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Evaluation of the bedside Quikread go® CRP test in the management of febrile infants at the emergency department

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European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

Recently C-reactive protein (CRP) point-of-care tests have been developed. We aimed to validate a bedside CRP test (QuikRead go® CRP), to compare it with the laboratory CRP (ARCHITECT c8000 Abbott, Germany) test in children with fever without source (FWS), and to evaluate the optimal CRP cut-off value to identify those patients at a high risk for serious bacterial infection (SBI). The CRP bedside test was prospectively performed in capillary blood samples concurrently with the laboratory CRP testing for 283 well-appearing infants aged 1 to 24 months with FWS attending the emergency department (ED) between May 2013 and August 2015. The mean difference between the laboratory CRP and the QuikRead go CRP values was 0.71 mg/L (p = 0.444). Pearson’s correlation coefficient between the CRPs was r = 0.929 (p < 0.001). SBI was diagnosed in 34 patients (12.0%). The area under the receiver operating characteristics (ROC) curve obtained was 0.87 (95%CI: 0.82–0.90) for an optimal CRP cut-off value of > 10 mg/L (sensitivity: 94.1%, specificity: 49.0%, positive predictive value: 20.1%, negative predictive value: 98.4%), as a predictor of SBI. Nearly 45% of the patients were at a low risk for SBI according to CRP value; thus, additional laboratory tests would have been hypothetically avoided. There was a very strong, positive correlation between the QuikRead go CRP test and laboratory CRP determination. The QuikRead go CRP test provides reliable results to rule out SBI. Its implementation at the ED would improve the management of infants with FWS.

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Authors and Affiliations

  1. Pediatric Emergency Department, Hospital Sant Joan de Déu Barcelona, Passeig Sant Joan de Déu 2, 08940, Esplugues de Llobregat (Barcelona), Spain

    S. Hernández-Bou, V. Trenchs, M. I. Vanegas & C. Luaces

  2. Laboratory Department, Hospital Sant Joan de Déu Barcelona, Passeig Sant Joan de Déu 2, 08940, Esplugues de Llobregat (Barcelona), Spain

    A. F. Valls

Authors
  1. S. Hernández-Bou
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  2. V. Trenchs
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  3. M. I. Vanegas
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  4. A. F. Valls
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  5. C. Luaces
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Correspondence to S. Hernández-Bou.

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Funding

This study was partly supported by Orion Corporation, Orion Diagnostica, Espoo, Finland, who provided the QuikRead go CRP instrument and kits for the study. No other external funding was received for this study. The study sponsor played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.

Conflicts of interest

The authors declare that they have no conflicts of interest and that they do not have a financial relationship with the organization that sponsored the research.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The Ethics Committee of the Hospital Sant Joan de Déu Barcelona approved the study (CEIC PIC-45-13).

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Signed informed consents were obtained from the parents or legal guardians of all participating children.

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Hernández-Bou, S., Trenchs, V., Vanegas, M.I. et al. Evaluation of the bedside Quikread go® CRP test in the management of febrile infants at the emergency department. Eur J Clin Microbiol Infect Dis 36, 1205–1211 (2017). https://doi.org/10.1007/s10096-017-2910-2

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  • DOI: https://doi.org/10.1007/s10096-017-2910-2

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