Improving tuberculosis treatment using mid-infrared spectroscopy for bedside therapeutic drug monitoring
Improving tuberculosis treatment using mid-infrared spectroscopy for bedside therapeutic drug monitoring
复制标题
使用中红外光谱进行床边治疗药物监测改善结核病治疗
DOI：
10.1117/12.2649135
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Rowe D
中科院分区：
文献类型：
--
作者：
Rowe D
利福平是一种用于治疗结核病的抗菌药物。结核病患者服用利福平后病情恶化是一种严重事件，可能有几种原因。快速床边测量利福平将使临床医生确定患者病情恶化是否是由于亚治疗水平，并迅速纠正剂量。它还将支持个性化给药，以最大限度地提高抗菌效果，同时最大限度地减少副作用。最佳治疗浓度范围为8 ~ 24mg /L。我们报告了用于床边治疗药物监测（TDM）的利福平检测的ATR-FTIR光谱数据。我们证明了20 μL全血样品的检出限为0.46 mg/L。直接使用全血可以实现床边测量，因为它不需要离心和移液来提取血浆，这通常在中心实验室进行。在最高测定浓度为100 mg/L之前，吸收-浓度线性关系良好（R2= 0.998）。我们将这些数据应用于使用硅光子学的TDM小型化中红外传感器的设计。我们利用利福平的吸收分析了一种倏逝波导传感器的最佳相互作用长度，并建立了一个数值模型来量化不同系统和器件噪声源的贡献。由于增强的倏逝电场强度和可调谐量子级联激光器的功率谱密度增加，这些传感器可以比台式等效传感器更敏感。
Rifampicin is an antimicrobial drug used to treat tuberculosis. The deterioration of a tuberculosis patient on rifampicin is a serious event with several possible causes. Rapid bedside measurement of rifampicin would enable clinicians to determine if patient deterioration was due to subtherapeutic levels and quickly correct the dosing. It would also support personalised dosing to maximise antimicrobial effectiveness whilst minimising side effects. The optimum therapeutic concentration range is 8 – 24 mg/L. We report ATR-FTIR spectroscopy data for the detection of rifampicin for bedside therapeutic drug monitoring (TDM). We demonstrate a limit of detection of 0.46 mg/L from 20 μL spiked whole blood samples. Using whole blood directly enables bedside measurements because it does not require centrifugation and pipetting to extract plasma, which are generally performed in a central laboratory. The absorption-concentration response had good linearity (R2= 0.998) up to the highest measured concentration of 100 mg/L. We apply this data to the design of a miniaturised mid-infrared sensor for TDM using silicon photonics. We present an analysis of the optimum interaction length for an evanescent waveguide sensor using the absorption of rifampicin and a numerical model to quantify the contributions of different system and device noise sources. These sensors can be made more sensitive than their benchtop equivalent because of the enhanced evanescent electric field strength and the increased power spectral density of tunable quantum cascade lasers.
影响因子：
1.8
作者：
Mishra, Pooja;Pawar, Rajendra-Prasad;Jain, Abhishek
通讯作者：
Jain, Abhishek
临床实践中的问题解决：早产儿持续性呼吸窘迫
影响因子：
5.2
作者：
Daniel R Owens;Clarissa Michelle Medalla;K. Brown;K. Wijewardena;Claire P Thomas;M. Iro;C. Jones;S. Faust;Sanjay Patel
通讯作者：
Sanjay Patel