Limulus Amebocyte Lysate Assay for Detection of Endotoxin in Patients with Sepsis Syndrome
Clinical predictions alone are insufficiently accurate to identify patients with specific types of bloodstream infection; laboratory assays might improve such predictions. Therefore, we performed a prospective cohort study of 356 episodes of sepsis syndrome and did Limulus amebocyte lysate (LAL) ass...
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Published in | Clinical infectious diseases Vol. 27; no. 3; pp. 582 - 591 |
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Main Authors | , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Chicago, IL
The University Chicago Press
01.09.1998
University of Chicago Press |
Subjects | |
Online Access | Get full text |
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Summary: | Clinical predictions alone are insufficiently accurate to identify patients with specific types of bloodstream infection; laboratory assays might improve such predictions. Therefore, we performed a prospective cohort study of 356 episodes of sepsis syndrome and did Limulus amebocyte lysate (LAL) assays for endotoxin. The main outcome measures were bacteremia and infection due to gram-negative organisms; other types of infection were secondary outcomes. Assays were defined as positive if the result was ⩾0.4 enzyme-linked immunosorbent assay units per milliliter. There were positive assays in 119 (33%) of 356 episodes. Assay positivity correlated with the presence of fungal bloodstream infection (P < .003) but correlated negatively with the presence of gram-negative organisms in the bloodstream (P = .04). A trend toward higher rates of mortality in the LAL assay-positive episodes was no longer present after adjusting for severity. Thus, results of LAL assay did not correlate with the presence of bacteremia due to gram-negative organisms or with mortality after adjusting for severity but did correlate with the presence of fungal bloodstream infection. |
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Bibliography: | ark:/67375/HXZ-WH37L2JT-2 Members of the AMCC Sepsis Project Working Group are listed after the text. Correspondence: Dr. David W. Bates, Division of General Medicine, Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, Massachusetts 02115. istex:AA4E0B7E888CB2B49C0DCD5938344E093365CBC5 ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 |
ISSN: | 1058-4838 1537-6591 |
DOI: | 10.1086/514713 |