Totally implanted catheters to reduce catheter-related infections in patients receiving interleukin-2: a 2-year experience.
A high incidence of bacterial infections has been previously reported during interleukin-2 (IL-2) treatment, mainly due to catheter-related infections. Antibiotic prophylaxis has been successfully used to decrease such infections. The goal of this study was to evaluate an alternative way to reduce catheter-related infections in IL-2-treated patients by the use of totally implanted catheters. A total of 74 patients with metastatic renal cell carcinoma, referred to our institution to receive IL-2 from March 1989 to July 1991, were included in this prospective study. IL-2 was given on a 2-days-a-week schedule (24 x 10(6) IU m-2 day-1) either alone (41 patients) or in association with interferon gamma (33 patients). All these patients were prospectively evaluated for fever, bacteremia and line-site infection. Seven patients (9.5%) had one (2 patients) or more (5 patients) positive blood cultures with Staphylococcus aureus. Antibiotics were used only in 5 patients, and the catheter had to be removed in only 2 of these patients. In the other patients, no further infection developed despite the lack of antibiotics. Moreover, 9 patients had positive blood cultures with Staphylococcus epidermidis (1.9% of total number of blood cultures). In conclusion, a totally implanted catheter appears to reduce the incidence of infections in IL-2-treated patients, at least on a 2-days-a-week schedule.
Escudier
B
B
Intensive Care Unit, Institut Gustave Roussy, Villejuif, France.
Lethiec
J L
JL
Angevin
E
E
Andremont
A
A
Cosset-Delaigue
M F
MF
Antoun
S
S
Leclercq
B
B
Nitenberg
G
G
D000970:Antineoplastic Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000209:etiology / Q000517:prevention & control; D001424:Bacterial Infections / Q000209:etiology / Q000517:prevention & control*; D002292:Carcinoma, Renal Cell / Q000628:therapy; D002408:Catheters, Indwelling / Q000009:adverse effects*; D006801:Humans; D007371:Interferon-gamma / Q000627:therapeutic use; D007376:Interleukin-2 / Q000008:administration & dosage*; D007680:Kidney Neoplasms / Q000628:therapy; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000209:etiology / Q000517:prevention & control; D013212:Staphylococcus epidermidis
D000970:Antineoplastic Agents; D007376:Interleukin-2; D007371:Interferon-gamma