RESUMEN
BACKGROUND: Dried blood spot (DBS) sampling is a blood collection tool that uses a finger prick to obtain a blood drop on a DBS card. It can be used for therapeutic drug monitoring, a method that uses blood drug concentrations to optimize individual treatment. DBS sampling is believed to be a simpler way of blood collection compared with venous sampling. The aim of this study was to evaluate the quality of DBSs from patients with tuberculosis all around the world based on quality indicators in a structured assessment procedure. METHODS: Total 464 DBS cards were obtained from 4 countries: Bangladesh, Belarus, Indonesia, and Paraguay. The quality of the DBS cards was assessed using a checklist consisting of 19 questions divided into 4 categories: the integrity of the DBS materials, appropriate drying time, blood volume, and blood spot collection. RESULTS: After examination, 859 of 1856 (46%) blood spots did not comply with present quality criteria. In 625 cases (34%), this was due to incorrect blood spot collection. The DBS cards from Bangladesh, Indonesia, and Paraguay seemed to be affected by air humidity, causing the blood spots not to dry appropriately. CONCLUSIONS: New tools to help obtain blood spots of sufficient quality are necessary and environmental specific recommendations to determine plasma concentration correctly. In addition, 3% of the DBS cards were rejected because the integrity of the materials suggesting that the quality of plastic ziplock bags currently used to protect the DBS cards against contamination and humidity may not be sufficient.
Asunto(s)
Antituberculosos/sangre , Pruebas con Sangre Seca/normas , Monitoreo de Drogas/métodos , Manejo de Especímenes/normas , Tuberculosis/sangre , Bangladesh , Pruebas con Sangre Seca/métodos , Humanos , Humedad , Indonesia , Paraguay , Reproducibilidad de los Resultados , República de Belarús , Sensibilidad y Especificidad , Manejo de Especímenes/métodos , Tuberculosis/diagnóstico , Tuberculosis PulmonarRESUMEN
Acute respiratory distress syndrome (ARDS) is a rare complication of enteric fever. We present an immunocompetent traveler to Nicaragua who developed enteric fever from Salmonella panama complicated by ARDS. Unlike her fellow travelers who also became ill, she was taking a proton pump inhibitor, which may have contributed to the disease severity.