Serial Quantitation of Endotoxemia and Bacteremia During Therapy for Gram-Negative Bacterial Sepsis

The clinical condition of some patients with gram-negative bacterial sepsis worsens despite antibiotic therapy that is highly effective against the infecting organism in vitro. A possible explanation is host-cell injury resulting from the persistence of endotoxin and other bacterial toxins left in t...

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Bibliographic Details
Published in:The Journal of infectious diseases 1988-03, Vol.157 (3), p.565-568
Main Authors: Shenep, Jerry L., Flynn, Patricia M., Barrett, Frederick F., Stidham, Gregory L., Westenkirchner, David F.
Format: Article
Language:English
Subjects:
Adolescent
Anti-Bacterial Agents - therapeutic use
Antibacterial agents
Antibiotics
Antibiotics. Antiinfectious agents. Antiparasitic agents
Bacteremia
Bacteria
Bacterial Infections - blood
Bacterial Infections - drug therapy
Biological and medical sciences
Blood
Blood plasma
Child
Child, Preschool
Concise Clinical and Laboratory Communications
Endotoxemia
Endotoxins
Endotoxins - blood
Female
Gram-Negative Bacteria
Health care administration
Hospital admissions
Humans
Infant
Male
Medical sciences
Pharmacology. Drug treatments
Sepsis
Sepsis - drug therapy
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Summary:The clinical condition of some patients with gram-negative bacterial sepsis worsens despite antibiotic therapy that is highly effective against the infecting organism in vitro. A possible explanation is host-cell injury resulting from the persistence of endotoxin and other bacterial toxins left in the wake of antibiotic-induced bacterial cell lysis. Supporting this hypothesis are studies, with experimentally infected animals, indicating that elevated plasma levels of endotoxin not only persist but can increase appreciably after effective antibiotic therapy. The authors quantified levels of plasma endotoxin and bacteremia serially in patients with gram-negative bacteria sepsis, beginning just before the first dose of antibiotics was administered. Plasma concentrations of bacterial cell-bound endotoxin and free endotoxin were measured separately to assess the degree of bacterial cell lysis.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/157.3.565