Rapid Point-of-Care Genotyping to Avoid Aminoglycoside-Induced Ototoxicity in Neonatal Intensive Care

Abstract

This pragmatic prospective implementation trial uses a rapid genotyping platform for the m.1555A>G variant to assess whether this technology could be implemented to avoid aminoglycoside-induced ototoxicity without disrupting normal clinical practice on neonatal intensive care units.

Options for Detecting Risk of Aminoglycoside-Induced Ototoxicity in Neonates—Reply

“…With prenatal testing, there would be no need to wait for or have access to newborn point-of-care testing. This research 1 showed no delay in care for the infants in the study. Although, as the authors point out, "Neonates requiring antibiotics immediately, as determined by the admitting clinician, with established intravenous access, were excluded."…”

“…We write to point out that technology exists for even more efficient testing-specifically, maternal testing prior to delivery. As mentioned, 1 the MT-RNR1 m.1555A>G is mitochondrial. Theoretically, a mother and her infant have the same gene.…”

“…To the Editor We are writing in response to the article by Mc-Dermott et al 1 The study is both hopeful and practical. It would be wonderful to see such point-of-care testing become more widespread.…”

Using a bedside test to detect genetic susceptibility to aminoglycoside‐induced hearing loss: Has the future arrived?

“…A recent publication described the use of a rapid point‐of‐care test (POCT) in a neonatal nursery in the United Kingdom for real‐time detection of infants at risk of AIHL, in whom exposure to aminoglycosides could then be avoided 5 . The trial was successful in demonstrating the analytical accuracy and feasibility of the assay, with the result for a patient being provided within 30 min of sample collection and there being no delay in initiating treatment.…”

Neonatal units in Manchester roll out genetic test for gentamicin ototoxicity

“…The findings, published in JAMA Pediatrics ,1 showed that 424 infants (80.6%) receiving antibiotics were successfully tested for the m.1555A>G variant within 26 minutes. The test demonstrated 100% sensitivity (95% confidence interval 93.9% to 100.0%) and specificity (98.5% to 100.0%), and it identified three babies with the variant in whom aminoglycoside antibiotics were avoided.…”