Please use this identifier to cite or link to this item: http://hdl.handle.net/11054/29
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dc.contributor.authorHurley, James C.en
dc.date.accessioned2012-10-10T05:03:04Zen
dc.date.available2012-10-10T05:03:04Zen
dc.date.issued2010en
dc.identifier.govdoc00016en
dc.identifier.issn0934-9723en
dc.identifier.urihttp://hdl.handle.net/11054/29en
dc.description.abstractThe limulus assay for endotoxin has been studied as a method for the rapid identification of gram-negative (GN) bacteraemia. The chromogenic (C-limulus) version is 100-fold more sensitive to an internal endotoxin standard than the earlier gelation version (G-limulus). The objective of this analysis is to compare the concordance between GN bacteraemia and endotoxaemia as determined in clinical studies using either version of the limulus assay. The summary results for the diagnostic odds ratio (DOR), sensitivity and specificity were derived using a hierarchical summary receiver operating characteristic (HSROC) method of meta-analysis. Fifty-eight studies (25 G-limulus and 33 C-limulus) were included. Surprisingly, the mean DOR (4.9; 3-7.9 versus 10.7; 5.2-21.8) was inferior for studies using the C-limulus versus the original G-limulus version of the assay. Moreover, among studies limited to sepsis syndrome patients, the mean DOR remains poor at 4.2 (1.8-9.5). The proportion of GN bacteraemic patients for whom endotoxaemia is not detectable with either version of the limulus assay is >20% among the 58 studies overall, but >30% after the exclusion of studies with <25 patients and >20% among studies of patients with sepsis syndrome. These findings help to reconcile seemingly disparate study results.en
dc.description.provenanceSubmitted by Gemma Siemensma (gemmas@bhs.org.au) on 2012-10-10T05:02:35Z No. of bitstreams: 0en
dc.description.provenanceApproved for entry into archive by Gemma Siemensma (gemmas@bhs.org.au) on 2012-10-10T05:03:04Z (GMT) No. of bitstreams: 0en
dc.description.provenanceMade available in DSpace on 2012-10-10T05:03:04Z (GMT). No. of bitstreams: 0 Previous issue date: 2010en
dc.publisherSpringeren
dc.titleDoes gram-negative bacteraemia occur without endotoxaemia? A meta-analysis using hierarchical summary ROC curves.en
dc.typeJournal Articleen
dc.type.specifiedArticleen
dc.bibliographicCitation.titleEuropean Journal of Clinical Microbiology & Infectious Diseasesen
dc.bibliographicCitation.volume29en
dc.bibliographicCitation.issue2en
dc.bibliographicCitation.stpage207en
dc.bibliographicCitation.endpage215en
dc.publisher.placeBerlinen
dc.subject.healththesaurusMETA ANALYSISen
dc.subject.healththesaurusENDOTOXEMIA - DIAGNOSISen
dc.subject.healththesaurusHUMANSen
dc.subject.healththesaurusLIMULUS TESTen
dc.subject.healththesaurusSTATISTICS AS TOPICen
dc.subject.healththesaurusGRAM NEGATIVE BACTERIAL INFECTIONS - DIAGNOSISen
dc.subject.healththesaurusGRAM NEGATIVE BACTERIAL INFECTIONS - COMPLICATIONSen
dc.date.issuedbrowse2010-01-01en
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