Case Study: CBC+CRP (C Reactive Protein) Testing in Hospital Central Laboratory Environment

Dr. Katsutoshi Nagasawa

Head of Pediatrics Dept.
Specialty: Pediatrics, renal disease (including nephrosis), food allergy

Takeda General Hospital, Takeda Health Foundation (Japan)

Instrument: Hematology analyzer
Parameters: CBC 3-Diff and CRP (C Reactive Protein)
Tests per day: 10-15 (higher during flu season)

We test CBC & CRP for about 30 emergency patients every day.
We draw 60 µL of sample from a finger, which is less stressful for children and easier for nursing staff to perform.

*Requireid time may vary with each case.

CBC (Complete Blood Count):

Contains red blood cells, white blood cells, and platelets. Helps diagnose various conditions.

CRP (C-Reactive Protein):

An acute-phase reactant increased in the serum of patients with pneumococcal infection.

Very helpful for children because it involves less pain and stress and is less of a burden for nursing staff.

What symptoms are most often seen in patients who visit the ER?

We have about 10,000 children visit the ER every year (average 30 daily), high fever, cough and vomiting are the top three symptoms seen.

How do you examine the children with high fever?

When the fever is over 102.2 °F (39.0 °C), a decision must be made. If CBC and CRP test results show negative inflammatory reaction, then a virus infection like ES is suspected, which does not require immediate action. On the other hand, if WBC is over 15,000, bacterial infection is suspected, which requires further testing.

How do you sample blood from children?

We draw blood samples from fingers, which is easier to perform by nurses than venous blood sampling which is more difficult due to the delicate thin veins in children.

How much blood do you sample from children?

The hematology analyzer we are using for emergency patients outside the clinic hours can measure CBC and CRP with only 60 µL of whole blood. Smaller blood samples reduce the stress and pain associated with blood draws from children. This is beneficial to both the patients and the nursing staff.

Does the test result determine whether antibiotics should be administered?

Antibiotics are effective for the treatment of bacterial infections. CBC and CRP results can distinguish between a bacterial or viral infection, which enables the physician to prescribe antibiotics for treatment. Of course, by not giving antibiotics to patients with viral infections, we reduce the incidence of mutating bacteria becoming drug-resistant. In addition, by measuring CBC and CRP, we are able to identify and treat about 30 cases of pyelonephritis patients per year.

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