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. 1973 Oct;26(4):521–524. doi: 10.1128/am.26.4.521-524.1973

Rapid Detection of Contaminated Intravenous Fluids Using the Limulus In Vitro Endotoxin Assay

James H Jorgensen 1,2,1, Rodney F Smith 1,2
PMCID: PMC379840  PMID: 4584590

Abstract

Intravenous fluids and administration sets may become contaminated with gram-negative bacteria during use and result in a life-threatening situation to the patient. The Limulus in vitro assay for endotoxin was used in two patients whose parenteral fluids had become contaminated with Pseudomonas aeruginosa. This test allowed rapid detection of the contaminated intravenous fluids and demonstrated a concomitant endotoxemia in both patients. The same strains of pseudomon were subsequently cultured from each patient's blood, intravenous catheter tip, and parenteral fluid and administration set. A different serotype of pseudomonas was unique to each patient, indicating two separate and unrelated cases of accidental contamination of the administration sets. Endotoxin-like activity was also demonstrated from several brands of commercial human serum albumin, which may contribute low-level activity detectable by the Limulus assay.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Cooper J. F., Hochstein H. D., Seligmann E. B., Jr The Limulus test for endotoxin (Pyrogen) in radiopharmaceuticals and biologicals. Bull Parenter Drug Assoc. 1972 Jul-Aug;26(4):153–162. [PubMed] [Google Scholar]
  2. Cooper J. F., Levin J., Wagner H. N., Jr Quantitative comparison of in vitro and in vivo methods for the detection of endotoxin. J Lab Clin Med. 1971 Jul;78(1):138–148. [PubMed] [Google Scholar]
  3. Deeb E. N., Natsios G. A. Contamination of intravenous fluids by bacteria and fungi during preparation and administration. Am J Hosp Pharm. 1971 Oct;28(10):764–767. [PubMed] [Google Scholar]
  4. Duma R. J., Warner J. F., Dalton H. P. Septicemia from intravenous infusions. N Engl J Med. 1971 Feb 4;284(5):257–260. doi: 10.1056/NEJM197102042840508. [DOI] [PubMed] [Google Scholar]
  5. Fauci A. S., Benacerraf B., Wolf S. M. Immunogenic properties of human gamma globulin free of endotoxin contamination. Proc Soc Exp Biol Med. 1971 Jan;136(1):264–267. doi: 10.3181/00379727-136-35242. [DOI] [PubMed] [Google Scholar]
  6. Greisman S. E., Hornick R. B. Comparative pyrogenic reactivity of rabbit and man to bacterial endotoxin. Proc Soc Exp Biol Med. 1969 Sep;131(4):1154–1158. doi: 10.3181/00379727-131-34059. [DOI] [PubMed] [Google Scholar]
  7. Jorgensen J. H., Smith R. F. Preparation, sensitivity, and specificity of Limulus lysate for endotoxin assay. Appl Microbiol. 1973 Jul;26(1):43–48. doi: 10.1128/am.26.1.43-48.1973. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Levin J., Poore T. E., Young N. S., Margolis S., Zauber N. P., Townes A. S., Bell W. R. Gram-negative sepsis: detection of endotoxemia with the limulus test. With studies of associated changes in blood coagulation, serum lipids, and complement. Ann Intern Med. 1972 Jan;76(1):1–7. doi: 10.7326/0003-4819-76-1-1. [DOI] [PubMed] [Google Scholar]
  9. Levin J., Poore T. E., Zauber N. P., Oser R. S. Detection of endotoxin in the blood of patients with sepsis due to gran-negative bacteria. N Engl J Med. 1970 Dec 10;283(24):1313–1316. doi: 10.1056/NEJM197012102832404. [DOI] [PubMed] [Google Scholar]
  10. Philip B. A., Herbert P., Hollingsworth J. W. Separation of contaminating pyrogenic material from commercial bovine serum albumin. Proc Soc Exp Biol Med. 1966 Nov;123(2):576–580. doi: 10.3181/00379727-123-31546. [DOI] [PubMed] [Google Scholar]
  11. Phillips I., Eykyn S., Laker M. Outbreak of hospital infection caused by contaminated autoclaved fluids. Lancet. 1972 Jun 10;1(7763):1258–1260. doi: 10.1016/s0140-6736(72)90981-6. [DOI] [PubMed] [Google Scholar]
  12. Pruitt B. A., Jr, Stein J. M., Foley F. D., Moncrief J. A., O'Neill J. A., Jr Intravenous therapy in burn patients. Suppurative thrombophlebitis and other life-threatening complications. Arch Surg. 1970 Apr;100(4):399–404. doi: 10.1001/archsurg.1970.01340220075013. [DOI] [PubMed] [Google Scholar]
  13. Reinhold R. B., Fine J. A technique for quantitative measurement of endotoxin in human plasma. Proc Soc Exp Biol Med. 1971 May;137(1):334–340. doi: 10.3181/00379727-137-35572. [DOI] [PubMed] [Google Scholar]
  14. Rojas-Corona R. R., Skarnes R., Tamakuma S., Fine J. The Limulus coagulation test for endotoxin. A comparison with other assay methods. Proc Soc Exp Biol Med. 1969 Nov;132(2):599–601. doi: 10.3181/00379727-132-34268. [DOI] [PubMed] [Google Scholar]
  15. VERDER E., EVANS J. A proposed antigenic schema for the identification of strains of Pseudomonas aeruginosa. J Infect Dis. 1961 Sep-Oct;109:183–193. doi: 10.1093/infdis/109.2.183. [DOI] [PubMed] [Google Scholar]
  16. Yin E. T., Galanos C., Kinsky S., Bradshaw R. A., Wessler S., Lüderitz O., Sarmiento M. E. Picogram-sensitive assay for endotoxin: gelation of Limulus polyphemus blood cell lysate induced by purified lipopolysaccharides and lipid A from Gram-negative bacteria. Biochim Biophys Acta. 1972 Jan 28;261(1):284–289. doi: 10.1016/0304-4165(72)90340-6. [DOI] [PubMed] [Google Scholar]

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