Plasma Endotoxin as a Predictor of Multiple Organ Failure and Death in Systemic Meningococcal Disease
We studied prospectively the quantitative relation of circulating endotoxin (lipooligosaccharides [LOSs)) and the development of multiple organ failure and death in 45 consecutively admitted patients with bacteriologically verified systemic meningococcal disease (SMD). A plasma illS level of >700...
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| Veröffentlicht in: | The Journal of infectious diseases 1989-02, Vol.159 (2), p.195-204 |
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| container_title | The Journal of infectious diseases |
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| creator | Brandtzaeg, Petter Kierulf, Peter Gaustad, Peter Skulberg, Andreas Bruun, Johan N. Halvorsen, Sverre Sørensen, Eigil |
| description | We studied prospectively the quantitative relation of circulating endotoxin (lipooligosaccharides [LOSs)) and the development of multiple organ failure and death in 45 consecutively admitted patients with bacteriologically verified systemic meningococcal disease (SMD). A plasma illS level of >700 ng/L correlated with development of severe septic shock (P .0001), adult respiratory distress syndrome (P = .(035), a pathologically elevated serum creatinine level (P < .0001), or death as a consequence of multiple organ failure (P = .0002). Initial plasma illS levels of 10 000 ng/L were associated with 0%, 14%, 27%, and 86% fatality, respectively. The illS half-life after initiation of antibiotic therapy was 1–3 h. Increasing plasma LOS levels were never seen. These observations suggest that LOS quantitation using the limulus amebocyte lysate assay with a chromogenic substrate gives important progsnotic information and may provide new insight concerning pathophysiological aspects of SMD. |
| doi_str_mv | 10.1093/infdis/159.2.195 |
| format | Article |
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A plasma illS level of >700 ng/L correlated with development of severe septic shock (P .0001), adult respiratory distress syndrome (P = .(035), a pathologically elevated serum creatinine level (P < .0001), or death as a consequence of multiple organ failure (P = .0002). Initial plasma illS levels of <25, 25–700, 700–10 000, and >10 000 ng/L were associated with 0%, 14%, 27%, and 86% fatality, respectively. The illS half-life after initiation of antibiotic therapy was 1–3 h. Increasing plasma LOS levels were never seen. These observations suggest that LOS quantitation using the limulus amebocyte lysate assay with a chromogenic substrate gives important progsnotic information and may provide new insight concerning pathophysiological aspects of SMD.</description><identifier>ISSN: 0022-1899</identifier><identifier>EISSN: 1537-6613</identifier><identifier>DOI: 10.1093/infdis/159.2.195</identifier><identifier>PMID: 2492587</identifier><identifier>CODEN: JIDIAQ</identifier><language>eng</language><publisher>Chicago, IL: The University of Chicago Press</publisher><subject>Adolescent ; Adult respiratory distress syndrome ; Antibiotics ; Bacterial diseases ; Bacterial diseases of the nervous system. Bacterial myositis ; Biological and medical sciences ; Blood ; Blood plasma ; Child ; Child, Preschool ; Endotoxins ; Endotoxins - blood ; Female ; Human bacterial diseases ; Humans ; Infant ; Infectious diseases ; Lipopolysaccharides - blood ; Male ; Medical sciences ; Meningitis, Meningococcal - blood ; Meningitis, Meningococcal - complications ; Meningitis, Meningococcal - mortality ; Meningococcal meningitis ; Multiple organ failure ; Multiple Organ Failure - physiopathology ; Neisseria meningitidis ; Neisseria meningitidis - isolation & purification ; Original Articles ; Pathology ; Prognosis ; Sepsis ; Septic shock ; Shock, Septic - blood ; Shock, Septic - complications ; Shock, Septic - mortality</subject><ispartof>The Journal of infectious diseases, 1989-02, Vol.159 (2), p.195-204</ispartof><rights>Copyright 1989 The University of Chicago</rights><rights>1990 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c480t-50a8fbc5a6b17419180d8263663f863e4315a1d7aac8e87bbd2ce7cacc2fc3263</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/30139365$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/30139365$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>314,776,780,799,27903,27904,57995,58228</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=6915783$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/2492587$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Brandtzaeg, Petter</creatorcontrib><creatorcontrib>Kierulf, Peter</creatorcontrib><creatorcontrib>Gaustad, Peter</creatorcontrib><creatorcontrib>Skulberg, Andreas</creatorcontrib><creatorcontrib>Bruun, Johan N.</creatorcontrib><creatorcontrib>Halvorsen, Sverre</creatorcontrib><creatorcontrib>Sørensen, Eigil</creatorcontrib><title>Plasma Endotoxin as a Predictor of Multiple Organ Failure and Death in Systemic Meningococcal Disease</title><title>The Journal of infectious diseases</title><addtitle>J Infect Dis</addtitle><description>We studied prospectively the quantitative relation of circulating endotoxin (lipooligosaccharides [LOSs)) and the development of multiple organ failure and death in 45 consecutively admitted patients with bacteriologically verified systemic meningococcal disease (SMD). A plasma illS level of >700 ng/L correlated with development of severe septic shock (P .0001), adult respiratory distress syndrome (P = .(035), a pathologically elevated serum creatinine level (P < .0001), or death as a consequence of multiple organ failure (P = .0002). Initial plasma illS levels of <25, 25–700, 700–10 000, and >10 000 ng/L were associated with 0%, 14%, 27%, and 86% fatality, respectively. The illS half-life after initiation of antibiotic therapy was 1–3 h. Increasing plasma LOS levels were never seen. These observations suggest that LOS quantitation using the limulus amebocyte lysate assay with a chromogenic substrate gives important progsnotic information and may provide new insight concerning pathophysiological aspects of SMD.</description><subject>Adolescent</subject><subject>Adult respiratory distress syndrome</subject><subject>Antibiotics</subject><subject>Bacterial diseases</subject><subject>Bacterial diseases of the nervous system. Bacterial myositis</subject><subject>Biological and medical sciences</subject><subject>Blood</subject><subject>Blood plasma</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Endotoxins</subject><subject>Endotoxins - blood</subject><subject>Female</subject><subject>Human bacterial diseases</subject><subject>Humans</subject><subject>Infant</subject><subject>Infectious diseases</subject><subject>Lipopolysaccharides - blood</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Meningitis, Meningococcal - blood</subject><subject>Meningitis, Meningococcal - complications</subject><subject>Meningitis, Meningococcal - mortality</subject><subject>Meningococcal meningitis</subject><subject>Multiple organ failure</subject><subject>Multiple Organ Failure - physiopathology</subject><subject>Neisseria meningitidis</subject><subject>Neisseria meningitidis - isolation & purification</subject><subject>Original Articles</subject><subject>Pathology</subject><subject>Prognosis</subject><subject>Sepsis</subject><subject>Septic shock</subject><subject>Shock, Septic - blood</subject><subject>Shock, Septic - complications</subject><subject>Shock, Septic - mortality</subject><issn>0022-1899</issn><issn>1537-6613</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1989</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUtv1DAUhS0EKkNhzwbJC8QuUz_i1xL1wbTqCwFSxca6cZzikjhTO5Haf49HMwxLVnfxnXOudA5C7ylZUmL4UYhdG_IRFWbJltSIF2hBBVeVlJS_RAtCGKuoNuY1epPzAyGk5lIdoANWGya0WiB_20MeAJ_GdpzGpxAxZAz4Nvk2uGlMeOzw1dxPYd17fJPuIeIzCP2cPIbY4hMP0y9cXN-e8-SH4PCVjyHej250Dnp8ErKH7N-iVx302b_b3UP04-z0-_Gqurz5cn78-bJytSZTJQjornECZENVTQ3VpNVMcil5pyX3NacCaKsAnPZaNU3LnFcOnGOd40V4iD5tc9dpfJx9nuwQsvN9D9GPc7ZKa0Frw_8rpIJpatRGSLZCl8ack-_sOoUB0rOlxG4msNsJisNYZssExfJhlz03g2_3hl3nhX_ccciloy5BdCXgr0waKpTm_2Iectlhjzmh3HC5eVNteSjNP-05pN9WKq6EXd39tHcXX8Xqur62hv8BESmpCA</recordid><startdate>19890201</startdate><enddate>19890201</enddate><creator>Brandtzaeg, Petter</creator><creator>Kierulf, Peter</creator><creator>Gaustad, Peter</creator><creator>Skulberg, Andreas</creator><creator>Bruun, Johan N.</creator><creator>Halvorsen, Sverre</creator><creator>Sørensen, Eigil</creator><general>The University of Chicago Press</general><general>University of Chicago Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>C1K</scope><scope>7X8</scope></search><sort><creationdate>19890201</creationdate><title>Plasma Endotoxin as a Predictor of Multiple Organ Failure and Death in Systemic Meningococcal Disease</title><author>Brandtzaeg, Petter ; Kierulf, Peter ; Gaustad, Peter ; Skulberg, Andreas ; Bruun, Johan N. ; Halvorsen, Sverre ; Sørensen, Eigil</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c480t-50a8fbc5a6b17419180d8263663f863e4315a1d7aac8e87bbd2ce7cacc2fc3263</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1989</creationdate><topic>Adolescent</topic><topic>Adult respiratory distress syndrome</topic><topic>Antibiotics</topic><topic>Bacterial diseases</topic><topic>Bacterial diseases of the nervous system. Bacterial myositis</topic><topic>Biological and medical sciences</topic><topic>Blood</topic><topic>Blood plasma</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Endotoxins</topic><topic>Endotoxins - blood</topic><topic>Female</topic><topic>Human bacterial diseases</topic><topic>Humans</topic><topic>Infant</topic><topic>Infectious diseases</topic><topic>Lipopolysaccharides - blood</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Meningitis, Meningococcal - blood</topic><topic>Meningitis, Meningococcal - complications</topic><topic>Meningitis, Meningococcal - mortality</topic><topic>Meningococcal meningitis</topic><topic>Multiple organ failure</topic><topic>Multiple Organ Failure - physiopathology</topic><topic>Neisseria meningitidis</topic><topic>Neisseria meningitidis - isolation & purification</topic><topic>Original Articles</topic><topic>Pathology</topic><topic>Prognosis</topic><topic>Sepsis</topic><topic>Septic shock</topic><topic>Shock, Septic - blood</topic><topic>Shock, Septic - complications</topic><topic>Shock, Septic - mortality</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Brandtzaeg, Petter</creatorcontrib><creatorcontrib>Kierulf, Peter</creatorcontrib><creatorcontrib>Gaustad, Peter</creatorcontrib><creatorcontrib>Skulberg, Andreas</creatorcontrib><creatorcontrib>Bruun, Johan N.</creatorcontrib><creatorcontrib>Halvorsen, Sverre</creatorcontrib><creatorcontrib>Sørensen, Eigil</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Brandtzaeg, Petter</au><au>Kierulf, Peter</au><au>Gaustad, Peter</au><au>Skulberg, Andreas</au><au>Bruun, Johan N.</au><au>Halvorsen, Sverre</au><au>Sørensen, Eigil</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Plasma Endotoxin as a Predictor of Multiple Organ Failure and Death in Systemic Meningococcal Disease</atitle><jtitle>The Journal of infectious diseases</jtitle><addtitle>J Infect Dis</addtitle><date>1989-02-01</date><risdate>1989</risdate><volume>159</volume><issue>2</issue><spage>195</spage><epage>204</epage><pages>195-204</pages><issn>0022-1899</issn><eissn>1537-6613</eissn><coden>JIDIAQ</coden><abstract>We studied prospectively the quantitative relation of circulating endotoxin (lipooligosaccharides [LOSs)) and the development of multiple organ failure and death in 45 consecutively admitted patients with bacteriologically verified systemic meningococcal disease (SMD). A plasma illS level of >700 ng/L correlated with development of severe septic shock (P .0001), adult respiratory distress syndrome (P = .(035), a pathologically elevated serum creatinine level (P < .0001), or death as a consequence of multiple organ failure (P = .0002). Initial plasma illS levels of <25, 25–700, 700–10 000, and >10 000 ng/L were associated with 0%, 14%, 27%, and 86% fatality, respectively. The illS half-life after initiation of antibiotic therapy was 1–3 h. Increasing plasma LOS levels were never seen. These observations suggest that LOS quantitation using the limulus amebocyte lysate assay with a chromogenic substrate gives important progsnotic information and may provide new insight concerning pathophysiological aspects of SMD.</abstract><cop>Chicago, IL</cop><pub>The University of Chicago Press</pub><pmid>2492587</pmid><doi>10.1093/infdis/159.2.195</doi><tpages>10</tpages></addata></record> |
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| subjects | Adolescent Adult respiratory distress syndrome Antibiotics Bacterial diseases Bacterial diseases of the nervous system. Bacterial myositis Biological and medical sciences Blood Blood plasma Child Child, Preschool Endotoxins Endotoxins - blood Female Human bacterial diseases Humans Infant Infectious diseases Lipopolysaccharides - blood Male Medical sciences Meningitis, Meningococcal - blood Meningitis, Meningococcal - complications Meningitis, Meningococcal - mortality Meningococcal meningitis Multiple organ failure Multiple Organ Failure - physiopathology Neisseria meningitidis Neisseria meningitidis - isolation & purification Original Articles Pathology Prognosis Sepsis Septic shock Shock, Septic - blood Shock, Septic - complications Shock, Septic - mortality |
| title | Plasma Endotoxin as a Predictor of Multiple Organ Failure and Death in Systemic Meningococcal Disease |
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