CRP (C-reactive protein)

The biomarker of choice to aid the diagnosis of infection and inflammatory disorders

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Infection (PCT, CRP) Myocardial infarction (TnI, CKBM, Myo) Heart failure (NT-proBNP) Pregnancy (ßhCG) Venous thromboembolism (D-dimer)

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Fast results
Early detection of inflammation
Evaluation of infection

CRP testing in the emergency department

When a patient is admitted with signs and symptoms of an infection, a C-reactive protein (CRP) test is used as an aid in the detection and evaluation of infection, tissue injury, inflammatory disorders, and associated diseases. CRP is valuable as an inflammation marker at the point-of-care, primary care and lab settings.

Increased CRP levels could be associated with bacterial, viral and fungal infections, sepsis, various forms of arthritis and several other infectious and inflammatory conditions [1]. CRP is an acute-phase protein produced by the liver and released into the blood a few hours after the onset of an infection, inflammation or tissue injury.

Because of the non-specific nature of the acute-phase response which leads to increased CRP levels, CRP should be used as a diagnostic aid in the clinical assessment of a patient [2].

Immunoassay biomarkers

CRP (C-reactive protein)

D-dimer

PCT (Procalcitonin)

Troponin I

βhCG (Human chorionic gonadotropin)

NT-proBNP

CRP values for evaluation of infection

When faced with a patient with signs and symptoms of an infection, the physician faces the clinical dilemma of:

Administering antibiotics in a timely manner [3].
Avoiding inappropriate usage of antibiotics. Misuse of antibiotics when not required has contributed to the problem of multiresistant bacterial infections, which are very difficult to treat [4].

Interpreting the CRP value

Clinical cut-offs can be used to determine if the infection is bacterial or viral [5].

CRP test on the AQT90 FLEX analyzer

The AQT90 FLEX immunoassay analyzer is a benchtop analyzer that brings rapid biomarker assessment capabilities right to the patient’s bedside.

The AQT90 FLEX analyzer delivers quantitative results on the CRP assay in less than 13 minutes, accelerating infection and inflammatory disorder diagnosis in the ED to support rapid clinical decision making.

The AQT90 FLEX CRP assay can be used both in the lab and at the point of care without any sample or assay preparations, providing a fast result without any exposure to blood. Its closed tube system makes CRP testing easy: the operator simply inserts the sample tube into the tube holder in the sample port and the analyzer performs all assay steps automatically.

All necessary reagents are included in the test cartridges, which remain stable onboard the analyzer for 20 days ensuring maximum availability and uptime.

Learn more about the AQT90 FLEX analyzer

Key benefits of CRP on the AQT90 FLEX analyzer

No blood exposure: Closed system
No sample or assay preparation
Sample types: EDTA and lithium-heparin
Specimen types: Venous whole blood and plasma
Sample tubes: Fits most 13 × 75 mm standard tubes
No presence of hook effect, carry-over or known interferences

CRP assay specifics

Turnaround time:

< 13 min.

CV % (plasma): Within-lab CV% at conc. 7.4 mg/L: 5.3%

95th percentile*: < 5 mg/L

Traceability: Standardization: Calibration is traceable to ERM - DA472/IFCC.

* This value should only be used as an example. Each laboratory should establish its own decision threshold level.

References

1. Testing. com. C-Reactive Protein (CRP) Test. https://www.testing.com/tests/c-reactive-protein-crp/. Accessed July 2022.
2. Seeger C et al. Acute care testing handbook 2014.
3. Joo YM et al. Impact of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock in the emergency department. Clinical and Experimental Emergency Medicine 2014;1, 1.
4. Lee Ventola C. The Antibiotic Resistance Crisis Part 1: Causes and Threats. P&T 2015; 40, 4.
5. Review Criteria for Assessment of C Reactive Protein (CRP), High Sensitivity C-Reactive Protein (hsCRP) and Cardiac C-Reactive Protein (cCRP) Assays - Guidance for Industry and FDA Staff. https://www.fda.gov/regulatory-information/search-fda-guidance-documents/review-criteria-assessment-c-reactive-protein-crp-high-sensitivity-c-reactive-protein-hscrp-and. Assessed Dec 2020.