title: Prevention of gram-negative shock and death in surgical patients by antibody to endotoxin core glycolipid.
abstract: The prophylactic effect of antibody to endotoxin core glycolipid was studied in surgical patients at high risk of gram-negative infection. At randomisation (on admission to intensive care unit), every 5 days thereafter, and at onset of septic shock, patients received plasma taken from donors before (control) or after immunisation with Escherichia coli J5, a mutant with only core determinants in its endotoxin. Gram-negative shock occurred in 15 of 136 controls and 6 of 126 J5 antibody recipients and related deaths in 9 of 136 and 2 of 126, respectively. J5 antibody was most effective in abdominal surgery patients, in whom shock occurred in 13 of 83 controls and 2 of 71 antibody recipients. Although antibody prophylaxis did not lower the infection rate, it prevented the serious consequences of gram-negative infections and thus improved the overall prognosis.
authors.forename: J D
authors.initials: JD
authors.lastname: Baumgartner
authors.forename: M P
authors.initials: MP
authors.lastname: Glauser
authors.forename: J A
authors.initials: JA
authors.lastname: McCutchan
authors.forename: E J
authors.initials: EJ
authors.lastname: Ziegler
authors.forename: G
authors.initials: G
authors.lastname: van Melle
authors.forename: M R
authors.initials: MR
authors.lastname: Klauber
authors.forename: M
authors.initials: M
authors.lastname: Vogt
authors.forename: E
authors.initials: E
authors.lastname: Muehlen
authors.forename: R
authors.initials: R
authors.lastname: Luethy
authors.forename: R
authors.initials: R
authors.lastname: Chiolero
mesh_terms: D001424:Bacterial Infections / Q000453:epidemiology; D001428:Bacterial Vaccines; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D004731:Endotoxins / Q000276:immunology*; D022361:Escherichia coli Vaccines; D005260:Female; D006017:Glycolipids / Q000276:immunology*; D006090:Gram-Negative Bacteria / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000453:epidemiology; D011183:Postoperative Complications / Q000517:prevention & control; D011897:Random Allocation; D012772:Shock, Septic / Q000453:epidemiology / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*
chemical_list: D001428:Bacterial Vaccines; D004731:Endotoxins; D022361:Escherichia coli Vaccines; D006017:Glycolipids; C042058:core endotoxin