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Modification of screening immunoassays to detect sub-threshold concentrations of cocaine, cannabinoids, and opiates in urine: use for detecting maternal and neonatal drug exposures.
Ann Clin Lab Sci. 2000 Jan; 30(1):85-91.AC

Abstract

Testing for drugs of abuse in urine is commonplace in emergency departments and neonatal units. However, the clinical sensitivity of immunochemical screening methods is limited by the threshold concentrations used to distinguish between positive and negative specimens. Immunochemical screening methods for cocaine metabolite (benzoylecgonine), cannabinoids, and opiates in urine were recalibrated to detect drugs at lower threshold concentrations. The precision and linearity of the signals at the modified thresholds were verified by diluting drug-positive urine specimens to concentrations below the conventional cutoff concentration and measuring the rate signals in triplicate. To assess the clinical performance of the modified methods, specimens that tested negative using the unmodified assays were re-screened at the lower threshold, and specimens that re-screened positive were submitted for gas chromatographic/mass spectrometric (GC/MS) confirmation. Reproducibility of sub-threshold measurements was comparable to the unmodified assays, and rate separations between successive dilutions were sufficient to give semi-quantitative results. Using the lower thresholds, drugs were detected in 4-5% of the subjects that had screened negative at the conventional threshold concentration. GC/MS analysis confirmed the presence of cannabinoids and cocaine metabolite in 74% and 84%, respectively, of urine specimens that re-screened positive. Morphine, codeine, hydromorphone, or hydrocodone was detected by GC/MS analysis in 31% of opiate-positive re-screens.

Authors+Show Affiliations

Department of Pathology, University of Florida Health Science Center, Jacksonville 32209, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10678589

Citation

Hattab, E M., et al. "Modification of Screening Immunoassays to Detect Sub-threshold Concentrations of Cocaine, Cannabinoids, and Opiates in Urine: Use for Detecting Maternal and Neonatal Drug Exposures." Annals of Clinical and Laboratory Science, vol. 30, no. 1, 2000, pp. 85-91.
Hattab EM, Goldberger BA, Johannsen LM, et al. Modification of screening immunoassays to detect sub-threshold concentrations of cocaine, cannabinoids, and opiates in urine: use for detecting maternal and neonatal drug exposures. Ann Clin Lab Sci. 2000;30(1):85-91.
Hattab, E. M., Goldberger, B. A., Johannsen, L. M., Kindland, P. W., Ticino, F., Chronister, C. W., & Bertholf, R. L. (2000). Modification of screening immunoassays to detect sub-threshold concentrations of cocaine, cannabinoids, and opiates in urine: use for detecting maternal and neonatal drug exposures. Annals of Clinical and Laboratory Science, 30(1), 85-91.
Hattab EM, et al. Modification of Screening Immunoassays to Detect Sub-threshold Concentrations of Cocaine, Cannabinoids, and Opiates in Urine: Use for Detecting Maternal and Neonatal Drug Exposures. Ann Clin Lab Sci. 2000;30(1):85-91. PubMed PMID: 10678589.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Modification of screening immunoassays to detect sub-threshold concentrations of cocaine, cannabinoids, and opiates in urine: use for detecting maternal and neonatal drug exposures. AU - Hattab,E M, AU - Goldberger,B A, AU - Johannsen,L M, AU - Kindland,P W, AU - Ticino,F, AU - Chronister,C W, AU - Bertholf,R L, PY - 2000/3/18/pubmed PY - 2000/3/18/medline PY - 2000/3/18/entrez SP - 85 EP - 91 JF - Annals of clinical and laboratory science JO - Ann Clin Lab Sci VL - 30 IS - 1 N2 - Testing for drugs of abuse in urine is commonplace in emergency departments and neonatal units. However, the clinical sensitivity of immunochemical screening methods is limited by the threshold concentrations used to distinguish between positive and negative specimens. Immunochemical screening methods for cocaine metabolite (benzoylecgonine), cannabinoids, and opiates in urine were recalibrated to detect drugs at lower threshold concentrations. The precision and linearity of the signals at the modified thresholds were verified by diluting drug-positive urine specimens to concentrations below the conventional cutoff concentration and measuring the rate signals in triplicate. To assess the clinical performance of the modified methods, specimens that tested negative using the unmodified assays were re-screened at the lower threshold, and specimens that re-screened positive were submitted for gas chromatographic/mass spectrometric (GC/MS) confirmation. Reproducibility of sub-threshold measurements was comparable to the unmodified assays, and rate separations between successive dilutions were sufficient to give semi-quantitative results. Using the lower thresholds, drugs were detected in 4-5% of the subjects that had screened negative at the conventional threshold concentration. GC/MS analysis confirmed the presence of cannabinoids and cocaine metabolite in 74% and 84%, respectively, of urine specimens that re-screened positive. Morphine, codeine, hydromorphone, or hydrocodone was detected by GC/MS analysis in 31% of opiate-positive re-screens. SN - 0091-7370 UR - https://www.unboundmedicine.com/medline/citation/10678589/Modification_of_screening_immunoassays_to_detect_sub_threshold_concentrations_of_cocaine_cannabinoids_and_opiates_in_urine:_use_for_detecting_maternal_and_neonatal_drug_exposures_ L2 - https://www.who.int/reproductivehealth/publications/cancers/a92126/en/ DB - PRIME DP - Unbound Medicine ER -