Antibody to endotoxin is associated with decreased frequency of postoperative infection

According to previous studies the presence of preoperative antibodies to gram-negative lipopolysaccharides has a protective effect against postoperative infection and pyrexia in patients undergoing urologic and cardiac surgical procedures. Preoperative serum specimens collected from 86 women awaiting major gynecologic surgery were tested for the presence of antiendotoxin by a qualitative method. These patients were closely followed up in the postoperative period and any evidence of pyrexia or infection was noted. There were 21 (24%) patients who had preexisting antibodies. Of the women studied, 47 (55%) had some form of postoperative infection, of which 32 (37%) were exclusively a result of gram-negative bacteria. There was a significant association (p less than 0.05) between postoperative infection and the absence of preexisting antibodies. This association was particularly striking (p less than 0.02) when postoperative urinary tract infections were considered. There was no association between postoperative pyrexia and the absence of preexisting antibody. Our results confirm the findings of previous studies to evaluate the protective role of antiendotoxin in surgical procedures. In the future immunization may be considered an adjunct or alternative to prophylactic antibiotics.