A rapid point-of-care test for vancomycin monitoring at the clinical bedside
Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine
Summary Vancomycin requires individualized dosing guided by therapeutic drug monitoring, but current laboratory assays are slow and centralized. We describe a competition-format microarray assay on a poly(oligo(ethylene glycol) methacrylate-co-glycidyl methacrylate) brush integrated into a single-use microfluidic cassette and portable reader to quantify vancomycin directly from fingerstick volumes of whole blood in 30 min. The assay shows a limit of detection of 0.8 μg/mL and precise quantification across the clinical range, with relative error below 20%. In a pilot study of 31 patient samples, cassette measurements correlated strongly with routine hospital testing with minimal bias, including when operated by minimally trained coordinators. This work establishes an approach for rapid, decentralized vancomycin monitoring that could support area-under-the-curve-based dosing in settings where access to high-complexity laboratories is limited and suggests a path toward extending therapeutic drug monitoring to point-of-care devices. abs0010 Graphical abstract http://www.w3.org/1999/xlink float portrait ga1.jpg undfig1 anchor portrait graphical abs0015 Highlights • A rapid point-of-care test quantifies vancomycin from whole blood within 30 min u0010 • The test showed strong agreement with the gold standard assay in a clinical pilot study u0015 • This work extends the D4 platform beyond proteins to enable therapeutic drug monitoring u0020 simple ulist0010 author-highlights abs0020
Abstract
Summary Vancomycin requires individualized dosing guided by therapeutic drug monitoring, but current laboratory assays are slow and centralized. We describe a competition-format microarray assay on a poly(oligo(ethylene glycol) methacrylate-co-glycidyl methacrylate) brush integrated into a single-use microfluidic cassette and portable reader to quantify vancomycin directly from fingerstick volumes of whole blood in 30 min. The assay shows a limit of detection of 0.8 μg/mL and precise quantification across the clinical range, with relative error below 20%. In a pilot study of 31 patient samples, cassette measurements correlated strongly with routine hospital testing with minimal bias, including when operated by minimally trained coordinators. This work establishes an approach for rapid, decentralized vancomycin monitoring that could support area-under-the-curve-based dosing in settings where access to high-complexity laboratories is limited and suggests a path toward extending therapeutic drug monitoring to point-of-care devices. abs0010 Graphical abstract http://www.w3.org/1999/xlink float portrait ga1.jpg undfig1 anchor portrait graphical abs0015 Highlights • A rapid point-of-care test quantifies vancomycin from whole blood within 30 min u0010 • The test showed strong agreement with the gold standard assay in a clinical pilot study u0015 • This work extends the D4 platform beyond proteins to enable therapeutic drug monitoring u0020 simple ulist0010 author-highlights abs0020 Public health; Medical tests teaser abs0025