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Published on: September 16, 2017
Bacteremia in patients receiving TNF-alpha antagonists--a prospective multicenter study
Pierre Loulergue1, Florence Tubach, Dominique Salmon
1Université Paris Descartes, Faculté de médecine, AP-HP, Service de Maladies Infectieuses, hôpital Necker Enfants Malades, Centre d'infectiologie Necker Pasteur, 75015 Paris, France.
Patients on TNF-alpha antagonists face a risk of bacteremia. Staphylococcus aureus is a common cause, often linked to bone and joint infections, necessitating its inclusion in initial treatment plans.
Area of Science:
- Immunology
- Infectious Diseases
- Pharmacology
Background:
- Tumor Necrosis Factor-alpha (TNF-alpha) antagonists are widely used for chronic inflammatory diseases.
- Previous studies suggest a potential link between TNF-alpha antagonist use and increased risk of serious bacterial infections.
Purpose of the Study:
- To investigate the incidence and characteristics of bacteremia in patients treated with TNF-alpha antagonists.
- To identify common pathogens and outcomes associated with bacteremia in this patient population.
Main Methods:
- A national prospective study was conducted in France (2004-2007) within the RATIO registry.
- Collected and validated 47 cases of severe bacterial infections, specifically bacteremia, in patients receiving TNF-alpha antagonists.
Main Results:
- Forty-seven episodes of bacteremia were reported.
- Staphylococcus aureus was the most frequent causative pathogen (40%).
- S. aureus infections were often associated with bone and/or joint infections (68%) and resulted in worse outcomes compared to other pathogens.
Conclusions:
- Patients receiving TNF-alpha antagonists are susceptible to bacteremia.
- Staphylococcus aureus should be considered in the empirical antimicrobial therapy for these patients.
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