PERBANDINGAN HASIL PEMERIKSAAN C-REACTIVE PROTEIN (CRP) ANTARA METODE PARTICLE ENHANCED TURBIDIMETRIC IMMUNOASSAY, REFLECTOMETRY-IMMUNOASSAY DAN SANDWICH IMMUNODETECTION PADA PASIEN SEPSIS

Pendahuluan. Kondisi sepsis memiliki angka mortalitas yang sangat tinggi terutama pada negara berkembang. Quick Sequential Organ Failure Asssessment (qSOFA) adalah modifikasi dari skor SOFA yang menggantikan kriteria Systemic Inflammatory Response Syndrome (SIRS) untuk diagnosis sepsis. C-reactive protein (CRP) adalah salah satu penanda untuk membantu diagnosis sepsis. Perbandingan hasil pengukuran CRP dengan alat otomatis (particle enhanced turbidimetric immunoassay (PETIA)), semi otomatis (sandwich immunodetection), dan point of care test (POCT) (reflectometry-immunoassay) belum ada. Penelitian ini bertujuan untuk menganalisis perbedaan hasil pemeriksaan dan menentukan nilai cut off CRP dengan ketiga metode tersebut pada pasien sepsis. Metode. Penelitian menggunakan sampel pasien sepsis yang dirawat instalasi rawat darurat, ruang observasi intensif, ruang perawatan intensif, ruang Intensive Care Unit (ICU) dan ruang perawatan penyakit dalam RSUD Dr. Soetomo Surabaya pada bulan Mei-September 2018. Sebanyak 85 subjek penelitian diperiksa dan dikelompokan menjadi kelompok sepsis (n=56) dan kontrol sehat (n=29) berdasarkan kriteria qSOFA. Pemeriksaan CRP metode PETIA, sandwich immunodetection, dan reflectometryimmunoassay dilakukan pada semua subjek penelitian. Hasil. Terdapat perbedaan bermakna kadar CRP pada kelompok sepsis yang mengunakan metode PETIA dan Reflectometry immunoassay (p = 0,003). Tidak didapatkan perbedaan bermakna antara kadar CRP dengan metode PETIA dan Sandwich Immunodetection (p= 0,172) serta Reflectometry immunoassay dan Sandwich Immunodetection (p = 0,251). Simpulan. Pemeriksaan kadar CRP Metode reflectometry immnunoassay dan metode PETIA tidak dapat menggantikan satu sama lain. Pemilihan spesifikasi alat dan metode pemeriksaan CRP disesuaikan dengan kebutuhan serta fasilitas laboratorium

C-Reactive Protein Levels of Sepsis Patients: A Comparison of Three Immunoassay Methods

C-Reactive Protein (CRP) is a marker to aid in diagnosing sepsis. Currently, there are not many studies about the comparison of CRP levels in sepsis patients with a variety of instruments and methods. This study aimed to analyze differences of CRP results using Particle Enhanced Turbidimetric Immunoassay (PETIA), Sandwich Immunodetection and Reflectometry Immunoassay, and to compare the characteristics of the instruments based on their specifications and practicality. The study used a total of 65 serum of sepsis patients who fulfilled the qSOFA criteria and were treated in the Emergency Department, Intensive Observation Room, Intensive Care Unit (ICU) and Internal Medicine Wards of the Dr. Soetomo Hospital Surabaya from May to September 2018. All samples were measured the CRP levels measured using the three methods. There were significant differences of CRP levels between the PETIA and Reflectometry immunoassay methods (p=0.003), suggesting a supportive role of both methods. There was no significant difference of CRP levels between PETIA and Sandwich Immunodetection (p=0.172) as well as Reflectometry immunoassay and Sandwich Immunodetection (p=0.251). The selection of instruments and methods for CRP examination must be adjusted to laboratory needs and facilities