Application of Endotoxin Testing in Diagnosis of Concurrent Infection after Chemotherapy of Leukemia

Leukemia patients are a common high-risk group of nosocomial infections. Due to the large dose of chemotherapy drugs, the lack of granulocytes or abnormal quality after chemotherapy leads to low immunity of the body. Infection has become a common complication after leukemia chemotherapy, and severe cases can die from infection. Due to the specificity of the treatment of leukemia patients, it is difficult to detect and identify infections in time by white blood cell count and classification. In addition, the positive rate of laboratory blood culture is very low, and it takes a long time (2 ~ 4d), it is difficult to provide clinical diagnosis and treatment in time in accordance with. The study found that plasma endotoxin (Endotoxin, ET) has a good correlation with bacterial infections, and the test turnaround time is short, and the operation is simple, which can be used as a testing indicator to diagnose the infection after chemotherapy of leukemia and guide anti-infection drugs.

Leukemia.Figure 1. Leukemia.

After chemotherapy, patients with leukemia showed initial symptoms of infection, and venous blood was used for serum PCT, plasma endotoxin testing, and blood culture. Plasma endotoxin was determined using the Limulus reagent dynamic turbidimetric quantitative method, and the clinical limulus test microbial quantitative testing system was used for measurement, with <0.035 EU / ml as the normal reference range.


Endotoxin is a unique cell wall component of Gram-negative bacteria (G-). It is an important trigger of systemic inflammatory response. Because endotoxin at the lesion enters the blood system or the bacteria invade the blood to release endotoxin. Infected patients are often accompanied by endotoxemia, and the testing of endotoxin is convenient and fast. The dynamic turbidimetric quantitative testing of Limulus reagent can be completed in about 1 hour. The sensitivity and specificity of endotoxin testing are high, which is helpful for the diagnosis and treatment of infection. Endotoxemia often worsens as the condition worsens, and alleviates as the condition eases. Clinically, although some patients are found to be bacterial infections, clinicians empirically using broad-spectrum antibiotics or antibiotics against Gram-positive bacteria are unreasonable or even ineffective for the treatment of Gram-negative bacterial infections. Endotoxin testing can quickly indicate the type of infected bacteria, reduce and avoid the unreasonable use of antibiotics. Therefore, endotoxin can be used as one of the indexes for clinical treatment and determining the efficacy and screening of appropriate drugs, and also as a reference index for monitoring the efficacy.

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