Vancomycin and creatinine determination in dried blood spots: Analytical validation and clinical assessment

Letícia Scribel; Alexandre P Zavascki; Douglas Matos; Francine Silveira; Talitha Peralta; Natalia Gonçalves Landgraf; Priscila Lamb Wink; Anne Caroline Cezimbra da Silva; Nadine Bordin Andriguetti; Letícia Loss Lisboa; Marina Venzon Antunes; Rafael Linden

doi:10.1016/j.jchromb.2019.121897

Vancomycin and creatinine determination in dried blood spots: Analytical validation and clinical assessment

J Chromatogr B Analyt Technol Biomed Life Sci. 2020 Jan 15:1137:121897. doi: 10.1016/j.jchromb.2019.121897. Epub 2019 Dec 10.

Affiliations

¹ Postgraduate Program in Medical Sciences, Medical School, Universidade Federal do Rio Grande do Sul, Porto Alegre/RS, Brazil. Electronic address: leticia.scribel@poa.ifrs.edu.br.
² Infectious Diseases Service, Hospital de Clínicas de Porto Alegre, Porto Alegre/RS, Brazil; Department of Internal Medicine, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
³ Research and Postgraduate Group, Hospital de Clínicas de Porto Alegre, Porto Alegre/RS, Brazil.
⁴ Bacterial Resistance Research Laboratory - LABRESIS, Hospital de Clínicas de Porto Alegre, Porto Alegre/RS, Brazil.
⁵ Laboratory of Analytical Toxicology, Institute of Health Sciences, Universidade Feevale, Novo Hamburgo/RS, Brazil.
⁶ Laboratory of Analytical Toxicology, Institute of Health Sciences, Universidade Feevale, Novo Hamburgo/RS, Brazil; Graduate Program on Toxicology and Analytical Toxicology, Universidade Feevale, Novo Hamburgo/RS, Brazil.

PMID: 31891859
DOI: 10.1016/j.jchromb.2019.121897

Abstract

This study aims to develop a liquid chromatography tandem-mass spectrometry (LC-MS/MS) method for vancomycin and creatinine measurement in dried blood spots (DBS) and to evaluate its clinical application. The analytes were extracted from DBS and analyzed by LC-MS/MS. Vancomycin and creatinine DBS and plasma concentrations were compared in 54 and 35 samples, respectively, from 29 patients. Accuracy was 94.4-102.6%, intra-assay precision was 2.1-5.6%, and inter-assay precision was 3.5-7.0%. Patients vancomycin plasma to DBS concentration ratios were highly variable (1.148-5.022), differently from creatinine (0.800-1.283). The assay has adequate analytical performance. Plasma concentrations can be satisfactorily predicted from DBS measurements for creatinine, but not for vancomycin, which limits its clinical application.

Keywords: Creatinine; Dried blood spots; Liquid chromatography-mass spectrometry; Therapeutic drug monitoring; Vancomycin.

MeSH terms

Adult
Chromatography, Liquid / methods
Creatinine / blood*
Dried Blood Spot Testing / methods*
Humans
Linear Models
Reproducibility of Results
Sensitivity and Specificity
Tandem Mass Spectrometry / methods
Vancomycin / blood*

Substances

Vancomycin
Creatinine