Skip to main content

Volume 18 Supplement 2

Sepsis 2014

  • Poster presentation
  • Published:

Early diagnosis of sepsis due to Gram-negative infection with the Endotoxin Activity Assay

Introduction

The Endotoxin Activity Assay (EAAâ„¢; Spectral Diagnostics Inc., Toronto, Canada) is a rapid in vitro diagnostic test of the neutrophil reaction to endotoxin and reflects the endotoxemia. A higher value of EAA (>0.60) has been shown to correlate with developing severe sepsis and a high mortality in other previous studies. We hypothesize that a value of EAA more than 0.55, not >0.60, may be useful to earlier diagnose sepsis due to Gram-negative organisms and to assess the severity.

Methods

The present study is a single-center retrospective observational analysis of adult septic patients in whom EAA was performed from July 2008 to July 2013. Patients were divided into two groups: (1) EAA >0.55 and (2) EAA < 0.54. Age, sex, days of ICU stay, ICU mortality, body temperature, WBC, CRP, procalcitonin (PCT), SOFA score, and microbiological data were compared between two groups. Values are expressed as mean ± SD. Data were analyzed by chi-square test and Mann-Whitney U test. P < 0.05 was considered significant. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and odds ratio were also evaluated.

Results

Five hundred and ninety-four patients (377 men and 217 women; mean age 65.0 ± 17.5 years) were studied. There were (1) 104 patients with EAA >0.55 and (2) 490 patients with EAA < 0.54. ICU mortality (39.4 vs. 26.6 %, P = 0.01), PCT (17.2 ± 36.0 vs. 11.8 ± vs. 30.6 ng/ml, P = 0.04), SOFA score (8.1 ± 4.9 vs. 6.2 ± 4.6, P = 0.04) and positive Gram-negative organisms in cultures (57.7 vs. 45.5 %, P = 0.02) were significantly higher in group (1) than group (2). Age, sex, body temperature, WBC and CRP were not significantly different between two groups. Using detections of Gram-negative organisms in cultures, the sensitivity, the specificity, the PPV and the NPV were 22.1, 85.2, 57.7 and 54.6%, respectively. The odds ratio was 1.64.

Conclusion

ICU mortality and severity were higher in patients with EAA >0.55 than in patients with EAA < 0.54. There is a possibility that an EAA value more than 0.55 is a meaningful value for early diagnosis of sepsis due to Gram-negative infection.

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kang, M., Tsunoda, M., Saito, M. et al. Early diagnosis of sepsis due to Gram-negative infection with the Endotoxin Activity Assay. Crit Care 18 (Suppl 2), P74 (2014). https://doi.org/10.1186/cc14077

Download citation

  • Published:

  • DOI: https://doi.org/10.1186/cc14077

Keywords