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A microbiological method for determining serum levels of broad spectrum β-lactam antibiotics in critically ill patients
Kalmar County Hospital.
Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Kalmar County Hospital.ORCID iD: 0000-0002-1707-2655
Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Kalmar County Hospital ; Linköping University.
2016 (English)In: Journal of Microbiological Methods, ISSN 0167-7012, E-ISSN 1872-8359, Vol. 129, 23-27 p.Article in journal (Refereed) Published
Abstract [en]

Background Recent studies show that suboptimal blood levels of β-lactam antibiotics are present in intensive care unit (ICU) patients. A common reference method for assessing drug concentrations is liquid chromatography coupled with mass-spectrometry (LC-MS) which is highly accurate but rarely available outside reference centres. Thus, our aim was to develop a microbiological method for monitoring β-lactam antibiotic serum levels which could be used at any hospital with a microbiological laboratory. Methods The method was developed as a 96-well broth microdilution format to assess the concentrations of cefotaxime (CTX), meropenem (MER), and piperacillin (PIP). Patient serum containing antibiotics were diluted in suspensions of bacteria with known minimal inhibitory concentrations (MICs). Serum antibiotic concentrations were calculated by dividing the MIC with the dilution factor at which the serum inhibited growth of the bacterial suspension. Serum (n = 88) from ICU patients at four hospitals in south-east Sweden were analysed and compared to LC-MS analysis. Results The overall accuracy and precision for spiked samples and patient samples was within the pre-set target of ± 20.0% for all drugs. There was a significant correlation between the microbiological assay and LC-MS for the patient samples (CTX: r = 0.86, n = 31; MER: r = 0.96, n = 11; PIP: r = 0.88, n = 39) and the agreement around the clinical cut-off for CTX (4.0 mg/l), MER (2.0 mg/l) and PIP (16.0 mg/l) was 90%, 100% and 87%, respectively. Conclusion The microbiological method has a performance for determination of serum levels of meropenem, piperacillin and cefotaxime suitable for clinical use. It is an inexpensive method applicable in any microbiology laboratory.

Place, publisher, year, edition, pages
2016. Vol. 129, 23-27 p.
Keyword [en]
Cefotaxime, Drug concentration, Meropenem, Microbiological method, Piperacillin, β-Lactam antibiotics
National Category
Microbiology in the medical area
Research subject
Ecology, Microbiology
Identifiers
URN: urn:nbn:se:lnu:diva-56060DOI: 10.1016/j.mimet.2016.07.020ISI: 000383941500005PubMedID: 27469351Scopus ID: 2-s2.0-84979730427OAI: oai:DiVA.org:lnu-56060DiVA: diva2:971477
Available from: 2016-09-16 Created: 2016-08-31 Last updated: 2017-02-16Bibliographically approved

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CiteExportLink to record
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Citation style
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