Bacteremia caused by Gram-negative facultative or aerobic rods is a major source of morbidity and mortality among hospitalized patients. Endotoxin, a lipopolysaccharide (LPS) found in Gram-negative bacteria, is considered to be the principal toxin responsible for the development of septic shock in these infections. Treatment strategies such as “cross-reactive” anti-core LPS antibodies have been based on this hypothesis. The detection of endotoxin in humans, however, has correlated inconsistently with important clinical events, even though the Limulus amebocyte lysate (LAL) assay is sensitive, relatively specific, and correlates with in vivo toxicity. Potential reasons for this discrepancy include variability between lysate preparations, circulating inhibitors, and rapid clearance of endotoxin from the circulation; however, a fully satisfactory explanation remains to be established. buy ampicillin
Recent clinical studies have demonstrated that organisms devoid of endotoxin (Gram-positive bacteria and fungi) are capable of producing a pattern of cardiovascular injury indistinguishable from that caused by Gram-negative sepsis. In a canine model of septic shock, we found that the hemodynamic changes produced by Staphylococcus aureus and Escherichia coli identical, yet endotoxemia did not occur in septic shock induced by S aureus.
Category: Pseudomonas aeruginosa
Tags: aeruginosa, endotoxin, sepsis, septic shock