Infections may trigger MS or worsen it. Although the role of infections in MS is not yet confirmed, researchers are investigating the connection between MS and some bacteria and viruses.

To show that a particular agent of infection is the cause for MS, researchers must prove that the infection is in the body before MS has developed and is not happening at the same time as MS. Epstein-Barr virus (EBV), human herpes virus 6 (HHV-6), Clostridium perfringens type B, and Chlamydophila pneumoniae are some of the agents that researchers have found to have connections with MS.

EBV infection is one of the most studied virus. Most people come into contact with EBV sometime in their life, developing antibodies against it. Previous studies have shown that people with higher level of antibodies to EBV are more likely to develop MS.

HHV-6 may also have a role in triggering MS flares.

A toxin produced by the bacteria C. perfringens may be involved in causing damage to the myelin producing cells, research has found.

C. pneumoniae, commonly associated with pneumonia has also been associated with different chronic conditions, including MS.

MS treatments are also associated with an increased risk of infection. Treatments should be oriented according to the patient. Treatments for managing relapses require individual management of potential infectious risks. Treatments that modify the disease course are safe as far as infectious complications, as long as they are correctly used, although the mechanism of action of new oral therapies may cause infectious problems. Immunosuppressive drugs and monoclonal antibodies can lead to some infectious complications; as a result, treatments should not be started in case of infection, and close monitoring is necessary.

A project on the connection of the progression of MS and systemic infections  is currently ongoing and aims to determine if systemic infections, such as colds, sinusitis, and chest infections re linked to progression in MS. A total of 50 people with MS will be monitored for 2.5 years, recording the number of infections that people have and their response to each infection by collecting and analyzing urine samples.

Managing infections in MS

Bladder infections are a common problem and may represent a serious health issue in people with MS. Bladder infections are treated with the appropriate antibiotic after the bacteria have been identified.

Bactrim; Septra (sulfamethoxazole) is a first-line treatment of acute, uncomplicated urinary tract infections (UTIs) caused by susceptible organisms.

Cipro (ciprofloxacin) is an antibiotic used to treat different types of bacterial infections.

Macrodantim (nitrofurantoin) is a broad-spectrum antibiotic for UTIs that kills bacteria found in the urine in therapeutic concentrations.

Hiprex (methenamine) is an antibiotic usually prescribed for the prevention of UTIs on a long-term basis.

Pyridium (phenazopyridine) is often prescribed along with an antibiotic to treat UTIs. It relieves pain, burning sensation, increased urination, and an increased urge to urinate.

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