Comparison of vancomycin assays in patients undergoing hemodialysis

Vancomycin is a glycopeptide antibiotic mainly excreted by glomerular filtration. Therefore, patients undergoing hemodialysis tend to accumulate its crystalline degradation product, which has been associated with cross-reaction in commercial immunoassays. The aim of this study was to assess the perf...

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Main Authors: Letícia Scribel, Aline Galiotto, Isadora de Souza Rodrigues, Roberta Hahn, Rafael Linden, Alexandre P. Zavascki
Format: Article
Language:English
Published: Elsevier 2024-09-01
Series:Brazilian Journal of Infectious Diseases
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Online Access:http://www.sciencedirect.com/science/article/pii/S1413867024001521
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author Letícia Scribel
Aline Galiotto
Isadora de Souza Rodrigues
Roberta Hahn
Rafael Linden
Alexandre P. Zavascki
author_facet Letícia Scribel
Aline Galiotto
Isadora de Souza Rodrigues
Roberta Hahn
Rafael Linden
Alexandre P. Zavascki
author_sort Letícia Scribel
collection DOAJ
description Vancomycin is a glycopeptide antibiotic mainly excreted by glomerular filtration. Therefore, patients undergoing hemodialysis tend to accumulate its crystalline degradation product, which has been associated with cross-reaction in commercial immunoassays. The aim of this study was to assess the performance of two commercial immunoassays for measuring vancomycin levels in patients undergoing hemodialysis. This method-comparison study enrolled patients undergoing hemodialysis at two hospitals in Porto Alegre, Brazil. Vancomycin serum concentrations measured by Chemiluminescent Microparticle Assay (CMIA) and measured by Kinetic Interaction of Microparticles in Solution (KIMS) were compared with Liquid Chromatography coupled with Tandem Mass Spectrometry (LC-MS/MS). A total of 64 samples from 42 patients and 54 samples from 23 patients were included in CMIA and KIMS groups. Both measurements were highly correlated with LC-MS/MS, with Spearman rank correlation coefficient r = 0.840 (p < 0.001) and r = 0.926 (p < 0.001), respectively. No deviation of linearity was observed (p = 0.81 and p = 0.49, respectively). The mean difference between CMIA and LC-MS/MS was -1.19 μg/mL and between KIMS and LC-MS/MS was -2.28 μg/mL. LC-MS/MS measured levels were, on average, 2.64 % higher than CMIA and 8.81 % higher than KIMS. CMIA and KIMS revealed accurate commercial methods to measure vancomycin serum concentrations in patients undergoing hemodialysis.
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spelling doaj-art-e78855cdf6a447d5a58ac59756b278632025-08-20T02:11:37ZengElsevierBrazilian Journal of Infectious Diseases1413-86702024-09-0128510386910.1016/j.bjid.2024.103869Comparison of vancomycin assays in patients undergoing hemodialysisLetícia Scribel0Aline Galiotto1Isadora de Souza Rodrigues2Roberta Hahn3Rafael Linden4Alexandre P. Zavascki5Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Programa de Pós-Graduação em Ciências Médicas, Porto Alegre, RS, Brazil; Instituto Federal de Educação, Ciência e Tecnologia do Rio Grande do Sul, Campus Porto Alegre, RS, Brazil; Corresponding author.Hospital Moinhos de Vento, Serviço de Farmácia, Porto Alegre, RS, BrazilHospital Moinhos de Vento, Serviço de Farmácia, Porto Alegre, RS, BrazilUniversidade Feevale, Instituto de Ciências da Saúde, Laboratório de Toxicologia, Novo Hamburgo, RS, BrazilUniversidade Feevale, Instituto de Ciências da Saúde, Laboratório de Toxicologia, Novo Hamburgo, RS, BrazilInfectious Diseases and Infection Control Service, Hospital Moinhos de Vento, Porto Alegre, RS, Brazil; Infectious Diseases Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil; Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BrazilVancomycin is a glycopeptide antibiotic mainly excreted by glomerular filtration. Therefore, patients undergoing hemodialysis tend to accumulate its crystalline degradation product, which has been associated with cross-reaction in commercial immunoassays. The aim of this study was to assess the performance of two commercial immunoassays for measuring vancomycin levels in patients undergoing hemodialysis. This method-comparison study enrolled patients undergoing hemodialysis at two hospitals in Porto Alegre, Brazil. Vancomycin serum concentrations measured by Chemiluminescent Microparticle Assay (CMIA) and measured by Kinetic Interaction of Microparticles in Solution (KIMS) were compared with Liquid Chromatography coupled with Tandem Mass Spectrometry (LC-MS/MS). A total of 64 samples from 42 patients and 54 samples from 23 patients were included in CMIA and KIMS groups. Both measurements were highly correlated with LC-MS/MS, with Spearman rank correlation coefficient r = 0.840 (p < 0.001) and r = 0.926 (p < 0.001), respectively. No deviation of linearity was observed (p = 0.81 and p = 0.49, respectively). The mean difference between CMIA and LC-MS/MS was -1.19 μg/mL and between KIMS and LC-MS/MS was -2.28 μg/mL. LC-MS/MS measured levels were, on average, 2.64 % higher than CMIA and 8.81 % higher than KIMS. CMIA and KIMS revealed accurate commercial methods to measure vancomycin serum concentrations in patients undergoing hemodialysis.http://www.sciencedirect.com/science/article/pii/S1413867024001521CMIAHemodialysisKIMSLC-MS/MSVancomycin
spellingShingle Letícia Scribel
Aline Galiotto
Isadora de Souza Rodrigues
Roberta Hahn
Rafael Linden
Alexandre P. Zavascki
Comparison of vancomycin assays in patients undergoing hemodialysis
Brazilian Journal of Infectious Diseases
CMIA
Hemodialysis
KIMS
LC-MS/MS
Vancomycin
title Comparison of vancomycin assays in patients undergoing hemodialysis
title_full Comparison of vancomycin assays in patients undergoing hemodialysis
title_fullStr Comparison of vancomycin assays in patients undergoing hemodialysis
title_full_unstemmed Comparison of vancomycin assays in patients undergoing hemodialysis
title_short Comparison of vancomycin assays in patients undergoing hemodialysis
title_sort comparison of vancomycin assays in patients undergoing hemodialysis
topic CMIA
Hemodialysis
KIMS
LC-MS/MS
Vancomycin
url http://www.sciencedirect.com/science/article/pii/S1413867024001521
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AT robertahahn comparisonofvancomycinassaysinpatientsundergoinghemodialysis
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