Comparative Evaluation of the Limulus Assay and the Direct Gram Stain for Detection of Significant Bacteriuria

Jorgensen, James H.; Jones, Pamela M.

doi:10.1093/ajcp/63.3.142

Cited by 42 publications

(34 citation statements)

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“…One disadvantage of the growth-dependent systems is the need for incubation, which may limit their use in some laboratories. Positive results may (33).…”

Section: Colorimetric Filtrationmentioning

confidence: 99%

Detection of urinary tract infections by rapid methods

Pezzlo

1988

Clin Microbiol Rev

121

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A review of rapid urine screens for detection of bacteriuria and pyuria demonstrates a number of available alternatives to the culture method. Selection of one or more of these systems for routine use is dependent upon the laboratory and the patient population being tested. The laboratory approach to the diagnosis of urinary tract infection should consider the clinical diagnosis of the patient whenever possible. Keeping in mind that quantitative urine cultures alone cannot be used to detect infection in some patient populations unless lower colony counts are considered, a rapid screen may be a more practical approach. It has become accepted that 10(5) CFU/ml can no longer be used as the standard for all patient groups, that pyuria often is important in making the diagnosis of a urinary tract infection, and that most of the rapid screens are more sensitive than the culture method at 10(5) CFU/ml. Presently, no one approach can be recommended for all laboratories and all patient groups. However, each diagnostic laboratory should select one approach which is best for its situation. It is not practical, efficient, or cost effective to define a protocol for each possible clinical condition; however, all should be considered when developing a protocol. This protocol should be compatible with the patient population and communicated to the physicians. Use of a rapid screen should be beneficial to the patient, the physician, and the laboratory.

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“…One disadvantage of the growth-dependent systems is the need for incubation, which may limit their use in some laboratories. Positive results may (33).…”

Section: Colorimetric Filtrationmentioning

confidence: 99%

Detection of urinary tract infections by rapid methods

Pezzlo

1988

Clin Microbiol Rev

121

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“…12 The present study was Received 29 Sept. 1992; accepted 23 Dec. 1992. undertaken to investigate how endotoxin and metabolites produced by overnight cultures of two different Escherichia coli strains in urine affect both phagocytosis and intracellular killing by PMNL in urine.…”

Section: Introductionmentioning

confidence: 96%

Effect of bacterial products including endotoxin on neutrophil function in infected urine

Gargan

Smith²,

Hamilton‐Miller³

et al. 1993

Journal of Medical Microbiology

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Summary. Experiments were performed to determine the effects of products of bacterial growth (including endotoxin) on phagocytosis and intracellular killing by polymorphonuclear leucocytes (PMNL) in urine. Bacteriologically filtered supernates of two strains of Escherichia coli grown in urine were added in varying amounts to mixtures of PMNL and E. coli, also in urine. Phagocytosis of the two strains was reduced from > 90 YO in controls to 66 YO and 48 YO, respectively, in the presence of undiluted culture filtrate (containing endotoxin 2-2.5 pg/ml). Intracellular killing was also decreased and was abolished by dilutions corresponding to endotoxin concentrations of 0.6 and 0.75 pglml. When PMNL exposed to these inhibitory dilutions were resuspended in fresh urine, their phagocytic ability was fully restored and 13-24 YO of their killing activity was regained. A minimum concentration of commercially purified E. coli endotoxin of 200pg/ml was required to abolished PMNL killing, with phagocytosis uninhibited. The results strongly suggest that bacterial growth metabolites, not endotoxin, are responsible for the depression of phagocytosis and intracellular killing in infected urine. A moderate dilution of the bacterial products in urine permits good PMNL function. Extrapolating this to the clinical situation, diluting the urine by water loading (as recommended for patients with urinary infections) should ensure efficient activity of PMNL under in-vivo conditions providing urinary pH and osmolality are not adversely affected.

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“…The enzymatic clotting cascade can be kinetically recorded with a turbidimetric reader (Jorgensen et al ., 1973). This sensitive assay has been widely used in detecting the endotoxin in different biosamples (Cooper et al ., 1972; Jorgensen and Jones, 1975). Compared to the conventional culture assay for GNB, the endotoxin AL assay is more sensitive and reliable (McCartney et al ., 1983).…”

Section: Introductionmentioning

confidence: 99%

A novel approach for fast detection of sepsis with Gram‐negative bacterial infection

Lin

Chen

Lin³

et al. 2018

Microbial Biotechnology

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SummarySepsis, a life‐threatening systemic infection, requires quick treatment. Gram‐negative bacteria (GNB) are the major causative pathogens and their endotoxin can be a surrogate biomarker for diagnosis. We explored a fast identification of GNB by first culturing blood to increase endotoxin levels and then detecting endotoxin by Tachypleus amebocyte lysate (TAL) with kinetic turbidimetric assay (KT‐TAL). Heating samples could significantly increase the endotoxin released from GNB; speed and time of centrifugation, and sample dilution could affect the endotoxin results. At a high GNB load, endotoxin was detected 3 h after culture, 6.5 h earlier than the BD BACTEC blood culture system detecting GNB. At a low GNB load, endotoxin was detected at 9 h after culture, 13 h earlier than by the BD BACTEC system. In a sepsis patient with Acinetobacter baumannii, we detected endotoxin at 12 h after culture, while the BD BACTEC system needed 28.5 h for detection, allowing physicians an earlier decision on appropriate treatment.

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Comparative Evaluation of the Limulus Assay and the Direct Gram Stain for Detection of Significant Bacteriuria

Cited by 42 publications

References 0 publications

Detection of urinary tract infections by rapid methods

Detection of urinary tract infections by rapid methods

Effect of bacterial products including endotoxin on neutrophil function in infected urine

A novel approach for fast detection of sepsis with Gram‐negative bacterial infection

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