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Related Experiment Video

Updated: May 20, 2026

A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data

A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data

Published on: December 9, 2015

Testing for urinary tract colonization before high-dose corticosteroid treatment in acute multiple sclerosis

M Rakusa^1,2, O Murphy¹, L McIntyre¹

¹National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK.

European Journal of Neurology

|July 24, 2012

Summary

A urine dipstick test effectively screens for urinary tract infections in multiple sclerosis (MS) patients before high-dose corticosteroid treatment. This rapid assessment helps safely manage MS relapses, though further refinement is needed to lower unnecessary antibiotic use.

Related Experiment Videos

Last Updated: May 20, 2026

A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data

A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data

Published on: December 9, 2015

Area of Science:

Neurology
Infectious Disease
Diagnostic Medicine

Background:

Acute relapses of multiple sclerosis (MS) often necessitate high-dose corticosteroid treatment.
Urinary tract infections (UTIs) are a concern in MS patients and can complicate treatment.
Rapid and accurate diagnosis of UTIs is crucial before initiating immunosuppressive therapy.

Purpose of the Study:

To evaluate the diagnostic performance of a urinary dipstick algorithm for detecting urinary tract colonization.
To assess the safety and efficacy of this algorithm in patients with acute MS relapses requiring high-dose corticosteroids.
To determine the utility of dipstick testing in guiding antibiotic co-treatment decisions.

Main Methods:

Prospective cohort study involving 249 patients with acute MS relapses undergoing corticosteroid treatment.
Analysis of urinary dipstick results (leukocyte esterase, nitrite) against significant bacteriuria.
Evaluation of dipstick sensitivity, specificity, positive predictive value, and negative predictive value.

Main Results:

The rate of significant bacteriuria was 11% in the studied MS population.
The dipstick test demonstrated a sensitivity of 65% and specificity of 78% for detecting UTIs.
A high negative predictive value (96%) was observed, with no adverse events in false-negative cases; however, 18% of patients received unnecessary antibiotics.

Conclusions:

Urinary dipstick testing provides a rapid and safe method for managing potential UTIs in acute MS relapses.
The current algorithm is conservative, leading to some overtreatment with antibiotics.
Further research is warranted to optimize the dipstick algorithm and reduce its false-positive rate, thereby minimizing unnecessary antibiotic exposure.