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Improving tuberculosis treatment using mid-infrared spectroscopy for bedside therapeutic drug monitoring

Improving tuberculosis treatment using mid-infrared spectroscopy for bedside therapeutic drug monitoring
Improving tuberculosis treatment using mid-infrared spectroscopy for bedside therapeutic drug monitoring

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.

ATR-FTIR spectroscopy, biosensors, mid-infrared applications, point-of-care, therapeutic drug monitoring, tuberculosis, waveguide sensors
0277-786X
SPIE
Rowe, David J.
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Owens, Daniel R.
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Nedeljković, Miloš
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Stirling, Callum J.
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Cathie, Katrina
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Parker, Suzanne L.
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Faust, Saul N.
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Mashanovich, Goran Z.
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Wilkinson, James S.
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Reed, Graham T.
Knights, Andrew P.
Rowe, David J.
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Owens, Daniel R.
3a66adc3-6a24-4eca-a171-1880a8372fe6
Nedeljković, Miloš
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Stirling, Callum J.
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Cathie, Katrina
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Parker, Suzanne L.
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Faust, Saul N.
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Mashanovich, Goran Z.
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Wilkinson, James S.
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Reed, Graham T.
Knights, Andrew P.

Rowe, David J., Owens, Daniel R., Nedeljković, Miloš, Stirling, Callum J., Cathie, Katrina, Parker, Suzanne L., Faust, Saul N., Mashanovich, Goran Z. and Wilkinson, James S. (2023) Improving tuberculosis treatment using mid-infrared spectroscopy for bedside therapeutic drug monitoring. Reed, Graham T. and Knights, Andrew P. (eds.) In Silicon Photonics XVIII. vol. 12426, SPIE. 7 pp . (doi:10.1117/12.2649135).

Record type: Conference or Workshop Item (Paper)

Abstract

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.

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Published date: 13 March 2023
Venue - Dates: Silicon Photonics XVIII 2023, , San Francisco, United States, 2023-01-30 - 2023-02-01
Keywords: ATR-FTIR spectroscopy, biosensors, mid-infrared applications, point-of-care, therapeutic drug monitoring, tuberculosis, waveguide sensors

Identifiers

Local EPrints ID: 484909
URI: http://eprints.soton.ac.uk/id/eprint/484909
ISSN: 0277-786X
PURE UUID: 9278bf33-10ac-4ddc-bfd6-135f95cd18c3
ORCID for David J. Rowe: ORCID iD orcid.org/0000-0002-1167-150X
ORCID for Miloš Nedeljković: ORCID iD orcid.org/0000-0002-9170-7911
ORCID for Saul N. Faust: ORCID iD orcid.org/0000-0003-3410-7642
ORCID for Goran Z. Mashanovich: ORCID iD orcid.org/0000-0003-2954-5138
ORCID for James S. Wilkinson: ORCID iD orcid.org/0000-0003-4712-1697

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Date deposited: 24 Nov 2023 17:35
Last modified: 29 Oct 2024 02:45

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Contributors

Author: David J. Rowe ORCID iD
Author: Daniel R. Owens
Author: Miloš Nedeljković ORCID iD
Author: Callum J. Stirling
Author: Katrina Cathie
Author: Suzanne L. Parker
Author: Saul N. Faust ORCID iD
Author: Goran Z. Mashanovich ORCID iD
Editor: Graham T. Reed
Editor: Andrew P. Knights

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