Urinary tract infections and multiple sclerosis: Recommendations from the French Multiple Sclerosis Society.
Asymptomatic bacteriuria
Disease modifying therapy
Multiple sclerosis
Practice guidelines
Urinary tracts infections
Journal
Revue neurologique
ISSN: 0035-3787
Titre abrégé: Rev Neurol (Paris)
Pays: France
ID NLM: 2984779R
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
received:
24
02
2020
accepted:
25
02
2020
pubmed:
10
9
2020
medline:
5
8
2021
entrez:
9
9
2020
Statut:
ppublish
Résumé
Establish recommendations for the management of UTIs in MS patients. Urinary tract infections (UTIs) are common during multiple sclerosis (MS) and are one of the most common comorbidities potentially responsible for deaths from urinary sepsis. The recommendations attempt to answer three main questions about UTIs and MS. The French Group for Recommendations in MS (France4MS) did a systematic review of articles from PubMed and universities databases (01/1980-12/2019). The RAND/UCLA appropriateness method, which has been developed to synthesize the scientific literature and expert opinions on health care topics, was used for reaching a formal agreement. 26 MS experts worked on the full-text review and a group of 70 multidisciplinary health care specialists validated the final evaluation of summarized evidences. UTIs are not associated with an increased risk of relapse and permanent worsening of disability. Only febrile UTIs worsen transient disability through the Uhthoff phenomenon. Some immunosuppressive treatments increase the risk of UTIs in MS patients and require special attention especially in case of hypogammaglobulinemia. Experts recommend to treat UTIs in patients with MS, according to recommendations of the general population. Prevention of recurrent UTIs requires stabilization of the neurogenic bladder. In some cases, weekly oral cycling antibiotics can be proposed after specialist advice. Asymptomatic bacteriuria should not be screened for or treated systematically except in special cases (pregnancy and invasive urological procedures). Physicians and patients should be aware of the updated recommendations for UTis and MS.
Sections du résumé
OBJECTIVES
OBJECTIVE
Establish recommendations for the management of UTIs in MS patients.
BACKGROUND
BACKGROUND
Urinary tract infections (UTIs) are common during multiple sclerosis (MS) and are one of the most common comorbidities potentially responsible for deaths from urinary sepsis.
METHODS
METHODS
The recommendations attempt to answer three main questions about UTIs and MS. The French Group for Recommendations in MS (France4MS) did a systematic review of articles from PubMed and universities databases (01/1980-12/2019). The RAND/UCLA appropriateness method, which has been developed to synthesize the scientific literature and expert opinions on health care topics, was used for reaching a formal agreement. 26 MS experts worked on the full-text review and a group of 70 multidisciplinary health care specialists validated the final evaluation of summarized evidences.
RESULTS
RESULTS
UTIs are not associated with an increased risk of relapse and permanent worsening of disability. Only febrile UTIs worsen transient disability through the Uhthoff phenomenon. Some immunosuppressive treatments increase the risk of UTIs in MS patients and require special attention especially in case of hypogammaglobulinemia. Experts recommend to treat UTIs in patients with MS, according to recommendations of the general population. Prevention of recurrent UTIs requires stabilization of the neurogenic bladder. In some cases, weekly oral cycling antibiotics can be proposed after specialist advice. Asymptomatic bacteriuria should not be screened for or treated systematically except in special cases (pregnancy and invasive urological procedures).
CONCLUSION
CONCLUSIONS
Physicians and patients should be aware of the updated recommendations for UTis and MS.
Identifiants
pubmed: 32900473
pii: S0035-3787(20)30617-2
doi: 10.1016/j.neurol.2020.02.011
pii:
doi:
Types de publication
Practice Guideline
Systematic Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
804-822Investigateurs
C Donzé
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C Papeix
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C Lebrun-Frénay
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N Collongues
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M de Seze
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A Dinh
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A Even
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C Scheiber-Nogueira
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C Bensa
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B Bourre
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C Carra-Dallière
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J Ciron
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M Cohen
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F Lebreton
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L Michel
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P Bernady
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P Clavelou
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P Tournaire
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H Zephir
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H Alchaar
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M Benazet
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D Bensmail
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A Blanchard-Dauphin
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M Bonnan
(M)
C Boutière
(C)
P Branger
(P)
S Bresch
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T De Broucker
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R Depaz
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X Douay
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C Dulau
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F Durand-Dubief
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O Fagniez
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M Faucher
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A Floch
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M Fournier
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A Fromont
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P Gallien
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X Gamé
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D Gault
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A Gayou
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M Giroux
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O Gout
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J Grimaud
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P Hautecoeur
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A Maurousset
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L Michel
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A Mont-Cuquet
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T Moreau
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(I)
D Peaureaux
(D)
M-C Pouget
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V Pourcher Martinez
(V)
C Radot
(C)
A Ruet
(A)
C Saint-Val
(C)
A Salmon
(A)
F Taithe
(F)
P Tatevin
(P)
M Vaillant
(M)
J-P Stahl
(JP)
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(F)
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(C)
Informations de copyright
Copyright © 2020 Elsevier Masson SAS. All rights reserved.