IL-1β and IL-10 Host Responses in Patients with Staphylococcus aureus Bacteremia Determined by Antimicrobial Therapy.
Clin Infect Dis. 2019 Aug 01;:
Authors: Volk CF, Burgdorf S, Edwardson G, Nizet V, Sakoulas G, Rose WE
INTRODUCTION: Patient IL-1β and IL-10 responses early in the course of Staphylococcus aureus bacteremia (SaB) are associated with bacteremia duration and mortality. We hypothesized that these responses vary depending on choice of antimicrobial therapy, with particular interest in knowing whether the superior performance of -lactams may be linked to key cytokine signaling pathways.
METHODS: Three medical centers included 59 patients with SaB (47 MRSA, 12 MSSA) from 2015-2017. In the first 48 h, patients were treated with either a β-lactam (n=24), including oxacillin, cefazolin, or ceftaroline, or a glyco-/lipopeptide (n=35), i.e. vancomycin or daptomycin (VAN/DAP). Patient sera from days 1, 3 and 7 were assayed for IL-1β and IL-10 by ELISA and compared using Mann-Whitney U.
RESULTS: On day 1 of presentation, IL-10 was elevated in patients with outcomes of mortality (P=0.008) and persistent bacteremia (P=0.034), while no difference occurred in IL-1β. Regarding treatment groups, IL-1β and IL-10 was similar at presentation prior to receiving an antibiotic. Patients treated with β-lactam had higher IL-1β on day 3 (median +5.6 pg/mL; P=0.007) and day 7 (+10.9 pg/ml; P=0.016). Ex vivo, the addition of IL-1 receptor antagonist anakinra to whole blood reduced staphylococcal killing, supporting a functional significance of the host IL-1β response in SaB clearance. β-lactam treated patients had sharper declines in IL-10 than VAN/DAP treated patients at days 3 and 7.
PMID: 31365924 [PubMed - as supplied by publisher]