TY - JOUR
T1 - Elevated serum interleukin-10 at time of hospital admission is predictive of mortality in patients with staphylococcus aureus bacteremia
AU - Rose, Warren E.
AU - Eickhoff, Jens C.
AU - Shukla, Sanjay K.
AU - Pantrangi, Madhulatha
AU - Rooijakkers, Suzan
AU - Cosgrove, Sara E.
AU - Nizet, Victor
AU - Sakoulas, George
N1 - Funding Information:
Financial support. This work was supported by the Sharp Healthcare Foundation (San Diego, CA) for laboratory analyses performed in this study. The funding source was not involved in the design and conduct of the study; data analysis and interpretation; or preparation, review, and approval of the manuscript.
Funding Information:
Potential conflicts of interest. W. E. R. received grant funding and is speaker honoraria for Cubist, received grant funding from Astellas, and consults for The Medicines Company and Visante; G. S. consults, received grant funding, and is speaker honoraria for Cubist; consults and is speaker honoraria for Astellas; and is speaker honoraria for Pfizer. All other authors report no potential conflicts.
PY - 2012/11/15
Y1 - 2012/11/15
N2 - Background. Staphylococcus aureus bacteremia (SaB) carries considerable morbidity and mortality. We examined the predictive value of serum concentrations of interleukin (IL)-10, proinflammatory cytokines, and terminal complement on patient survival and SaB duration.Methods.Clinical information on consecutive patients with SaB at a tertiary medical center were collected prospectively. Patient serum samples obtained at the day of clinical presentation were assayed for tumor necrosis factor-, IL-1, IL-10, and complement membrane attack complex C5b-9 concentrations using enzyme-linked immunoassay. Logistic regression identified predictors of mortality and duration of bacteremia.Results.In 59 patients with SaB, 14 died and 17 had prolonged bacteremia (>4 days). Elevated IL-10 serum concentrations (>7.8 pg/mL) identified all 8 patients who died, whereas there were no deaths in patients with normal IL-10 (P =. 016). The lack of an IL-1 response (≤0.45 pg/mL) defined all patients with SaB >4 days. In multivariate analysis, patient age (odds ratio [OR], 1.16; P =. 022), duration of bacteremia (OR, 1.16; P =. 031), and serum IL-10 (OR, 1.05; P =. 014) were identified as independent predictors of patient mortality.Conclusions.SaB mortality was confined strictly to patients with elevated IL-10 concentrations. We recommend that future clinical trials of SaB stratify patients according to IL-10 and IL-1 serum concentrations in order to better evaluate the impact of therapeutic interventions on patient outcome.
AB - Background. Staphylococcus aureus bacteremia (SaB) carries considerable morbidity and mortality. We examined the predictive value of serum concentrations of interleukin (IL)-10, proinflammatory cytokines, and terminal complement on patient survival and SaB duration.Methods.Clinical information on consecutive patients with SaB at a tertiary medical center were collected prospectively. Patient serum samples obtained at the day of clinical presentation were assayed for tumor necrosis factor-, IL-1, IL-10, and complement membrane attack complex C5b-9 concentrations using enzyme-linked immunoassay. Logistic regression identified predictors of mortality and duration of bacteremia.Results.In 59 patients with SaB, 14 died and 17 had prolonged bacteremia (>4 days). Elevated IL-10 serum concentrations (>7.8 pg/mL) identified all 8 patients who died, whereas there were no deaths in patients with normal IL-10 (P =. 016). The lack of an IL-1 response (≤0.45 pg/mL) defined all patients with SaB >4 days. In multivariate analysis, patient age (odds ratio [OR], 1.16; P =. 022), duration of bacteremia (OR, 1.16; P =. 031), and serum IL-10 (OR, 1.05; P =. 014) were identified as independent predictors of patient mortality.Conclusions.SaB mortality was confined strictly to patients with elevated IL-10 concentrations. We recommend that future clinical trials of SaB stratify patients according to IL-10 and IL-1 serum concentrations in order to better evaluate the impact of therapeutic interventions on patient outcome.
UR - http://www.scopus.com/inward/record.url?scp=84867733152&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84867733152&partnerID=8YFLogxK
U2 - 10.1093/infdis/jis552
DO - 10.1093/infdis/jis552
M3 - Article
C2 - 22966128
AN - SCOPUS:84867733152
SN - 0022-1899
VL - 206
SP - 1604
EP - 1611
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 10
ER -