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April 1990

Interferon Gamma and Tumor Necrosis Factor AlphaUse in Gram-negative Infection After Shock

Author Affiliations

From the Departments of Surgery (Drs Malangoni, Livingston, and Polk) and Microbiology and Immunology (Dr Sonnenfeld), University of Louisville (Ky) and Louisville Veterans Administration Medical Center.

Arch Surg. 1990;125(4):444-446. doi:10.1001/archsurg.1990.01410160030005

• Shock increases the propensity to develop infection after injury or operation. This study evaluated the effect of cefoxitin, interferon gamma (INF-γ), and tumor necrosis factor alpha (TNF-α) on the development of a polymicrobial soft-tissue infection. After sham operation or hemorrhagic shock and resuscitation, Sprague-Dawley rats were inoculated with 1 × 108Escherichia coli and 1 × 109Bacteroides fragilis in a 5% fecal suspension. Animals received either no treatment, cefoxitin, recombinant rat INF-γ, recombinant human TNF-α, or cefoxitin/cytokine combinations. Cefoxitin reduced abscess size by 57% in animals without shock but only by 26% after shock. Although neither INF-γ nor TNF-α alone had a salutary effect when given with cefoxitin in animals after shock, INF-γ and TNF-α reduced abscess size by 50% and 55%, respectively. These results suggest that INF-γ and TNF-α may be useful to reduce the severity of mixed gram-negative infections after shock with bacterial contamination.

(Arch Surg. 1990;125:444-446)