Cited by 318Sepsis Diagnosis and TreatmentBacterial Identification and Susceptibility TestingInflammation biomarkers and pathways

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Endotoxemia: methods of detection and clinical correlates

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Hurley, J C·1995·Clinical Microbiology Reviews

DOI 10.1128/cmr.8.2.268PMC PMC172859

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Abstract

As an assay for endotoxin, the Limulus amebocyte lysate assay has several desirable properties: sensitivity, specificity, and potential for adaptation to a quantitative format. Several modifications have been developed to enhance its potential for clinical application. The modifications that allow quantitative measurement of endotoxin and also improve its application to blood samples are described in this review. In fluids other than blood, the detection of endotoxin with the Limulus amebocyte lysate assay can be used as an aid to identify the presence of gram-negative bacteria, and the assay has established utility. With blood, however, there are a range of factors that interfere with the detection of endotoxemia and there are disparate views with respect to the diagnostic and prognostic significance of the test results. In general, the clinical significance of the finding of endotoxemia broadly parallels the frequency and importance of gram-negative sepsis in the patient groups studied and a decline in endotoxin levels accompanies clinical improvement. However, with therapies designed to reduce levels of endotoxin, or to antagonize its effects, it is unclear whether clinical improvement occurs as a consequence of changes in the levels of endotoxemia.

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Authors: Hurley, J. C.
Affiliations: Seattle Children's Hospital (US)
Corresponding author: Hurley, J C
ORCID: Hurley, J C
Venue: Clinical Microbiology Reviews
Publisher: American Society for Microbiology
Published: 1995-04
Volume: 8
Issue: 2
Pages: 268-292
ISSN: 0893-8512 (ISSN-L)
1098-6618
DOI: 10.1128/cmr.8.2.268
PMC: PMC172859
OpenAlex: W2134508859
Cited by: 318
References: 423
Citations by year: 2026: 12 · 2025: 5 · 2024: 7 · 2023: 12 · 2022: 10 · 2021: 10 · 2020: 14 · 2019: 8 · 2018: 11 · 2017: 20 · 2016: 25 · 2015: 6 · 2014: 18 · 2013: 9 · 2012: 20
FWCI: 6.55
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: journals.asm.org/non-commercial-tdm-license (tdm)
Locations: Clinical Microbiology Reviews (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
Health Sciences › Medicine › Microbiology (medical) › Bacterial Identification and Susceptibility Testing
Life Sciences › Immunology and Microbiology › Immunology › Inflammation biomarkers and pathways
Keywords: endotoxemia, Limulus amebocyte lysate assay, endotoxin detection, gram-negative sepsis, blood culture, assay interference, Gram-negative bacteria, endotoxin antagonists
MeSH terms: Endotoxins, Humans, Limulus Test, Risk Factors, Toxemia, Treatment Outcome, Sepsis

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