Urinary tract infection in patients with multiple sclerosis: An overview

Medeiros, Washigton Luiz Gomes de; Demore, Caio César; Mazaro, Larissa Peres; Souza, Matheus Fellipe Nascimento de; Parolin, Laura Fiuza; Melo, Luíz Henrique; Werka, Cláudio Rogério; Gonçalves, Marcus Vinícius Magno

doi:10.1016/j.msard.2020.102462

Cited by 20 publications

(5 citation statements)

References 33 publications

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“…Our findings reveal a 10-fold increase in the incidence of urinary tract infections and cases of urosepsis among people with MS. This pronounced difference can be attributed to the well-documented association between MS and bladder dysfunction affecting up to 70% of people with MS, which significantly elevates the susceptibility to urinary tract infections ( 16 , 17 ). Admission due to pneumonia was also more than three times as frequent among people with MS than in the controls from the general population.…”

Section: Discussionmentioning

confidence: 99%

Comorbidity in the aging population with multiple sclerosis: a Danish nationwide study

Holm,

Wandall-Holm,

Sellebjerg

et al. 2023

Front. Neurol.

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IntroductionMultiple sclerosis (MS) is a neurodegenerative disease accumulating disabilities over time. However, the mean age of individuals with MS is increasing, consequently elevating their risk of developing comorbidities. Comorbidities' impact on MS is widely debated. Yet very few countries possess population-based registries, which provide unique opportunities for individual-level data linkage. This study aims to assess acute and chronic comorbidities among elderly patients with MS, comparing them to matched controls. Additionally, this study seeks to investigate the influence of chronic comorbidities on all-cause mortality.MethodsA nationwide register-based study using the Danish Multiple Sclerosis Registry to identify all living patients with MS older than 50 years at the reference date (January 1st, 2022). Patients were matched 1:10 with individuals from the general population. Comprehensive healthcare data within the Danish hospital system were obtained. Chronic comorbidities were classified according to the Charlson Comorbidity Index, while acute comorbidities were based on ICD-10 codes and an “acute” admission type. To investigate all-cause mortality, a Cox regression analysis was conducted.ResultsThe study encompassed a total of 8,688 individuals with MS, matched with 86,880 controls. The mean age was 63.5 years, with females constituting 68.3%. Individuals with MS exhibited a higher frequency of acute hospitalizations (OR: 2.1, 95% CI: 1.9–2.2), primarily due to various infectious diseases, along with longer median hospital stays (4 vs. 3 days, p < 0.001). When assessed using the Charlson Comorbidity Index, individuals with MS carried a significantly greater burden of chronic comorbidities (p < 0.001). The most prevalent chronic comorbidity among individuals with MS was “Uncomplicated Diabetes” (20.1%). Notably, while individuals with MS displayed an overall lower 5-year survival rate, this difference ceased to be statistically significant among those with a high Charlson Comorbidity Index score of ≥4 (p = 0.32).ConclusionThis study highlights a heightened prevalence of both acute and chronic comorbidities among individuals with MS, with chronic comorbidities significantly increasing the risk of mortality. These findings underscore the critical importance of factoring in comorbidities when devising treatment strategies for individuals living with MS.

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Section: Discussionmentioning

confidence: 99%

Comorbidity in the aging population with multiple sclerosis: a Danish nationwide study

Holm,

Wandall-Holm,

Sellebjerg

et al. 2023

Front. Neurol.

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“…Freeman et al urinary tract infections is the higher prevalence of urinary disorders and bladder dysfunction in people with MS and is not necessarily due to treatment with DMTs. 29,34,35 At the time of data collection, the only available herpes zoster vaccine contained a live attenuated virus and, thus, although recommended for adults 60 years or older, was not suitable for people with MS 36 ; however, a recombinant herpes zoster vaccine is now approved and recommended for immunocompetent adults 50 years or older, including people with MS. 37 Considering the current COVID-19 pandemic, it is reassuring that this analysis showed that acute respiratory tract infections and pneumonia occurred in similar proportions of people in both cohorts. Overall, the present findings suggest that clinicians should be vigilant in monitoring older people with MS for potential infections.…”

Section: International Journal Of Ms Carementioning

confidence: 99%

Outcomes and Health Care Service Use in Adults 50 Years or Older With and Without Multiple Sclerosis: A 6-Year Observational Analysis

Freeman

Lucas

Jia

et al. 2022

International Journal of MS Care

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Background: Multiple sclerosis (MS) typically presents in young adulthood. Recent data show the highest prevalence of MS in people aged 55 to 64 years; however, there are limited studies of this population. Methods: Administrative US claims data from IBM-Truven MarketScan commercial and Medicare databases (2011–2017) were analyzed. People with MS 50 years or older were assigned to the aging MS cohort (n = 10,746). The matched controls were people 50 years or older without MS (n = 10,746). Multivariable models compared outcomes between groups. Results: Infections were more frequent in the aging MS cohort vs matched controls (61% vs 45%; P < .0001); urinary tract, acute upper respiratory tract, and herpes zoster were the most frequent infection types. Malignancy rates were 20% for both groups (P = .8167); skin, breast, and prostate malignancies were the most frequent types. Skilled nursing facilities (aging MS cohort, 12%; matched controls, 3%; P < .0001) and MRI (aging MS cohort, 87%; matched controls, 37%; P < .0001) were used more frequently in the aging MS cohort; brain and spine were the most frequent types of MRI in the aging MS cohort. Time to first cane/walker or wheelchair use was shorter in the aging MS cohort (cane/walker use: HR, 2.1; 95% CI, 1.9–2.3; P < .0001; wheelchair use: HR, 6.9; 95% CI, 6.0–8.1; P < .0001). Conclusions: In people 50 years or older, measures typically associated with worse health primarily resulted from having MS rather than being a consequence of aging alone.

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“… 3 A UK study found that infections represented the most common comorbidity in MS, affecting 80% of 1713 incident cases on or after MS diagnosis 4 in the primary care setting. Among the most common are the urinary tract infections 5 , 6 which cause an estimated 30–50% of all hospitalizations amongst MS patients. 6 Infections can trigger MS relapses and disease activity and carry a significant economic burden.…”

Section: Introductionmentioning

confidence: 99%

“…Among the most common are the urinary tract infections 5 , 6 which cause an estimated 30–50% of all hospitalizations amongst MS patients. 6 Infections can trigger MS relapses and disease activity and carry a significant economic burden. 7 A 2023 US study estimated that average annual in-hospital charges for all MS inpatient hospitalizations was $US3 billion (adjusted to 2010 dollars) with infections, such as urinary tract-related, skin and soft tissue and pneumonia being major contributors.…”

Section: Introductionmentioning

confidence: 99%

Disease-modifying drugs, multiple sclerosis and infection-related healthcare use in British Columbia, Canada: a population-based study

Graf,

Ng,

Zhu

et al. 2024

The Lancet Regional Health - Americas

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Urinary tract infection in patients with multiple sclerosis: An overview

Cited by 20 publications

References 33 publications

Comorbidity in the aging population with multiple sclerosis: a Danish nationwide study

Comorbidity in the aging population with multiple sclerosis: a Danish nationwide study

Outcomes and Health Care Service Use in Adults 50 Years or Older With and Without Multiple Sclerosis: A 6-Year Observational Analysis

Disease-modifying drugs, multiple sclerosis and infection-related healthcare use in British Columbia, Canada: a population-based study

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