6-month follow-up. Univariate and multivariate analyses were performed. Median NIHSS was 7,
IgA and
IgG antichlamydia pneumoniae seropositivities were observed in 308 (37.1%) and 207 (23.6%) patients, respectively. Multivariate analyses showed significant correlations between PSIs and NIHSS (RR: 1.06; 95% CI 1.02-1.09; p < 0.001) and PSIs and
IgA antichlamydia pneumoniae seropositivity (RR: 3.84; 95% CI 2.53-5.84; p < 0.001). Significant disability was associated with baseline NIHSS (RR: 1.32; 95% CI 1.16-1.50; p < 0.001),
IgA (RR: 2.67; 95% CI 1.06-6.70; p = 0.035) and
IgG antichlamydia (RR: 5.75; 95% CI 1.83-18.03; p = 0.003) seropositivity and
atrial fibrillation (RR: 2.58; 95% CI 1.81-3.67; p < 0.001). While previous
infections were not associated with functional outcome, antichlamydia
antibodies play a negative role in
ischemic stroke patients. Preventive strategies may reduce the
stroke burden and improve the clinical outcome.