Department of Urology, University Hospital Brno, Czech Republic; Faculty of Medicine, Masaryk University Brno, Czech Republic.
Department of Urology, University Hospital Brno, Czech Republic; Faculty of Medicine, Masaryk University Brno, Czech Republic.
Actas Urol Esp (Engl Ed). 2022 Dec;46(10):606-612. doi: 10.1016/j.acuroe.2022.08.007. Epub 2022 Aug 5.
To evaluate the incidence and course of urinary tract infections (UTI) in patients with multiple sclerosis (MS) and their relationship to the method of bladder evacuation.
Patients with neurogenic bladder dysfunction due to MS (n=111) were enrolled in the study. During one-year follow-up, clinical examination with urine culture was performed every 4 months or whenever symptoms occurred. The control group included patients with symptomatic UTI, without neurological or autoimmune disease. Incidence of symptomatic and asymptomatic bacteriuria, the effect of urine drainage on UTI incidence, and the effect of antibiotics were statistically evaluated.
54 MS patients completed the protocol. The mean incidence of symptomatic and asymptomatic bacteriuria in the MS group was 12.5% and 29.6%, respectively. A decreasing trend in the incidence of symptomatic, and an increasing trend in the incidence of asymptomatic bacteriuria was observed. Eradication of UTI in symptomatic MS patients was significantly lower than in controls (37.75% vs. 92.93%, P<0.05). Causative agents significantly differed in both groups (P=0.0005). The hypothesis that the incidence of UTIs in MS patients is independent of the method of bladder evacuation was not rejected (P>0.99 at visit 0, 1 and 3, P=0.078 at visit 2).
There is a significant difference between the causative agents of UTI in both groups. Eradication of bacteriuria in symptomatic MS patients is difficult when compared to the normal population. We have insufficient evidence to confirm the relationship between the incidence of UTI and the method of bladder evacuation.
评估多发性硬化症（MS）患者尿路感染（UTI）的发生率和病程及其与膀胱排空方法的关系。
本研究纳入了 111 例因 MS 导致神经源性膀胱功能障碍的患者。在为期一年的随访中，每 4 个月或出现症状时进行临床检查和尿液培养。对照组包括有症状的 UTI 患者，但无神经或自身免疫性疾病。对有症状和无症状菌尿的发生率、尿液引流对 UTI 发生率的影响以及抗生素的效果进行了统计学评估。
54 例 MS 患者完成了方案。MS 组有症状和无症状菌尿的平均发生率分别为 12.5%和 29.6%。有症状和无症状菌尿的发生率呈下降和上升趋势。在有症状的 MS 患者中，UTI 的根除率明显低于对照组（37.75%对 92.93%，P<0.05）。两组的病原体明显不同（P=0.0005）。MS 患者 UTI 发生率与膀胱排空方法无关的假设未被拒绝（在访视 0、1 和 3 时 P>0.99，在访视 2 时 P=0.078）。
两组 UTI 的病原体有显著差异。与正常人群相比，MS 患者有症状的菌尿的清除较为困难。我们没有足够的证据证实 UTI 的发生率与膀胱排空方法之间的关系。
