SynthesisJournal of clinical microbiology2009
Diagnosis of endotoxemia with gram-negative bacteremia is bacterial species dependent: a meta-analysis of clinical studies.
Synthesis in Journal of clinical microbiology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Does gram-negative bacteraemia occur without endotoxaemia? A meta-analysis using hierarchical summary ROC curves.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2010Pooled it
- Co-variation between blood stream infections with Candida species versus Pseudomonas aeruginosa, Staphylococcus aureus, and other isolates among 60 ICU patient cohorts.Medical mycology · 2026Article
- Arms-Based Meta-Analysis of Microbiological Endpoints of 88 VAP Prevention Studies Using Antimicrobial Versus Non-Antimicrobial Strategies-Towards 'VAP-Zero'?Antibiotics (Basel, Switzerland) · 2026Article
- Electrochemical plasmonic sensing strategy for sensitive detection of gram-negative endotoxin in blood samples.Biomedical optics express · 2025Article
- Structural Equation Modelling as a Proof-of-Concept Tool for Mediation Mechanisms Between Topical Antibiotic Prophylaxis and Six Types of Blood Stream Infection Among ICU Patients.Antibiotics (Basel, Switzerland) · 2024Review
- Visualizing and diagnosing spillover within randomized concurrent controlled trials through the application of diagnostic test assessment methods.BMC medical research methodology · 2024Article
- Association between periodontitis treatment and dementia in Taiwanese adults.BMC oral health · 2023Article
- Can physiologic colonic [European journal of nuclear medicine and molecular imaging · 2023Article
- Establishing the safety of selective digestive decontamination within the ICU population: a bridge too far?Trials · 2023Article
- Impact of Scaling and Periodontal Treatment during Pregnancy on the Risk of Adverse Birth Outcomes.Journal of personalized medicine · 2022Article
- Burkholderia pseudomallei-loaded cells act as a Trojan horse to invade the brain during endotoxemia.Scientific reports · 2018Article
- The LPS Responsiveness in BN and LEW Rats and Its Severity Are Modulated by the Liver.Journal of immunology research · 2018Article
- Comparative Study of Plasma Endotoxin with Procalcitonin Levels in Diagnosis of Bacteremia in Intensive Care Unit Patients.Chinese medical journal · 2016Article
- Towards clinical applications of anti-endotoxin antibodies; a re-appraisal of the disconnect.Toxins · 2013Review
- Prognostic value of endotoxemia in patients with Gram-negative bacteremia is bacterial species dependent.Journal of innate immunity · 2013Article
- Endotoxemia and mortality prediction in ICU and other settings: underlying risk and co-detection of gram negative bacteremia are confounders.Critical care (London, England) · 2012Review
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Endotoxemia is undetectable for up to 60% of cases of bacteremia caused by gram-negative (GN) species, a discordance attributed to the limitations of the Limulus assay for endotoxemia. The lipid A structure of the endotoxin molecule is critical for the sensing of GN bacteria by the host immune system although not so for sensing by the Limulus assay. The lipid A structure of commensal Enterobacteriaceae is hexa-acyl, whereas non-Enterobacteriaceae have a broader range of structures. By using a previously published classification of lipid A structures (R. S. Munford, Infect. Immun. 76:454-465, 2008), the association of endotoxemia with bacteremia caused by GN organisms is reexamined for 580 GN bacteremic patients from 46 studies. Endotoxemia was less commonly detected for cases of bacteremia caused by Salmonella enterica serovar Typhi (four studies; 15 of 55 cases of bacteremia [27%]) than for cases of bacteremia caused by Neisseria meningitidis (five studies; 69 of 84 cases [82%]) and Pseudomonas pseudomallei (one study; 38 of 41 cases [93%]) among studies restricted to those with specified cases of bacteremia caused by GN organisms. Among 23 unrestricted studies, endotoxemia was less commonly detected for cases of bacteremia with a commensal member of the Enterobacteriaceae (104 of 240 cases [43%]) than with non-Enterobacteriaceae (59 of 100 cases [59%]) (summary odds ratio, 0.53 [90% confidence interval, 0.33 to 0.85]). This finding is consistent across all the unrestricted studies, even including studies with seemingly contrary results for endotoxemia diagnosis among cases of bacteremia caused by GN bacteria overall. Surprisingly, with bacteremia caused by commensal Enterobacteriaceae, the diagnosis of endotoxemia appears to be unrelated to the Limulus assay sensitivity. Across these 45 studies, the association of endotoxemia with GN bacteremia is variable but consistent for different types of GN bacteremia.
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