Elevated serum interleukin-10 at time of hospital admission is predictive of mortality in patients with staphylococcus aureus bacteremia

Warren E. Rose, Jens C. Eickhoff, Sanjay K. Shukla, Madhulatha Pantrangi, Suzan Rooijakkers, Sara Cosgrove, Victor Nizet, George Sakoulas

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1604-1611
Number of pages8
JournalJournal of Infectious Diseases
Volume206
Issue number10
DOIs
StatePublished - Nov 15 2012

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Bacteremia
Interleukin-10
Staphylococcus aureus
Mortality
Serum
Interleukin-1
Complement Membrane Attack Complex
Odds Ratio
Immunoenzyme Techniques
Multivariate Analysis
Tumor Necrosis Factor-alpha
Logistic Models
Clinical Trials
Cytokines
Morbidity

ASJC Scopus subject areas

  • Infectious Diseases
  • Immunology and Allergy

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Elevated serum interleukin-10 at time of hospital admission is predictive of mortality in patients with staphylococcus aureus bacteremia. / Rose, Warren E.; Eickhoff, Jens C.; Shukla, Sanjay K.; Pantrangi, Madhulatha; Rooijakkers, Suzan; Cosgrove, Sara; Nizet, Victor; Sakoulas, George.

In: Journal of Infectious Diseases, Vol. 206, No. 10, 15.11.2012, p. 1604-1611.

Research output: Contribution to journalArticle

Rose, Warren E. ; Eickhoff, Jens C. ; Shukla, Sanjay K. ; Pantrangi, Madhulatha ; Rooijakkers, Suzan ; Cosgrove, Sara ; Nizet, Victor ; Sakoulas, George. / Elevated serum interleukin-10 at time of hospital admission is predictive of mortality in patients with staphylococcus aureus bacteremia. In: Journal of Infectious Diseases. 2012 ; Vol. 206, No. 10. pp. 1604-1611.
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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

AU - Nizet, Victor

AU - Sakoulas, George

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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.

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