Treatment of gram-negative bacteremia and shock with human antiserum to a mutant Escherichia coli.
Treatment of gram-negative bacteremia and shock with human antiserum to a mutant Escherichia coli.
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用针对突变型大肠杆菌的人抗血清治疗革兰氏阴性菌血症和休克。
DOI：
10.1056/nejm198211113072001
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发表时间：
1982
期刊：
影响因子：
--
通讯作者：
Braude,AI
中科院分区：
文献类型：
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作者：
Ziegler,EJ;McCutchan,JA;Fierer,J;Glauser,MP;Sadoff,JC;Douglas,H;Braude,AI
为了减少革兰氏阴性菌血症和内毒素休克的死亡，我们用人抗内毒素(内毒素)核心的抗血清治疗细菌血症患者。抗血清是通过用热致死的大肠杆菌J5接种健康人而制备的；这种突变株缺乏脂多糖低聚糖侧链，因此与大多数其他革兰氏阴性细菌几乎相同的核心暴露于抗体形成。在一项随机对照试验中，患者在接近发病时静脉注射J5抗血清或免疫前对照血清。对照组细菌血症患者死亡42例(39%)，J5抗血清受者死亡23例(22%)(P=0.011)。在深度休克患者中，对照组死亡率为30/39(77%)，接受J5抗血清治疗的患者死亡率为18/41(44%)(P=0.003)。我们的结论是，抗脂多糖核心的人抗血清可以显著减少革兰氏阴性菌血症的死亡。(英国医学杂志)1982年；307：1225-30。)
In an effort to decrease deaths from gram-negative bacteremia and endotoxin shock, we treated bacteremic patients with human antiserum to endotoxin (lipopolysaccharide) core. Antiserum was prepared by vaccinating healthy men with heat-killedEscherichia coliJ5; this mutant lacks lipopolysaccharide oligosaccharide side chains, so that the core, which is nearly identical to that of most other gram-negative bacteria, is exposed for antibody formation. In a randomized controlled trial, patients were given either J5 antiserum or preimmune control serum intravenously, near the onset of illness. The number of deaths in the bacteremic patients was 42 of 109 (39 per cent) in controls and 23 of 103 (22 per cent) in recipients of J5 antiserum (P = 0.011). In those with profound shock, mortality was 30 of 39 (77 per cent) in controls and 18 of 41 (44 per cent) in recipients of J5 antiserum (P = 0.003). We conclude that human antiserum to the lipopolysaccharide core can substantially reduce deaths from gram-negative bacteremia. (N Engl J Med. 1982; 307:1225–30.)