Early Diagnosis of Gram-Negative Peritonitis in Continuous Ambulatory Peritoneal Dialysis Patients with the Lymulus Amebocyte Lysate Assay
作者:
Gari Peer,
Irina Serban,
Miriam Blum,
Shaltiel Cabili,
Adrian Iaina,
期刊:
American Journal of Nephrology
(Karger Available online 1992)
卷期:
Volume 12,
issue 1-2
页码: 19-21
ISSN:0250-8095
年代: 1992
DOI:10.1159/000168412
出版商: S. Karger AG
关键词: CAPD peritonitis;Lymulus amebocyte lysate test;Gram negative
数据来源: Karger
摘要:
The treatment of peritonitis in continuous ambulatory peritoneal dialysis patients is empiric until the bacteriological results are available. The Lymulus amebocyte lysate assay (LAL) is a very sensitive method for the detection of endotoxin, a structural component of gram-negative bacteria. We performed the LAL assay in a prospective study in 36 consecutive episodes of peritonitis. The LAL assay was positive in all 10 episodes of gram-negative peritonitis (100% specificity). Treatment directed specifically against gram-negative or -positive infection was started based on the LAL assay result. In 26 episodes with LAL-negative test, a gram-positive bacterium was cultured in 23 episodes, in 1 there was fungal infection and 2 were sterile. In summary: the LAL assay is a rapid (1 h) and sensitive method for the differentiation of gram-positive or -negative peritonitis and enables starting an immediate and more appropriate antibiotic therapy.
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