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Detection of gram‐negative bacteraemia in early sepsis by a quantitative chromogenic and kinetic endotoxin assay
Author(s) -
MASSIG D.,
LEPAPE A.,
DEBIZE G.,
REMILLIEUX M. F.,
DE PASQUALE V.,
BANSSILLON V.,
CŒUR P.
Publication year - 1996
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1046/j.1365-2362.1996.1810531.x
Subject(s) - limulus , sepsis , chromogenic , dilution , limulus amebocyte lysate , gram , septic shock , medicine , chromatography , bacteremia , chemistry , microbiology and biotechnology , immunology , biology , bacteria , paleontology , physics , genetics , antibiotics , lipopolysaccharide , thermodynamics
A kinetic chromogenic limulus test was carried out in order to investigate the possibility of a sensitive and specific detection of circulating endotoxin during the first 24 h of septic shock or severe sepsis in 76 patients. Two commercial kits, Whittaeker (W) and Chromogenix (C), were used. Blood culture was taken as a reference. At 1 : 10 plasma dilution (a currently used dilution in the end point limulus test) abnormal reaction kinetics were found in 13% and 41% of tests, for C and W respectively ( P = 0.0008), resulting in unreliable results. Retesting plasma at a greater dilution, until the reaction kinetic was identical to calibration curve control values, gave similar results between the two kits and a better accuracy. Beyond a 0.5 EU mL −1 endotoxin level, the probability of Gram‐negative bacteraemia was high (sensitivity = 0.53 and 0.47; specificity = 0.95 and 0.93 for C and W respectively). This kinetic limulus amoebocyte lysate (LAL) test may be useful in therapeutic decisions for treatment of endotoxaemia.