Tang Magdalene H Y, Ching C K, Poon Simon, Chan Suzanne S S, Ng W Y, Lam M, Wong C K, Pao Ronnie, Lau Angus, Mak Tony W L
Hospital Authority Toxicology Reference Laboratory, Hong Kong, China.
Department of General Adult Psychiatry, Castle Peak Hospital, Hong Kong, China.
Forensic Sci Int. 2018 May;286:113-120. doi: 10.1016/j.forsciint.2018.03.004. Epub 2018 Mar 12.
Rapid oral fluid testing (ROFT) devices have been extensively evaluated for their ability to detect common drugs of abuse; however, the performance of such devices on simultaneous screening for ketamine has been scarcely investigated. The present study evaluated three ROFT devices (DrugWipe 6S, Ora-Check and SalivaScreen) on the detection of ketamine, opiates, methamphetamine, cannabis, cocaine and MDMA. A liquid chromatography tandem mass spectrometry (LCMS) assay was firstly established and validated for confirmation analysis of the six types of drugs and/or their metabolites. In the field test, the three ROFT devices were tested on subjects recruited from substance abuse clinics/rehabilitation centre. Oral fluid was also collected using Quantisal for confirmation analysis. A total of 549 samples were collected in the study. LCMS analysis on 491 samples revealed the following drugs: codeine (55%), morphine (49%), heroin (40%), methamphetamine (35%), THC (8%), ketamine (4%) and cocaine (2%). No MDMA-positive cases were observed. Results showed that the overall specificity and accuracy were satisfactory and met the DRUID standard of >80% for all 3 devices. Ora-Check had poor sensitivities (ketamine 36%, methamphetamine 63%, opiates 53%, cocaine 60%, THC 0%). DrugWipe 6S showed good sensitivities in the methamphetamine (83%) and opiates (93%) tests but performed relatively poorly for ketamine (41%), cocaine (43%) and THC (22%). SalivaScreen also demonstrated good sensitivities in the methamphetamine (83%) and opiates (100%) tests, and had the highest sensitivity for ketamine (76%) and cocaine (71%); however, it failed to detect any of the 28 THC-positive cases. The test completion rate (proportion of tests completed with quality control passed) were: 52% (Ora-Check), 78% (SalivaScreen) and 99% (DrugWipe 6S).
快速口腔液检测（ROFT）设备已针对其检测常见滥用药物的能力进行了广泛评估；然而，此类设备同时筛查氯胺酮的性能鲜有研究。本研究评估了三种ROFT设备（DrugWipe 6S、Ora-Check和SalivaScreen）对氯胺酮、阿片类药物、甲基苯丙胺、大麻、可卡因和摇头丸的检测情况。首先建立并验证了液相色谱串联质谱（LCMS）分析法，用于这六种药物和/或其代谢物的确证分析。在现场测试中，对从药物滥用诊所/康复中心招募的受试者使用这三种ROFT设备进行检测。还使用Quantisal收集口腔液进行确证分析。本研究共收集了549份样本。对491份样本的LCMS分析显示存在以下药物：可待因（55%）、吗啡（49%）、海洛因（40%）、甲基苯丙胺（35%）、四氢大麻酚（8%）、氯胺酮（4%）和可卡因（2%）。未观察到摇头丸阳性病例。结果表明，所有3种设备的总体特异性和准确性均令人满意，符合DRUID标准（>80%）。Ora-Check的灵敏度较低（氯胺酮36%、甲基苯丙胺63%、阿片类药物53%、可卡因60%、四氢大麻酚0%）。DrugWipe 6S在甲基苯丙胺（83%）和阿片类药物（93%）检测中显示出良好的灵敏度，但在氯胺酮（41%）、可卡因（43%）和四氢大麻酚（22%）检测中表现相对较差。SalivaScreen在甲基苯丙胺（83%）和阿片类药物（100%）检测中也显示出良好的灵敏度，对氯胺酮（76%）和可卡因（71%）的灵敏度最高；然而，它未能检测出28例四氢大麻酚阳性病例中的任何一例。测试完成率（通过质量控制的测试比例）分别为：52%（Ora-Check）、78%（SalivaScreen）和99%（DrugWipe 6S）。
