Lucchini Matteo, Del Giacomo Paola, De Arcangelis Valeria, Nociti Viviana, Bianco Assunta, De Fino Chiara, Presicce Giorgia, Cicia Alessandra, Carlomagno Vincenzo, Mirabella Massimiliano
UOC Neurologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy.
Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, CERSM, 00168 Rome, Italy.
J Pers Med. 2022 Apr 7;12(4):591. doi: 10.3390/jpm12040591.
The complexity of the MS patient's management is constantly growing. Consequently, the MS care unit requires a multidisciplinary approach, including an infectious disease specialist to minimise the risk of infectious complications related both to the disease and DMTs.
We retrospectively evaluated the infectious disease consultations performed from 2015 to 2019 in our MS centre.
We identified 107 patients with at least one infectious disease consultation out of 1088 patients. We found a progressive increase in the number of consultations from 2015 to 2019. Nearly half of the consultations were requested at the time of starting MS treatment. The most frequent requests were represented by chronic or acute infections. The most prevalent infectious agents were Herpesviridae and Mycobacterium tuberculosis. Antibiotic or antiviral treatment and prophylactic treatment or vaccination represented together the most frequent outcomes of the consultations. Finally, a treatment delay was significantly associated with the advice of a prophylactic treatment or of a vaccination.
There is an increasing awareness of the potential infectious complications of MS and of exposure to DMTs. The interaction between the MS neurologist and infectious disease specialist is fundamental to minimise the infectious risk related to the disease and to the DMTs, with a progressive shift from complication management to a broader prevention workup at the time of MS diagnosis, including both vaccination and prophylactic treatments.
多发性硬化症（MS）患者管理的复杂性不断增加。因此，MS护理单元需要多学科方法，包括感染病专家，以尽量降低与疾病和疾病修正治疗（DMTs）相关的感染并发症风险。
我们回顾性评估了2015年至2019年在我们的MS中心进行的感染病会诊。
在1088例患者中，我们确定了107例至少进行过一次感染病会诊的患者。我们发现从2015年到2019年会诊次数逐渐增加。近一半的会诊是在开始MS治疗时提出的。最常见的会诊请求是慢性或急性感染。最常见的感染病原体是疱疹病毒科和结核分枝杆菌。抗生素或抗病毒治疗以及预防性治疗或疫苗接种共同构成了会诊最常见的结果。最后，治疗延迟与预防性治疗或疫苗接种的建议显著相关。
人们越来越意识到MS以及接触DMTs可能产生的感染并发症。MS神经科医生和感染病专家之间的互动对于将与疾病和DMTs相关的感染风险降至最低至关重要，在MS诊断时，工作重点正逐渐从并发症管理转向更广泛的预防检查，包括疫苗接种和预防性治疗。
