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:10.20944/preprints202004.0376.v1

Cited by 3 publications

(4 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients with autoimmune diseases, such as MS, are often treated with immunomodulatory drugs that may increase their susceptibility to infection and sepsis. For example, urinary tract infection and respiratory infection are both common causes of sepsis (22) and complications for MS patients, relative to the general population (23,24). In fact, compared with the general healthy population, individuals with MS are at greater risk of sepsis, sepsis-induced complications, and death because of infection (25).…”

Section: Introductionmentioning

confidence: 99%

Autoimmunity Increases Susceptibility to and Mortality from Sepsis

Jensen

McGonagill

et al. 2021

ImmunoHorizons

View full text Add to dashboard Cite

We recently demonstrated how sepsis influences the subsequent development of experimental autoimmune encephalomyelitis (EAE) presented a conceptual advance in understanding the postsepsis chronic immunoparalysis state. However, the reverse scenario (autoimmunity prior to sepsis) defines a high-risk patient population whose susceptibility to sepsis remains poorly defined. In this study, we present a retrospective analysis of University of Iowa Hospital and Clinics patients demonstrating increased sepsis prevalence among multiple sclerosis (MS), relative to non-MS, patients. To interrogate how autoimmune disease influences host susceptibility to sepsis, well-established murine models of MS and sepsis and EAE and cecal ligation and puncture, respectively, were used. EAE, relative to non-EAE, mice were highly susceptible to sepsis-induced mortality with elevated cytokine storms. These results were further recapitulated in LPS and Streptococcus pneumoniae sepsis models. This work highlights both the relevance of identifying highly susceptible patient populations and expands the growing body of literature that host immune status at the time of septic insult is a potent mortality determinant. ImmunoHorizons, 2021, 5: 844-854.

show abstract

Section: Introductionmentioning

confidence: 99%

Autoimmunity Increases Susceptibility to and Mortality from Sepsis

Jensen

McGonagill

et al. 2021

ImmunoHorizons

View full text Add to dashboard Cite

show abstract

“…Urinary tract infection (UTI) aggravates neurological symptoms in MS patients. It is both one of the main factors leading to pseudorelapse and one of the main causes of mortality and morbidity in MS patients [ 8 – 13 ]. UTI refers to the occurrence of fever, chills, dysuria, frequent urination, suprapubic pain, and pathologic urinalysis or positive culture [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…UTI refers to the occurrence of fever, chills, dysuria, frequent urination, suprapubic pain, and pathologic urinalysis or positive culture [ 10 ]. Factors such as sphincter dysfunction, female gender, incomplete bladder depletion, and constant or occasional use of a urinary catheter augment the risk of this infection in people with MS [ 13 – 15 ]. Also, the longer the MS duration and the higher the Expanded Disability Status Scale (EDSS) score, the greater the risk of UTI in these patients [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Urinary Tract Infection following Corticosteroid Therapy in Patients with Multiple Sclerosis Exacerbation

Bazi

Baghbanian

Ghazaeian

et al. 2021

Canadian Journal of Infectious Diseases and Medical Microbiolog

View full text Add to dashboard Cite

The first treatment for multiple sclerosis exacerbation is usually short-term intravenous methylprednisolone (IVMP), with or without a regimen of oral prednisone taper (OPT). This study aims to evaluate the effects of IVMP and OPT in comparison with IVMP alone in raising the risk of urinary tract infection (UTI) and posttreatment improvement of urinary tract symptoms in patients with relapsing-remitting multiple sclerosis. This double-blind randomized clinical trial was conducted on 56 people with multiple sclerosis relapse who had undergone methylprednisolone for 5 days. Patients were randomly split into two groups: oral prednisolone and placebo (tapering for 20 days). Demographic data, duration of multiple sclerosis, urinary tract symptoms, the Expanded Disability Status Scale (EDSS) score, and urine data were analyzed. The incidence of UTI in the intervention and control groups did not differ significantly ( p = 560 ). However, the improvement of urinary tract symptoms in the intervention group was significantly more favorable than in the control group ( p ≤ 0.001 ). Furthermore, administering OPT after IVMP did not increase the risk of UTI occurrence in patients with multiple sclerosis exacerbation. The urine analysis results did not show any differences at baseline and after the corticosteroid tapering regimen. Due to the risk of infection by corticosteroids, it is no longer necessary to do further urinary screening in this group of patients.

show abstract

“…Patients with autoimmune diseases, such as MS, are often treated with immunomodulatory drugs that may increase their susceptibility to infection and sepsis. For example, urinary tract infection (UTI) and respiratory infection, are both a common causes of sepsis (Jeganathan et al, 2017) and complications for MS patients, relative to the general population (Harding et al, 2020;Medeiros Junior et al, 2020). In fact, compared to the general healthy population, individuals with MS are at greater risk of sepsis, sepsis-induced complications, and death due to infection (Capkun et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Autoimmunity increases susceptibility to and mortality from sepsis

Jensen

McGonagill

et al. 2021

Preprint

View full text Add to dashboard Cite

Our prior publication detailing how sepsis influences subsequent development of EAE presented a conceptual advance in understanding the post-sepsis chronic immunoparalysis state (Jensen et al., 2020). However, the reverse scenario (autoimmunity prior to sepsis) defines a high-risk patient population whose susceptibility to sepsis remains poorly defined. Herein, we present a retrospective analysis of University of Iowa Hospital and Clinics patients demonstrating increased sepsis incidence among MS, relative to non-MS, patients. To interrogate how autoimmune disease influences host susceptibility to sepsis well-established murine models of MS and sepsis, EAE and CLP, respectively, were utilized. EAE, relative to non-EAE, mice were highly susceptible to sepsis-induced mortality with elevated cytokine storms. These results were further recapitulated in LPS and S. pneumoniae sepsis models. This work highlights both the relevance of identifying highly susceptible patient populations and expands the growing body of literature that host immune status at the time of septic insult is a potent mortality determinant.

show abstract

Urinary Tract Infection in Patients with Multiple Sclerosis: An Overview

Cited by 3 publications

References 23 publications

Autoimmunity Increases Susceptibility to and Mortality from Sepsis

Autoimmunity Increases Susceptibility to and Mortality from Sepsis

Evaluation of Urinary Tract Infection following Corticosteroid Therapy in Patients with Multiple Sclerosis Exacerbation

Autoimmunity increases susceptibility to and mortality from sepsis

Contact Info

Product

Resources

About