Hindman S H, Favero M S, Carson L A, Petersen N J, Schonberger L B, Solano J T
Lancet. 1975 Oct 18;2(7938):732-4. doi: 10.1016/s0140-6736(75)90721-7.
Between July 24 and Aug. 19, 1974, an outbreak of pyrogenic reactions occurred in patients at a private haemodialysis centre in a suburb of Washington, D.C. 49 reactions characterised by chills, fever, and hypotension occurred in twenty-three of the seventy patients dialysed during this period. No infections could be documented in any of the affected individuals. Despite the fact that only low levels of gram-negative bacterial contamination of the haemodialysis system were found, high levels of endotoxin contamination of dialysis fluid and endotoxaemia in patients experiencing overt reactions were recorded using the Limulus lysate test. The cause of these reactions was traced to an increase in endotoxin contamination of the tap water used to prepare dialysate, possibly caused by an increase in the algae levels in the local water source. The installation of a reverse osmosis system for water treatment may be a solution to the problem of endotoxin contamination of water used to prepare dialysis fluid.
1974年7月24日至8月19日期间，华盛顿特区郊区一家私立血液透析中心的患者中爆发了热原反应。在此期间接受透析的70名患者中有23名出现了49次以寒战、发热和低血压为特征的反应。在任何受影响的个体中均未发现感染。尽管血液透析系统中仅发现了低水平的革兰氏阴性细菌污染，但使用鲎试剂试验记录到，发生明显反应的患者透析液中的内毒素污染水平很高，且存在内毒素血症。这些反应的原因可追溯到用于制备透析液的自来水内毒素污染增加，这可能是由于当地水源中藻类数量增加所致。安装用于水处理的反渗透系统可能是解决制备透析液用水内毒素污染问题的一种方法。
