The Role of Surface Enhanced Raman Scattering for Therapeutic Drug Monitoring of Antimicrobial Agents

A new perspective on antimicrobial therapeutic drug monitoring: Surface-enhanced Raman spectroscopy

Therapeutic drug monitoring (TDM) enables the personalization of treatment regimens, enhancing efficacy in combating infectious diseases while minimizing toxicity risks and reducing the potential for pathogenic resistance. However, existing TDM techniques still present certain limitations. Chromatographic analysis involves a prolonged detection period, which hampers its capacity for rapid multi-sample analysis. Immunoassay is constrained by poor specificity and stability, as well as a restricted range of detectable drugs. Surface-enhanced Raman spectroscopy (SERS) amplifies the Raman signals of target molecules via the local electromagnetic field and charge transfer effects on the surface of plasmonic materials, offering many significant advantages including high sensitivity, rapid detection, minimal sample requirements, and the ability to provide molecular fingerprints. SERS biosensing has demonstrated considerable potential in the field of blood drug concentration monitoring. This paper comprehensively reviews the research on the application of SERS in the TDM of antimicrobial agents. Beginning with the clinical practice of antimicrobial TDM, this review systematically introduces the principles of SERS techniques, the enhancement substrates, and the commonly used data processing methods including machine learning. It then provides a detailed discussion of the application of SERS in the TDM of various types of antimicrobials. Finally, it summarizes four major challenges currently faced by SERS techniques in antimicrobial TDM-namely protein corona effects, matrix interferences, substrate heterogeneity, and quantification reproducibility-and proposes potential future directions. This paper aims to offer new strategies and perspectives for the TDM and personalized dosage of antimicrobial agents.

SERS based determination of ceftriaxone, ampicillin, and vancomycin in serum using WS2/Au@Ag nanocomposites and a 2D-CNN regression model

Accurate therapeutic drug monitoring (TDM) of antibiotics including ceftriaxone, ampicillin, and vancomycin plays an important role in the treatment of neonatal sepsis, a common and life-threatening disease in neonates. A highly sensitive surface-enhanced Raman spectroscopy (SERS) method using tungsten disulfide/gold and silver core-shell (WS2/Au@Ag) nanocomposites was developed for the rapid detection of the three antibiotics, with a wide response range (0.5-1000 μg/mL). A two-dimensional convolutional neural network (2D-CNN) regression model was proposed to predict antibiotic concentrations in complex mixed serum solutions, simulating various drug use scenarios. The model achieved excellent regression results for ceftriaxone and ampicillin simultaneously, with R-squared (R2) values of 0.9993 and 0.9997. The integration of ultra-sensitive SERS with the 2D-CNN based deep learning model provides a promising approach for rapid TDM and personalized patient treatment.

Advances in Surface-Enhanced Raman Spectroscopy for Therapeutic Drug Monitoring

Therapeutic drug monitoring (TDM) is pivotal for optimizing drug dosage regimens in individual patients, particularly for drugs with a narrow therapeutic index. Surface-enhanced Raman spectroscopy (SERS) has shown great potential in TDM due to high sensitivity, non-destructive analysis, specific fingerprint spectrum, low sample consumption, simple operation, and low ongoing costs. Due to the rapid development of SERS for TDM, a review focusing on the analytical method is presented to better understand the trends. This review examines the latest advancements in SERS substrates and their applications in TDM, highlighting the innovations in substrate design that enhance detection sensitivity and selectivity. We discuss the challenges faced by SERS for TDM, such as substrate signal reproducibility and matrix interference from complex biological samples, and explore solutions like digital colloid-enhanced Raman spectroscopy, enrichment detection strategies, microfluidic SERS, tandem instrument technologies, and machine learning-enabled SERS. These advancements address the limitations of traditional SERS applications and improve analytical efficiency in TDM. Finally, conclusions and perspectives on future research directions are presented. The integration of SERS with emerging technologies presents a transformative approach to TDM, with the potential to significantly enhance personalized medicine and improve patient outcomes.

Biomedical SERS - the current state and future trends

Surface enhanced Raman spectroscopy (SERS) is meeting the requirements in biomedical science being a highly sensitive and specific analytical tool. By employing portable Raman systems in combination with customized sample pre-treatment, point-of-care-testing (POCT) becomes feasible. Powerful SERS-active sensing surfaces with high stability and modification layers if required are available for testing and application in complex biological matrices such as body fluids, cells or tissues. This review summarizes the current state in sample collection and pretreatment in SERS detection protocols, SERS detection schemes, i.e. direct and indirect SERS as well as targeted and non-targeted SERS, and SERS-active sensing surfaces. Moreover, the recent developments and advances of SERS in biomedical application scenarios, such as infectious diseases, cancer diagnostics and therapeutic drug monitoring is given, which enables the readers to identify the sample collection and preparation protocols, SERS substrates and detection strategies that are best-suited for their specific applications in biomedicine.

SERS as a tool for determination of structurally related compounds: The case of sulfanilamide class antibiotics

Analysis of real objects based on surface-enhanced Raman spectroscopy (SERS) often utilizes new SERS substrates and/or complex analysis procedures, and they are optimized for only the determination of a single analyte. Moreover, analysis simplicity and selectivity are often sacrificed for maximum (sometimes unnecessary) sensitivity. Consequently, this trend limits the versatility of SERS analysis and complicates its practical implementation. Thus, we have developed a universal, but simple SERS assay suitable for the determination of structurally related antibiotics (five representatives of the sulfanilamide class) in complex objects (human urine and saliva). The assay involves only mixing of acidified analyzed solution with co-activating agent (polydiallyldimethylammonium chloride - PDDA) and SERS substrate (standard colloidal silver nanoparticles). Acidification promotes the generation of SERS spectra with maximum similarity and intensity, which is explained by the favorable enhancement of the protonated sulfanilamide moiety (a structurally similar part of the studied antibiotics) as a result of its strong electrostatic interaction with the SERS-active surface. Meanwhile, the addition of PDDA improves analysis selectivity by reducing background signal from body fluids, enabling to simplify sample pretreatment (dilution for urine; mucin removal and dilution for saliva). Therefore, the assay allows for rapid (≤10 min), precise, and accurate class-specific determination of sulfanilamides within concentration ranges suitable for non-invasive therapeutic drug monitoring in urine (40-600 μM) and saliva (10-30 μM). We also believe that thorough investigation of structurally related analytes and accompanying effects (e.g., high spectral similarity) is a promising direction to improve the understanding of SERS in general and expand its capabilities as an analytical tool.

A novel strategy for therapeutic drug monitoring: application of biosensors to quantify antimicrobials in biological matrices

Over the past few years, therapeutic drug monitoring (TDM) has gained practical significance in antimicrobial precision therapy. Yet two categories of mainstream TDM techniques (chromatographic analysis and immunoassays) that are widely adopted nowadays retain certain inherent limitations. The use of biosensors, an innovative strategy for rapid evaluation of antimicrobial concentrations in biological samples, enables the implementation of point-of-care testing (POCT) and continuous monitoring, which may circumvent the constraints of conventional TDM and provide strong technological support for individualized antimicrobial treatment. This comprehensive review summarizes the investigations that have harnessed biosensors to detect antimicrobial drugs in biological matrices, provides insights into the performance and characteristics of each sensing form, and explores the feasibility of translating them into clinical practice. Furthermore, the future trends and obstacles to achieving POCT and continuous monitoring are discussed. More efforts are necessary to address the four key 'appropriateness' challenges to deploy biosensors in clinical practice, paving the way for personalized antimicrobial stewardship.

Magnetic polyphosphazene@Au particles as substrates for multiple-detection of immunoproteins by surface-enhanced Raman spectroscopy

Au coated magnetic polyphosphazene (MPCTP) composite particles (MPCTP@Au) were fabricated with sensitive SERS activity. The MPCTP particles were generated by coating polyphosphazene on Fe₃O₄ nanoparticles through precipitation polycondensation of hexachlorocyclotriphosphazene and phloroglucinol. MPCTP@Au composite particles were obtained by deposition of Au nanoparticles on MPCTP by the reduction of HAuCl₄. The size and the thickness of the Au shell can be controlled by varying the amount of HAuCl₄. The magnetic core endowed the composite particles with good magnetic responsiveness, which allowed the analyte to be enriched and separated from the complex matrix, and significantly simplifying the sample pretreatment procedure. The SERS activity of MPCTP@Au composite particles were evaluated by DTNB as model Raman reporter, and the limits of detection (LOD) of DTNB was 10^-8 mol/L. A high efficient SERS immunoassay system based on the MPCTP@Au substrates for the detection of immunoproteins was developed. Human IgG and rabbit IgG were quantitatively determinated simultaneously by this immunoassay system. The quantitative determination of the immunoglobulin G (IgG) was achieved and the LOD of human IgG, rabbit IgG and the mixture of human IgG and rabbit IgG were as low as 10 fg/mL, 100 pg/mL and 1 ng/mL, respectively. The results showed that the MPCTP@Au composite particles have broad application prospects as high performance SERS active substrates for immunoprotein analysis.

Cyclodextrin-assisted SERS determination of fluoroquinolone antibiotics in urine and blood plasma

This paper describes the use of cyclodextrins (CDs) to improve the determination of fluoroquinolone antibiotics in human body fluids using surface-enhanced Raman spectroscopy (SERS). CDs were used to (i) prepare the CD-SERS substrate (synthesis and stabilization of silver nanoparticles), (ii) increase the sensitivity of the assay by enhancing the interaction between analyte molecules and the substrate, and (iii) improve the analysis accuracy by reducing the interaction between the substrate and endogenous components of body fluids. Two native CDs (α-CD and β-CD) and two of their derivatives with hydroxypropyl groups were tested, and the best results were obtained with CD-SERS substrate prepared using native β-CD. The CD-SERS assay has been developed and optimized for the determination of commonly used and structurally related fluoroquinolones (ciprofloxacin, norfloxacin, pefloxacin, and levofloxacin) in urine and blood plasma samples. Importantly, the non-significant difference in the interaction of the CD-modified SERS substrate with various fluoroquinolones has been successfully used to develop a versatile assay suitable for the analyte-class-specific analysis. Calibration plots were obtained for concentration ranges suitable for the determination of the antibiotics in urine (50-500 μg mL^-1) and blood plasma (1-6 μg mL^-1). The following figures of merit were obtained (for urine and blood plasma, respectively): RSD values are ≤15% and ≤23%, LOD values are 2.9-5.8 and 0.05-0.34 μg mL^-1, recovery ranges are 96-105% and 91-111%. In addition, the influence of excessive concentrations of some main endogenous components of the body fluids on the analytical signal was studied. This step was used to evaluate possible limitations of the assay associated with the deviation of the composition of the body fluid matrix. Therefore, accounting for the short analysis time (≤15 min) and the use of a portable Raman spectrometer, the proposed assay can be suggested for therapeutic drug monitoring in hospitals.

Can DFT Calculations Provide Useful Information for SERS Applications?

Density functional theory (DFT) calculations allow us to reproduce the SERS (surface-enhanced Raman scattering) spectra of molecules adsorbed on nanostructured metal surfaces and extract the most information this spectroscopy is potentially able to provide. The latter point mainly concerns the anchoring mechanism and the bond strength between molecule and metal as well as the structural and electronic modifications of the adsorbed molecule. These findings are of fundamental importance for the application of this spectroscopic technique. This review presents and discusses some SERS-DFT studies carried out in Italy as a collaboration between the universities of Modena and Reggio-Emilia and of Florence, giving an overview of the information that we can extract with a combination of experimental SERS spectra and DFT modeling. In addition, a selection of the most recent studies and advancements on the DFT approach to SERS spectroscopy is reported with commentary.