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PubMed1987

[Microbiologic-immunologic laboratory diagnosis in suspected meningitis/encephalitis].

The diagnosis on the exclusion of infectious diseases of the central nervous system, especially of bacterial infections still is one of the most important issues in clinical microbiology. In bacterial meningitis, where lethal courses as well as severe sequelae are still frequent, there should be a rapid diagnosis not only with microscopy but also with Limulus test and antigen detection tests because a specific therapy should be initiated as soon as possible. But also viral infections caused by varicella or herpes virus are increasingly susceptible to chemotherapy. The indication for the examination of cerebrospinal fluid, the minimal volume for exhaustive laboratory tests and the possibilities of a stepwise diagnostic procedure are given with reference data from literature for the various techniques. In our experience the synopsis of laboratory results and clinical symptoms yielded in 75% of all cases the exclusion of an infectious etiology of the disease. In 17% a bacterial meningitis or the infection of a hydrocephalus shunt could be diagnosed. Viral infections could be proven in 4% either by antibody or by antigen detection. Only in 1% of all patients the clinical symptoms and the laboratory parameters remained unclear.

Antigens, Bacterial↗
PubMedDate not supplied

Preliminary study on the concentration and species composition of bacteria, fungi and mites in samples of house dust from Silesia (Poland).

Twenty-one samples of house dust collected from dwellings situated in Upper Silesia (Poland) were subjected to bacteriological, mycological and acarological examination. Moreover, in two samples the concentration of bacterial endotoxin was estimated by the use of Limulus test. The mean concentration of bacteria in the examined samples was 2831.9 thousands cfu (colony forming units) per gram, that of fungi - 28.4 thousands cfu per gram, and that of mites - 51.5 specimens per gram. No significant correlation could be found between the numbers of these three components of house dust. Two examined samples of house dust contained high amounts of bacterial endotoxin which are comparable to the concentration of endotoxin in agricultural dusts, and could be of immunopathogenic significance. In the bacterial flora of the examined house dust samples, staphylococci prevailed in 45.9% of all isolates, streptococci (23.2%), corynebacteria (13.9%) and spore-forming bacilli (12.2%). Among fungi, the most numerous were strains of the genus Penicillium (39.4%), yeasts (29.5%) and strains of the genus Aspergillus (8.4%). Both bacteria and fungi comprise species that are known for their allergenic properties. The mite fauna of the examined samples was dominated by Dermatophagoides farinae (62.7% of all specimens) and Dermatophagoides pteronyssinus (30.4%); both species are known as important allergens of house dust. The results hitherto obtained indicate the potential significance of all the investigated components (bacteria, fungi and mites) in causing allergy to house dust.

Animals↗
PubMed1985

[In vitro release of lipopolysaccharide in Escherichia coli by addition of antiseptic and disinfectant products].

Release of lipopolysaccharide (LPS) by E. coli following addition of antiseptics and disinfectants was investigated using the Limulus test. The five following compounds were studied: glutaraldehyde (cidex 2%), chlorhexidine 0.05%, povidone iodine 5%, aqueous formol 37%, and cetavlon 20%. These compounds were used in concentrations 2 to 4 times greater than the previously determined minimal inhibitory concentrations. LPS concentration falls sharply following addition of glutaraldehyde (cidex) to a suspension of E. coli (approximately 10(6)/ml). Released LPS is completely inhibited by formol and cetavlon. In contrast, high levels of LPS persist in the presence of chlorhexidine and povidone iodine. These results illustrate the need for thoroughly and generously washing all non-autoclavable equipment exposed to these chemical agents.

Anti-Infective Agents, Local↗
PubMedDate not supplied

[Toxic activity of Legionella pneumophila: current findings and prospects].

The AA. report the personal contributions and the recent findings of other investigators dealing with the toxic activities of Legionella pneumophila, the causative agent of Legionnaires' Disease. From the results of some tests (particularly Limulus endotoxin assay, pyrogenic reaction, skin Shwartzman reaction) there is an increasing evidence that Legionella pneumophila possesses some of the in vitro and in vivo biological properties associated with endotoxins of Gram negative bacteria, even if to a different of potency in different strains. However, the exact roles of an endotoxin and other bacterial products (e.g. haemolysins) as a pathogenetic mediators of the pathophysiological events of the disease remain to be determined.

Animals↗
PubMed1977

[Septic shock in the urologic patient. III. Microbiological problems (author's transl)].

From a microbiological point of view, the onset of septicemia in urology is related mainly to nosocomial germs; germs acquired outside of the hospital play a lesser role. The special problems caused by this kind of germ are analyzed in terms of our own cases. The limulus test as a possible method for the early diagnosis of gram negative septicemia is discussed critically. Chemotherapy as well as prophylactic measures is discussed.

Age Factors↗
PubMedDate not supplied

[Endotoxemia and phagocytic function in premature infants. II. Role of the blood platelets].

The AA. have studied the relationship between endotoxaemia, detected in premature children and platelets function, according to the most recent finding, supporting the presence of specific receptors for endotoxin at the surface of thrombocytes. The finding of 6 positive Limulus test on platelets over 7 cases support the ability of clearance from platelets towards endotoxin. Furthermore, the AA. suggest that the presence of endotoxaemia in the plasma is due to an impairment of more complex mechanism, as liver's detoxification, which seems the most important.

Blood Platelets↗
PubMed1984

Research and development of infant formulae with reduced allergenic properties.

Infant formulae based on hydrolyzed proteins or elemental diets offer the best treatment of cow's milk allergy whenever exclusive breast-feeding is not possible. In situations with a family history of atopy, formulae using other protein sources such as soya or chicken meat can also be a good preventive measure. The food industry needs reliable research methods for the evaluation of every new option before considering clinical trials. Allergenicity of cow's milk proteins was evaluated by the induction of mouse monoclonal reagins and also by oral administration of milk preparations to mice and guinea pigs. Animals initially raised on commercial diets containing about 1% milk whey could not be sensitized. Maintenance of a milk-free diet from pregnancy until weaning, and feeding milk in a liquid form led to an optimal sensitization of the guinea pigs. These animals suffered systemic anaphylaxis and their sera sensitized skin in virgin hosts. Under optimal conditions, while giving liquid preparations to drink, a considerable proliferation of the milk flora occurred. As no mucosal alterations could be detected, primary gut damage due to infection was probably not the triggering factor for oral sensitization. Bacterial products (e.g., endotoxins, enterotoxins) could stimulate the gut response towards milk proteins, either due to an adjuvant effect or to increased mucosal permeability. Microbial contamination of milk is practically unavoidable and it can generally induce biologic activity, e.g., fresh milk regularly gives a positive limulus test for endotoxin by the time it is consumed or processed. Reduction of bacterial contaminants by milk protective factors might help to prevent oral sensitization.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1983

[Constant infusion of 15-O-labeled water and inhalation of 11C-labeled carbon monoxide for the regional determination of lung water by positron emission tomography].

A method was developed for the continuous infusion of 15O-labeled water which allows the tomographic reconstruction of the total lung water (TLW). Subsequent inhalation of 11C-labeled carbon-monoxide permits the reconstruction of the blood volume (BV). After normalization of intravascular activities the difference of TLW minus BV yields a quantitative value of regional extravascular lung water (rELW). 15O-O2 is converted on-line to 15O-H2O and trapped in a 2 ml buffer reservoir which is fed by a pump with 0.9% NaCl. A precision pump is used to withdraw the labeled H2O and infuse it at a rate of 6 ml/min. The radioactivity level of the infusate (ca. 3.7 MBq/sec) is controlled and can be kept constant with a deviation of less than 5% over 40 min. The sterility and apyrogenicity of the system effluent is assured by frequent bacteriological, rabbit and limulus tests. A constant radioactivity level in the lung area is reached after 8-10 min. The infusion is continued for the tomographic reconstruction (Positron Camera System 4200, Cyclotron Corp.) which takes 15 min. A fast change of cyclotron parameters (MC-36, Scanditronix) and automated chemistry procedures allow a single breath administration of 11C-CO (ca. 40 MBq) 15 min after the end of the 15O-H2O infusion. Blood pool equilibrium is reached after 3-4 min, and the blood volume is reconstructed within 15 min also. Intravascular activities as determined from reconstructed slices in the region of the aortic arch correlate linearly with blood sample activities up to 100 kBq/ml.

Body Water↗
PubMed1981

Rapid laboratory diagnosis of infectious diseases.

The countercurrent immunoelectrophoresis and latex particle agglutination tests are rapid, do not require expensive apparatus, and are easy to perform if specific antigens and antisera are available. Both tests have been shown to be of value in the diagnosis of bacterial infections (such as those caused by H. influenzae, Streptococcus pneumoniae, N. meningitidis, E. coli, Staphylococcus aureus and group B streptococcus) and of viral infections (HRVLA and hepatitis B); they may also be of value in fungal and parasitic infections. Etiologic diagnosis of commonly seen clinical conditions (such as pneumonia, meningitis, cellulitis, osteomyelitis, lymphadenitis, and arthritis) by practicing physicians can be made using these tests to detect antigens in various body fluids in a hospital laboratory.

Bacterial Infections↗
PubMed1980

[Intensive treatment of septic shock].

In order to identify a septic shock syndrome, the Limulus test (positive results in 10 cases out of 12) is preferable to hemoculture (positive in 9 cases out of 22), as a valid tool for a precocious diagnosis and to support both the clinical diagnosis and the precocious case finding of the septic conditions. According to the Authors, as far as intensive treatment is concerned, the simultaneous finding of the central venous pressure (CVP) and the lung capillary (LC) allows an accurate evaluation of the rate of cardiac impairment and the alterations to the distribution of blood volume in connection with treatment. The Authors have also reported the data related to the clinical course of illness and mortality rate (68%) in 21 cases of septic shock, as well as the hemodynamic parameters with the pertinent correlations (CVP-PAP-Pcp and Da-v) in 12 patients affected by septic shock from the very beginning and throughout the whole period of treatment.

Critical Care↗
PubMed1982

Rapid diagnostic techniques for bacterial meningitis.

The purpose of this review is to provide an overview of the most prevalent current methods for rapid diagnosis of meningitis. In addition, some of those techniques which, while not yet practicable for most laboratories but are on the clinical horizon, have been surveyed. Two principles which emerge from this review are that many of the older techniques, such as Gram stain, retain their clinical utility by virtue of their practicality, cost-benefit ratio, and simplicity; and many of the more sophisticated techniques which are now emerging from the research arena (such as FPEC-GLC), facilitate rapid diagnosis where it has not previously existed. Also, when identification of the infectious agent depends on antigen detection, prior treatment will not compromise the results. Therefore, the combination of old and new laboratory methods for diagnosing meningitis provides a much wider, more effective and efficient set of diagnostic tools than was previously available.

Antigens, Bacterial↗
PubMed1980

[Endotoxinemia in acute pancreatitis (author's transl)].

In a clinical study the question was asked, whether endotoxinemia of intestinal origin accompanying acute pancreatitis would influence decisively the course of this disease. In 21 of 32 patients with acute pancreatitis endotoxinemia could be diagnosed by the Limulus test, in this group 9 patients died. In the group of patients without endotoxinemia however no patient died. Extrapancreatic complications as for instance coagulation defects, renal failure, and pulmonary changes were predominant in the patients with endotoxinemia. From these findings the conclusion is made, that endotoxinemia occurs frequently in acute pancreatitis and influences decisively the course of the disease.

Acute Disease↗
PubMed1995

[The role of tumor necrosis factor in acute pancreatitis and associated multiple organ failure].

In 32 patients with acute pancreatitis (AEP = 15, ANP = 17), tumor necrosis factor (TNF) activity, oxygen-derived free radicals (OFR) and endotoxin contents were determined by L929 cell bioassay, Tetrabarbituric acid fluorometry and Limulus test respectively. The results showed that TNF and OFR elevated in patients with AP at the admission (P < 0.05 vs normal). The change of TNF and OFR responded to the clinical symptoms. TNF correlated to early multiple organ failure (MOF). In patients with late MOF, TNF and OFR were both the important factors. By measuring endotoxin, we found that endotoxemiae were not so important in early phase of the disease as in late phase, in which they made TNF and OFR released profusely.

Acute Disease↗
PubMed1994

Endotoxin in the occupational environment of bakers: method of detection.

The present study was conducted in a large mechanical city bakery. The AS-50 aspirators equipped with cellulose membrane filters were used for dust sampling. Airborne microbial content was assessed by means of sedimentation and aspiration using an Andersen sampler on Petri plates containing McConkey's medium. The following Gram-negative rods were detected in the bakery atmosphere: Erwinia herbicola, Acinetobacter Lwoffi and Klebsiella oxytoca, in concentrations ranging from 1.4 10(4) to 3.5 10(5) colony forming units per cubic meter (cfu/m3). Endotoxin concentration in flour dust sampled in selected work areas of the bakery ranged from 6.7 micrograms of endotoxin per gram of dust (micrograms/g) to 20.3 micrograms/g. Endotoxin level in the air was 0.04-0.05 micrograms of endotoxin per cubic meter (micrograms/m3). The results of our show that aspiration sampling is necessary for evaluation of airborne bacterial content and demonstrate the efficacy of the Limulus test of varying sensitivity to assay endotoxin level in the airborne dust. The advantage of this method is the possibility of assessing endotoxin in crude dust extracts.

Air Pollutants, Occupational↗
PubMedDate not supplied

Sepsis--the Wayne State University Symposium--part III. Bacteremia and endotoxemia: a discussion of their roles in the pathophysiology of gram-negative sepsis.

Bacteremia, or the presence of live bacteria in the bloodstream, does not seem a prerequisite for septic shock. Indeed, only a small portion of all patients who sustain gram-negative bacteremia ever develop the shock syndrome. Endotoxin in the laboratory model is capable of producing a number of pathophysiological alterations which can partly explain the varied picture of septic shock seen in man. Endotoxin is released from gram-negative bacteria upon their death, and it probably acts as an antigen which reacts with antibody and subsequently activates the complement cascade. The resultant production of vasoactive polypeptides and release of histamine from mast cells might account for the increased vascular permeability and early hyperdynamic cardiovascular function seen in septic shock. These changes may also contribute to ultimate stagnation and pooling in the peripheral microcirculation. Endotoxin is a potent stimulus to the sympathoadrenal system which causes varying effects on the periphery. Continued catecholamine stimulation at the periphery may ultimately contribute to stagnant anoxia by an effect on pre- and postcapillary sphincters. Endotoxin, by itself, will not directly impair cardiac contractility, but evidence for depressed function implies an interaction of endotoxin with other biochemical systems, such as vasoactive polypeptides, to indirectly produce the observed effects. Expression of a hemodynamic model closely approximating human septic shock requires, in addition to a source of endotoxin, a focus of inflammation. Such a focus, in all probability, supplies some as yet unidentified factor(s) which help produce the observed increase in cardiac output. The Limulus test has confirmed the presence of endotoxemia in gram-negative shock and has raised questions about the contribution of gut flora to the propagation of the syndrome. An enterogenous source of endotoxin may also be important in patients in whom a source of inflammation is not readily observable. Gram-negative shock remains an important and grave clinical problem. Knowledge about the relative roles of endotoxin various foci of inflammation, and generation of vasoactive peptides is accumulating slowly. Hopefully, by creating a clearer understanding of the pathophysiology, such knowledge will ultimately result in further improvement in our efforts to prevent and treat this syndrome.

Animals↗
PubMedDate not supplied

Endotoxemia detected by Limulus assay in severe malnourished children. Plasma effects on leucocyte migration: preliminary investigations.

The Authors have examined 10 cases of severe malnourished children (7 cases of kwashiorkor, 2 cases of marasmus, 1 case of marasmic kwashiorkor). Experiments were carried in order to detect endotoxemia by means of Limulus test, bacteremia with blood cultures and possible effects of plasma on leucocyte migration by Leucocytes Migration Agarose Test (LMAT). The relationship between severe malnutrition, endotoxemia and leucocytes migration has been discussed.

Arthropods↗