Nosocomial sepsis associated with interleukin-2.

Area of Science:

• Oncology
• Infectious Diseases
• Immunotherapy

Background:

• Cancer immunotherapy utilizing interleukin-2 (IL-2) with or without lymphokine-activated killer (LAK) cells is a critical treatment modality.
• Nosocomial bacteremia poses a significant threat to immunocompromised patients undergoing intensive therapies.
• Understanding infection risks associated with novel cancer treatments is crucial for patient safety.

Purpose of the Study:

• To investigate the incidence, clinical severity, and risk factors of nosocomial bacteremia in patients undergoing IL-2-based cancer immunotherapy.
• To compare bacteremia rates in IL-2 treated patients with control groups receiving different intensive care interventions.
• To identify specific pathogens and associated morbidities in patients developing bacteremia during IL-2 therapy.

Main Methods:

• A cohort study design was employed, enrolling patients undergoing IL-2 +/- LAK cell therapy over a 28-month period.
• Control groups included patients in surgical intensive care units, receiving total parenteral nutrition, and those with solid tumors.
• Data collection focused on bacteremia incidence, causative pathogens, clinical outcomes, and identified risk factors such as catheter colonization and skin integrity.

Main Results:

• Nineteen percent (20/107) of IL-2 treated patients developed bacteremia, with 12 cases associated with intravenous catheters.
• Staphylococcus aureus was the predominant pathogen, identified in 13 instances.
• Significant risk factors for S. aureus bacteremia included S. aureus colonization (6.3-fold increased risk) and skin desquamation at the catheter site (2.0-fold increased risk).

Conclusions:

• Interleukin-2 therapy is associated with a higher incidence of staphylococcal bacteremia compared to control patient groups.
• Nosocomial bacteremia in this cohort leads to considerable morbidity, including suppurative thrombophlebitis and septic complications.
• Preventive strategies targeting S. aureus colonization and meticulous catheter site care are essential for reducing bacteremia risk in IL-2 treated patients.