The detection of endotoxemia with the LAL assay in human infection has in some studies correlated poorly with clinical events and outcomes. These investigations included patients from diverse clinical settings who were infected with a wide variety of Gram-negative bacteria that differed in virulence factors, growth characteristics, and endotoxin structure. In this study, using a canine model of septic shock, two different Gram-negative bacteria, E coli and P aeruginosa, were found to produce qualitatively identical patterns of hemodynamic change.
The particular strain of P aeruginosa used in these experiments, however, resulted in tenfold lower plasma endotoxin concentrations, but greater cardiovascular abnormalities and a higher mortality compared with the E coli isolate. This dissociation between endotoxemia and the severity of septicemia argues that in some Gram-negative infections, bacterial products other than endotoxin may be important contributors to cardiovascular injury and mortality in septic shock. If correct, therapeutic strategies aimed at inhibiting or blocking endotoxin, such as anti-core LPS antibodies and lipid X, may not be universally efficacious in all cases of Gram-negative septic shock. buy flovent inhaler
Extrapolating these findings to human studies on endotoxemia suggests that plasma endotoxin concentrations are unlikely to correlate with the severity or course of infection when comparisons are made among different genera of gram-negative bacteria.
Category: Pseudomonas aeruginosa
Tags: aeruginosa, endotoxin, sepsis, septic shock