New research from MSFHR trainee Dr. Jose Wijnands, a member of Dr. Helen Tremlett’s Pharmacoepidemiology in Multiple Sclerosis Research Group, fills knowledge gaps and establishes a baseline for understanding infection risk, as measured by healthcare system usage for people with multiple sclerosis (MS) relative to those without MS.

The researchers tracked health data from the period between 1996 and 2013 and looked at whether people with MS accessed healthcare services related to infections more than people without MS. By analyzing a large amount of population-based data, they were able to detect patterns in health care usage, including more than two times as many hospitalizations and 41 per cent more physician visits related to infections for people with MS as compared to those without MS.

The increases in infection-related healthcare services among people with MS included two times as many hospitalizations for sepsis, skin infection, and intestinal infections. Other studies have shown that sepsis represents one of the costliest conditions treated in the hospital setting, with substantial morbidity and mortality risks for patients. While intestinal infections are often self-limiting for adults in developed countries, our observations of higher hospitalizations suggests they can pose a serious health problem in those with MS.

In addition to hospital and physician visits, people with MS filled over 50 per cent more infection-related prescriptions. Antibiotics were the most frequently prescribed of the antimicrobials. Notwithstanding the necessity for appropriate access to antimicrobials, it would be of value for future studies to consider the broader health implications of their elevated use in MS, such as the impact on the emergence of antimicrobial drug resistance or alterations in the gut microbiota.

“By informing clinicians and researchers about the rate and type of infections as well as the rate of antimicrobial prescriptions filled, we hope to further strengthen the research focus on infections and infection management in this high-risk population” says Wijnands.

This study was funded by the National Multiple Sclerosis Society (RG5063A4/1, PI: Helen Tremlett, University of British Columbia). Dr. Jose Wijnands is funded by the Michael Smith Foundation for Health Research and The Koehle Family Foundation.  Dr. Tremlett is the Canada Research Chair in Neuroepidemiology and Multiple Sclerosis.


Wijnands JMA,  Kingwell E,  Zhu F, Zhao Y, Fisk JD,  Evans C,  Marrie RA, Tremlett H. Infection-related health care utilization among people with and without multiple sclerosis. Mult Scler. DOI: 10.1177/1352458516681198