0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Nosocomial Sepsis Associated with Interleukin-2

David R. Snydman, MD; Bernadette Sullivan, RN; Maura Gill, RN; Jody A. Gould, RN; David R. Parkinson, MD; and Michael B. Atkins, MD
[+] Article and Author Information

Grant Support: In part by General Clinical Research Center Grant CRR-00088 and contract N01-CM-73706 from the National Institutes of Health.

Presented in part on October 1988 at the Twenty-Ninth Interscience Conference on Antimicrobial Agents and Chemotherapy, Los Angeles, California.

Requests for Reprints: David R. Snydman, MD, Box 238, New England Medical Center, 750 Washington Street, Boston, MA 02111.

Current Author Addresses: Drs. Snydman and Atkins, and Ms. Sullivan, Gill, and Gould: New England Medical Center, 750 Washington Street, Boston, MA 02111.

Dr. Parkinson: M.D. Anderson Hospital, 1515 Holcombe Boulevard, Houston, TX 77030.


©1990 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1990;112(2):102-107. doi:10.7326/0003-4819-112-2-102
Text Size: A A A

Study Objective: To determine the incidence, clinical magnitude, and risk factors for nosocomial bacteremia in patients given interleukin-2 with or without (±) lymphokine activated killer (LAK) cells for cancer immunotherapy.

Design: Cohort study.

Setting: Clinical study unit of tertiary medical center.

Patients: All patients entering the interleukin-2 ±LAK cancer immunotherapy protocol during a 28-month period. Control groups were patients in a surgical intensive care unit, patients receiving total parenteral nutrition, and patients with solid tumors.

Measurements and Main Results: Twenty of 107 (19%) interleukin-2-treated patients developed sepsis; in 12 of these patients, sepsis was intravenous catheter-associated. The bacteremia rate among patients receiving total parenteral nutrition, in the surgical intensive care unit, or having solid tumors was 2.8%, 4.1%, and 1.9%, respectively. Staphylococcus aureus was the pathogen in 13 courses; Staphylococcus epidermidis, in 5; and Escherichia coli, in 2. Two patients died; three developed suppurative thrombophlebitis; one developed septic arthritis; one, septic arterial aneurysm; and one, peritonitis with probable meningitis. Colonization with S. aureus increased the risk of S. aureus bacteremia 6.3-fold (95% CI, 2.8 to 14.5; P < 0.001); skin desquamation at the catheter site increased the relative risk 2.0-fold (95% CI, 1.3 to 3.1; P = 0.031). Both colonization with S. aureus and skin desquamation increased the relative risk of S. aureus bacteremia 14.5-fold (95% CI, 4.1 to 50.9; P < 0.0001).

Conclusions: Staphylococcal bacteremia is more frequent in patients receiving interleukin-2 therapy and is associated with substantial morbidity and toxic skin reactions.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)