Lack of Cross-Reactivity & Interference of Commonly Used Intravenous (IV) Antimicrobials with a Lateral-Flow Device (LFD) for the Diagnosis of Invasive Aspergillosis (IA)

Ref ID: 18663

Author:

N. P. Wiederhold – Associate Professor1,2, C. R. Thornton – Senior Lecturer 3

Author address:

1Univ. Texas, Austin, TX, 2UTHSCSA, San Antonio, TX, 3Univ. Exeter, Exeter, United Kingdom.

Full conference title:

52nd Annual ICAAC

Date: 9 September 2014

Abstract:

Background: Early diagnosis and prompt initiation of antifungal therapy can improve outcomes in patients with IA. However, cross-reactivity with antimicrobials is a concern for available surrogate markers (i.e., galactomannan and (1,3)-β -D-glucan). Our objective was to evaluate the cross-reactivity and interference of commonly used IV antimicrobial agents with a LFD that uses an IgG monoclonal antibody to detect a hyphal specific Aspergillus antigen. Methods: 28 IV antimicrobials (22 antibiotics & 6 antifungals) were evaluated. Aspergillus fumigatus culture supernatant served as the positive control and was tested with each antimicrobial agent. 0.1 mL of the reconstituted vial concentration (RVC) of each antimicrobial in the presence and absence of the positive control was applied to LFDs. Cross-reactivity was defined as a positive LFD result when the antimicrobial was tested alone. Interference was defined as a negative result when the antimicrobial and the positive control were applied together to the LFD. If cross-reactivity or interference were observed at the RVC, the lower drug infusion concentration (DIC) was tested. If cross-reactivity or interference were observed at the DIC, then the plasma Cmax of the antimicrobial was evaluated. Results: No cross-reactivity or interference was observed with the LFD for 11 antimicrobials at the RVC. Assay interference was observed for 16 agents at the RVC. However, cross-reactivity or interference was no longer observed for 15 of these agents at the DIC. Although vancomycin interfered with the LFD at the RVC, cross-reactivity was observed at the DIC, but was absent at the Cmax (50 μg/mL). Only doxycycline resulted in cross-reactivity at each concentration tested. Conclusions: The lack of cross-reactivity and assay interference with the LFD at high drug concentrations for 27 of 28 commonly used IV antimicrobials points to the potential clinical utility of this point of care diagnostic assay. Additional studies with other pharmaceutical agents are warranted.

Abstract Number: M-1538

Conference Year: 2012

Link to conference website: NULL

New link: NULL

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