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Evaluation of the Microsemi CRP, an automated hematology analyzer for rapid

3-part WBC differential and CRP using whole blood

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DOI: 10.1111/ijlh.12312

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 International Journal of Laboratory Hematology
The Official journal of the International Society for Laboratory Hematology

ORIGINAL ARTICLE INTERNAT IONAL JOURNAL OF LABORATO RY HEMATO LOGY

Evaluation of the Microsemi CRP, an automated hematology analyzer

for rapid 3-part WBC differential and CRP using whole blood
N. NOMURA*, K. SAITO † , M. IKEDA*, S. YUASA*, M. PASTORE ‡ , C. CHABERT ‡ , E. KONO § , A. SAKAI § ,
H. TANAKA § , T. IKEMOTO § , T. TAKUBO §

*HORIBA Medical, S U M M A RY
MiyanohigashiKisshoin,
Minami-ku, Kyoto, Japan Introduction: We evaluated the basic performance of Microsemi CRP,
†
HORIBA Ltd, Tokyo Office: an unique automated hematology analyzer which can simultaneously
Kanda-Awaji cho, Kanda,
Chiyoda-ku, Tokyo, Japan measure CBC including 3-part WBC differential (3-Diff) and CRP
‡
HORIBA ABX, Parc using whole blood treated with EDTA-2K anticoagulant.
Euromedecine, Montpellier Method: We found that it produced generally the acceptable results
Cedex 4, France for all parameters performed (repeatability, reproducibility, linear-
§
Department of Central
Laboratory, Osaka Medical ity, interference effect, carry over, and correlation) using control
College Hospital, Daigaku- materials, fresh human whole bloods, and serum samples.
machi, Takatsuki, Japan Results: CBC data examined using Microsemi CRP showed the good
correlation with the previous model, Micros CRP200 (r ≧ 0.9), and
Correspondence:
Kensuke Saito, Horiba Ltd, also those obtained using the routine analyzer, ADVIA 2120i
Tokyo Office: Kanda-Awaji cho, (r ≧ 0.989). Concerning the 3-Diff, both GRA (%) and LYM (%)
Kanda, Chiyoda-ku, Tokyo showed the excellent correlation coefficient between Microsemi
101-0063, Japan.
CRP and Micros CRP200 (r ≧ 0.992) as well as ADVIA 2120i
Tel.: +81-3-6206-4719;
Fax: +81-3-6206-4720; (r ≧ 0.957). MON (%) showed good correlation between Microsemi
E-mail: kensuke.saito@ CRP and Micros CRP200 (r = 0.959), but lower correlation between
horiba.com Microsemi CRP and ADVIA 2120 i (r = 0.471). CRP data showed
the good correlation with HITACHI7600 (r ≧ 0.997) and Micros
doi:10.1111/ijlh.12312
CRP200 (r ≧ 0.997).
Conclusion: From these findings, we concluded that Microsemi CRP
Received 17 July 2014; accepted seemed the convenient laboratory analyzer in the setting of point
for publication 1 October 2014 of care testing (POCT) especially at NICU or primary care unit.

Keywords
Automated hematology analyzer
Microsemi CRP, 3-part WBC
differential (3-Diff), C-reactive
protein (CRP), point of care
testing (POCT), inflammatory
disease

© 2014 John Wiley & Sons Ltd, Int. Jnl. Lab. Hem. 1
2 N. NOMURA ET AL. | EVALUATION OF THE MICROSEMI CRP
INTRODUCTION
Complete blood count (CBC) including WBC differen-
tial and C-reactive protein (CRP) have been frequently
utilized as the biomarkers for inflammatory diseases
such as bacterial infection [1–3]. Generally, CBC
including WBC differential has been examined using
whole blood anticoagulated with ethylenediaminetet-
raacetic acid (EDTA) [4]. CRP has been examined
using serum samples. Therefore, centrifugation of the
completely coagulated blood for about 15 min is
necessary to obtain the serum value of CRP [5].
To avoid such time-consuming preanalytical pro-
cess, Horiba Medical (Kyoto, Japan) has developed
the automated hematology analyzer Microsemi series
which can simultaneously measure CBC including
3-part WBC differential (3-Diff) and CRP using EDTA-
2K anticoagulated whole blood without centrifugation
for serum preparation [6]. Here, we presented Micro-
semi CRP, the latest version of Microsemi series, and
evaluated its basic performance as well as the correla-
tion with other analyzers.
M AT E R I A L S A N D M E T H O D S
Principle of Microsemi CRP
The Microsemi CRP is equipped with the electrical resis-
tance method for CBC with 3-Diff of granulocytes
(GRA) contain neutrophils eosinophils and basophils,
lymphocytes (LYM), monocytes (MON). CRP is mea-
sured with the latex immune turbidimetry method fol-
lowing the prompt hemolyzation of EDTA-2K
anticoagulated whole blood. The obtained value is then con-
verted into plasma concentration according to HCT (%) of
respective sample to finally provide as ‘whole blood CRP’.
Microsemi CRP needs only 60 lL (18 lL for analyzer
and 42 lL for dead volume) of EDTA-2K anticoagulat-
ed whole blood for the simultaneous measurement of
CBC with 3-Diff and CRP and rapidly provides these
data within approximately 4 min.
Samples preparation
CL019 Linearity kit (R&D Systems; Minneapolis, MN,
USA) was used for linearity test. Three levels of con-
trol blood (ABX Minotrol CRP; R&D Systems), control
serum (DENKA SEIKEN, Tokyo, Japan), and fresh
human whole blood samples were used for repeatabil-
ity, reproducibility, and linearity tests. For the correla-
tion study, a total of 244 fresh whole blood samples
(145 normal and 99 abnormal, respectively) were
obtained at the Osaka Medical College Hospital. Mea-
surements of the 3 levels of control blood were
assayed before and after measurement twice per day.
All these fresh samples were tested for CBC with
3-Diff, and 120 samples, measured CRP by the routine
test analyzer, were also tested for CRP. We used only
one sample taken for each test individual and carried
out within 4 h after blood collection. This study was
approved by the institutional review board.
Repeatability test
Repeatability test was performed during several days
to assess the within-run imprecision of the Microsemi
CRP by replicate measurements.
The repeatability was evaluated using 3 levels of
ABX Minotrol CRP (low, normal, and high) and 5
fresh whole blood samples with elevated serum CRP.
Each sample was run 10 times in CBC+CRP mode.
Reproducibility test
Reproducibility study was performed, in accordance
with EP5-A2 [7], to assess the within-run imprecision
and total imprecision of the Microsemi CRP system by
replicate measurements of control materials.
The reproducibility was evaluated for 25 days using
3 levels of ABX Minotrol CRP (low, normal, and high)
and control serums (Level I and III).
Linearity test
Linearity test for CBC parameters (WBC, RBC, HGB,
and PLT) was conducted using CL019 linearity kit
(R&D Systems). This commercially available kit con-
sists of 4 components: (i) low range kit enabling lin-
earity test in the low range for WBC, RBC, HGB,
and PLT; (ii) WBC full range kit for optimum range
on WBC test; (iii) RBC full range kit for optimum
range on RBC and HGB test; and (iv) PLT full range
kit for optimum range on PLT test. Each kit con-
tains 6 levels of samples. The linearity was
evaluated according to the manufacturer’s recom-
mendation.
© 2014 John Wiley & Sons Ltd, Int. Jnl. Lab. Hem.

Concerning the linearity of CRP, physiological sal-
ine and whole blood samples were used to prepare
the stepwise series of CRP concentration.
Interference-effect test
Potentially interfering 5 substances (albumin (g/
L):66,69,97, triglyceride (mmoL/L):1.3,1.42,1.86, urea
(mmoL/L): 44.05,46.27,73.54, bilirubin (lmoL/L):
111.2,150.5,212.1, and hemoglobin(g/dL):0.2,0.3,1.4)
were added to the sample of interest, and the bias rela-
tive to a control portion of the sample was evaluated
(paired-difference testing) for 9 hematological measure-
ment items (WBC, RBC, HGB, HCT, mean corpuscular
volume (MCV), mean corpuscular hemoglobin (MCH),
mean corpuscular hemoglobin concentration (MCHC),
PLT and mean platelet volume (MPV) and CRP accord-
ing to the CLSI EP7-A2 [8]. If certain substance showed a
clinically significant effect suspicious of interference, they
were further examined to determine the relationship
between the interference concentration and the degree of
interference. The number of times of replicates for each
sample was defined according to the CSLI EP7-A2. [8].
The effect was then evaluated on three analytic levels
(low, normal, and high) as following:
• Prepare blood samples of low, normal, and high
concentrations and add quantity of potential interfer-
ing substance to the blood samples.
• Prepare negative reference materials with diluent to
the same concentrations. Measure alternately the
blood samples and the negative reference materials 3
times to calculate means and SD.
• We calculate the ranges of 95% confidence limits
for negative references and positive references.
• We confirm that the ranges satisfy the imprecision
that was taken from the Westgard bias specifications
described by Ricos et al. [9].
• If the ranges satisfy the imprecision, we judge no
significant effect, influence by interference matters
(no significant effect), and if the ranges do not satisfy
the imprecision, we judge that there is some influence
by interference materials (significant effect).
Carry over test
Carry over was conducted following the protocol
discussed in the CLSI H26-A2 [10]. The potential
for sample carry over was tested using alternating
© 2014 John Wiley & Sons Ltd, Int. Jnl. Lab. Hem.
N. NOMURA ET AL. | EVALUATION OF THE MICROSEMI CRP 3
high and low concentrations samples following the
protocol below:
Run the low samples three times (L1, L2, and L3)
and record the results.
Run the high samples three times (H1, H2, and H3)
and record the results.
Run the low samples three times (L4, L5, and L6)
and record the results.
The percentage of carry over is calculated using the
formula below:
L4  L6
Ct % ¼  100
H3  L6
High and low level samples for whole blood were
prepared as following concentration, for WBC (high:
40–90 9 106/L, low: 0–3 9 106/mL), RBC (high: 6–
9 9 109/L, low: 0–1.5 9 109/L), HGB (high: 15–22 g/
dL, low: 0–5 g/dL), and PLT (high: 900–1000 9 106/L,
low: 0–50 9 10106/L). Serum samples for CRP were
prepared (high: 100–150 mg/L, low: 0–7 mg/L). Whole
blood samples (HCT > 23%) for CRP were also pre-
pared (high: 150–200 mg/L, low: 0–7 mg/L).
Correlation test
Comparison test was designed using CLSI Procedure
EP9-A2 [11] and employed linear square regression
analysis. CBC-3Diff of fresh whole blood samples
obtained using Microsemi CRP were compared with
those of Micros CRP200 (Horiba Medical), a preceding
model, and also those of ADVIA 2120i (Siemens,
Munich, Germany) routine hematology analyzer. To com-
pare WBC differential between Microsemi CRP and ADVIA
2120i, we regarded the sum of neutrophils, eosinophils, and
basophils as GRA when measured by ADVIA 2120i in this
study. To compare WBC differential between three analyz-
ers and manual microscopic counts, we examined counts by
two laboratory technologists with 200 cells per one-person.
The results of fresh whole blood and serum CRP obtained
using Micros CRP200 were compared with those of serum
CRP obtained using HITACHI 7600 routine analyzer.
R E S U LT S
Repeatability test
As was shown in Table 1, CV% of respective CBC
parameter and 3-Diff was entirely below 5% when
4 N. NOMURA ET AL. | EVALUATION OF THE MICROSEMI CRP

Table 1. Repeatability of CBC with 3-Diff and CRP about fresh whole blood, whole blood controls, and CRP
controls examined with the Microsemi CRP

WBC RBC HGB HCT PLT GRA LYM MON CRP

(9109/L) (91012/L) (g/L) (%) (9109/L) (%) (%) (%) (mg/L)

a) ABX Minotrol CRP

L Mean 1.99 2.44 61.10 17.24 76.30 26.35 62.01 11.64 4.90
CV% 1.59 1.07 0.52 0.96 4.33 2.48 1.45 3.19 6.45
N Mean 7.60 4.90 137.30 39.06 249.60 60.19 32.79 7.02 20.40
CV% 1.52 0.64 0.84 0.72 3.02 0.50 1.17 3.34 2.53
H Mean 20.15 5.78 181.30 51.74 477.60 78.92 15.52 5.56 32.20
CV% 0.85 0.92 0.37 0.97 1.16 0.32 1.24 3.08 3.21
b) Fresh whole blood samples
1 Mean 2.53 1.76 57.20 16.53 35.95 53.53 35.95 10.52 3.50
CV% 1.91 1.49 1.11 1.34 3.59 2.58 3.59 4.61 3.56
2 Mean 4.88 4.17 122.70 37.51 37.55 53.97 37.55 8.48 19.00
CV% 2.12 0.99 0.77 1.28 3.15 1.62 3.15 6.69 2.48
3 Mean 6.29 3.87 110.70 34.07 22.45 73.16 22.45 4.39 40.20
CV% 1.17 1.46 0.74 1.57 3.66 1.10 3.66 8.07 3.28
4 Mean 5.83 4.60 141.60 43.03 24.71 68.82 24.71 6.47 84.10
CV% 2.43 0.64 0.49 0.74 3.30 1.18 3.30 3.65 3.65
5 Mean 6.03 4.47 142.40 43.31 26.29 67.84 26.29 5.87 168.40
CV% 2.08 0.90 0.59 0.89 4.02 1.12 4.02 8.46 3.59

a: JCCLS proposed allowable width: WBC < 5% RBC < 4% PLT < 7%.
b: JCCLS proposed allowable width: WBC < 5% RBC < 4% PLT < 7%.

examined using 3 levels of ABX Minotrol CRP. The
maximal CV% of respective parameter was as follows,
1.59% for WBC, 1.07% for RBC, 0.84% for HGB,
0.97% for HCT, 4.33% for PLT, 2.48% for GRA,
1.45% for LYM, and 3.34% for MON. These data
were within the acceptable criteria (WBC 5%, RBC
4%, HGB 3%, and PLT 7%) proposed by the Japanese
Committee for Clinical Laboratory Standards (JCCLS)
which was decided by the Questionnaire by physi-
cians in Japan [12]. Whereas, CV% of CRP was
6.45% when evaluated using low level of ABX Mino-
trol CRP.
Repeatability evaluated using 5 fresh whole blood
samples was also generally excellent and within
acceptable criteria of JCCLS. The deviation of GRA
(%) and LYM (%) with all tested samples were within
3%. The deviation of MON (%) in 3 samples showed
the CV% more than 5% (6.69% in sample 2, 8.07%
in sample 3, and 8.46% in sample 5).
normal and high levels of ABX Minotrol CRP. But,
those of PLT and MON (%) exceeded 5% (8.34% and
6.95%, respectively) when examined using low level
of ABX Minotrol CRP. Concerning those of CRP, CV%
was between 5 and 10% at every level of ABX Mino-
trol CRP. It seemed slightly lower when examined
using 2 levels of control serum.
Linearity test
We confirmed the linearity of CBC parameters using
linearity kit as follows: WBC 0.40–92.25 9 106/L,
RBC 0.250–8.380 9 109/L, HGB 0.70–23.80 g/dL,
HCT 2.38–72.28%, and PLT 9.80–1350.8 9 106/L.
Concerning CRP, it was confirmed between 17.00–
157.00 mg/L in serum and 20.53–210.60 mg/L in
whole blood, respectively.
Interference-effect test

Albumin showed high possibility to cause acceptable

Reproducibility test
difference, <1 fL, to MPV result in three levels (low
As was shown in Table 2, CV% of CBC parameters 6.6 g/L, normal 6.9 g/L, and high 9.7 g/L). Triglycer-
containing 3-Diff were <5% when evaluated using ide positively affected the result of low level HGB

© 2014 John Wiley & Sons Ltd, Int. Jnl. Lab. Hem.
 N. NOMURA ET AL. | EVALUATION OF THE MICROSEMI CRP 5

Table 2. Reproducibility of CBC with 3-Diff and CRP about control samples examined with the Microsemi CRP

a) ABX Minotrol CRP

WBC RBC HGB HCT PLT GRA LYM MON CRP

(9109/L) (91012/L) (g/L) (%) (9109/L) (%) (%) (%) (mg/L)

L Mean 1.97 2.41 59.80 17.20 74.49 25.99 62.73 11.28 5.44
CV% 3.60 1.55 1.50 2.10 8.34 3.69 1.98 6.95 9.60
N Mean 7.48 4.84 134.00 38.69 242.66 59.72 33.43 6.85 24.11
CV% 2.13 1.51 1.31 1.74 3.58 1.04 2.07 4.57 7.49
H Mean 19.69 5.72 178.50 51.52 481.40 78.65 15.71 5.64 36.57
CV% 1.68 1.49 1.25 1.54 3.17 0.54 3.02 3.87 8.18

b) Control serum

CRP
(mg/L)

I Mean 4.79
CV% 5.71
III Mean 78.21
CV% 4.11

(7.3 g/dL), MCH, and MCHC when it was added at
1.3mmoL/L as intralipid. No significant interference
effect was observed after adding the other substances
(urea: 44.05–73.54mmoL/L, bilirubin: 111.2–
212lmoL/L, and hemolysis/hemoglobin: 0.2–1.4 g/
dL).
The other evaluated parameters (WBC, RBC, HCT,
MCV, and PLT) were not affected by any levels of
substances examined in this study.
ter, the correlation coefficient provided satisfactory
results(r ≧ 0.997) when compared between Microsemi
CRP and Micros CRP200, Microsemi CRP and
HITACHI7600 (Figure 3).
Concerning correlation between manual micro-
scopic counts and three analyzers, correlation coeffi-
cient was indicated below. Lymphocyte(manual
method to Microsemi CRP, Micros CRP200, and
ADVIA2120i:0.876,0.830,0.909), monocyte(same
as:0.356,0.425,0.405), GRA(same as:0.804,0.790,0.782).

Carry over test

All carry over results were within the maximum
allowable carryover values (Ct < 2%) (Data not
shown).
Correlation test
The least-square regression with the intercept and the
correlation coefficient for the main parameters
(CBC+3Diff) provided satisfactory results (r ≧ 0.959)
when compared between Microsemi CRP and Micros
CRP200 (Figure 1). It was also generally excellent
(r ≧ 0.957) between Microsemi CRP and ADVIA 2120i
except for MON (%) as r = 0.471(Figure 2). In addi-
tion, PLT counts of the Microsemi CRP seemed
slightly lower than ADVIA2120i. For the CRP parame-
DISCUSSION
In this study, we evaluated the basic performance of
Microsemi CRP, the latest-generation hematology
analyzer of the Micros CRP series, which could simul-
taneously measure CBC including 3-Diff and CRP
using only 18 lL whole blood within approximately
4 min. Microsemi CRP utilizes noncyanide reagent to
measure HGB concentration different from the previ-
ous model Micros CRP200.
Concerning CBC with 3-Diff, Microsemi CRP
showed the excellent repeatability (CV<5%) except
MON (%), which seemed ascribed to relatively low
MON (%) in fresh peripheral blood analyzed in this
study. In addition, MON (%) showed the less excel-
lent reproducibility (5%) together with PLT, which

© 2014 John Wiley & Sons Ltd, Int. Jnl. Lab. Hem.
6 N. NOMURA ET AL. | EVALUATION OF THE MICROSEMI CRP

WBC RBC HGB HCT PLT

(×109/L) (×1012/L) (×10 g/L) (%) (×109/L)
150 y = 0.958x – 0.046 10 y = 0.970x + 0.023 25 y = 0.976x + 0.140 80 y = 0.987x + 0.619 1000
y = 0.976x + 7.561
r = 0.999 r = 0.996 r = 0.999 r = 0.984 r = 0.989
n = 244 8 n = 244 20 n = 244 60 n = 244 750 n = 244
100
6 15
40 500
4 10
50
20 250
2 5
Microsemi CRP

0 0 0 0 0
0 50 100 150 0 2 4 6 8 10 0 5 10 15 20 25 0 20 40 60 80 0 250 500 750 1000
(×109/L) (×1012/L) (×10 g/L) (%) (×109/L)

GRA LYM MON

(%) (%) (%)
100 y = 0.970x + 3.852 100 y = 0.982x + 0.088 50 y = 0.830x + 0.4794
r = 0.993 r = 0.992 r = 0.959
75 n = 244 75 n = 244 40 n = 244
30
50 50
20
25 25
10

0 0 0
0 25 50 75 100 0 25 50 75 100 0 10 20 30 40 50
(%) (%) (%)

Micros CRP200

Figure 1. Correlation between Microsemi CRP and Micros CRP200 about CBC parameter, with 3-Diff.

(×109/L) WBC (×1012/L) RBC (×10 g/L) HGB (%) HCT (×109/L) PLT
120 10 25 80 1000
y = 0.930x + 0.370 y = 0.965x – 0.041 y = 0.959x + 0.222 y = 0.995x – 0.3237
100 8 r = 0.992 800 y = 0.870x + 11.290
r = 0.994 20 r = 0.999
60 r = 0.992
80 r = 0.989
n = 244 6 n = 244 15 n = 244 n = 244 600 n = 244
60 40
4 10 400
40
20 200
20 2 5
0 0 0 0 0
Microsemi CRP

0 20 40 60 80 100 120 0 2 4 6 8 10 0 5 10 15 20 25 0 20 40 60 80 0 500 1000

(×109/L) (×1012/L) (×10 g/L) (%) (×109/L)

(%) GRA (%) LYM (%) MON

100 100 50
y = 0.973x – 0.109 y = 0.884x + 3.263 y = 0.449x + 5.081
80 r = 0.957 80 r = 0.957 40 r = 0.471
60 n = 244 60 n = 244 30 n = 244
40 40 20
20 20 10
0 0 0
0 50 100 0 50 100 0 10 20 30 40 50
(%) (%) (%)

ADVIA 2120i

Figure 2. Correlation between Microsemi CRP and ADVIA2120i about CBC parameter, with 3-Diff.

seemed also due to low levels in analyzed sample. CBC parameters (RBC, WBC, PLT, HGB, and HCT)
Concerning whole blood CRP, repeatability in low including 3-Diff obtained using Microsemi CRP
level control and reproducibility in all levels of them showed the excellent correlation (r > 0.9788) with
resulted into 5–10%. These results were in accor- those of Micros CRP200, whereas only MON (%) did
dance with those by Tugirimana et al. [13] who not show the good correlation when compared
measured serum CRP by the new turbidimetric between Microsemi CRP and ADVIA 2120i. This
method. seemed partially due to the different mechanism

© 2014 John Wiley & Sons Ltd, Int. Jnl. Lab. Hem.
 N. NOMURA ET AL. | EVALUATION OF THE MICROSEMI CRP 7

Whole blood Serum

(mg/L) (mg/L)
25 y = 1.003x – 0.085 20 y = 0.986x – 0.137

Microsemi CRP

Microsemi CRP
r = 0.997 r = 0.997
20 n = 120 15 n = 120
15
10
10
5
5
0 (mg/L) 0 (mg/L)
0 5 10 15 20 25 0 5 10 15 20
HITACHI 7600

Whole blood Serum

(mg/L) (mg/L)
25 y = 1.017x – 0.014 20 y = 1.025x – 0.1490
r = 0.998 r = 0.999
Microsemi CRP

Microsemi CRP
20 n = 120 15 n = 120
15
10
10
5
5
0 (mg/L) 0 (mg/L)
0 5 10 15 20 25 0 5 10 15 20
Micros CRP 200

Figure 3. Correlation between Microsemi CRP and HITACHI7600 and Micros CRP200 about CRP.

equipped in respective analyzer for WBC Diff, namely
Microsemi CRP examined WBC 3-Diff according to
the cell volume obtained using the electrical resistance
method. ADVIA 2120i utilized the cytochemical mye-
loperoxidase staining in addition to the electrical resis-
tance method for WBC 5-Diff. Consequently, MON
(%) obtained using Microsemi CRP might include, on,
theory, neutrophils, lymphocyte, eosinophils, and ba-
sophils of considerable level in certain patients. Fur-
thermore, there is few monocyte counts. Such a loose
correlation of MON (%) between the previous model
of Micros CRP series (LC-667CRP) and XE-2100 (Sys-
mex, Kobe, Japan) has been also reported [6]. Con-
cerning differential correlation to manual microscopic
counts (400 counts), GRA(%) and lymphocyte(%)
showed the good correlation(r > 0.782) except mono-
cyte(%) (r = 0.358:Microsemi CRP: 0.425:Micros
CRP200, 0.405:ADVIA2120i). As low levels of MON
give worse correlation, MON showed the low correla-
tion in any analyzers. It was the same as the report of
Siekmeier, using ABX pentra 120 and Coulter STKS
[14].
Next generation-hematology analyzer simulta-
neously available CBC with 5-Diff and CRP might
improve this problem in the future. Although PLT was
well correlated between Microsemi CRP and ADVIA
2120i, Microsemi CRP showed slightly lower levels
than ADVIA 2120i. Both analyzers utilized the same
mechanism for PLT counting, but seemed different in
the threshold for PLT counting. This was presumed by
the previous report in which 6 types of hematology
analyzers including ADVIA series were compared to
evaluate the respective correlation [15].
In this study, we showed that both whole blood
and serum CRP obtained using Microsemi CRP were
good correlated with those of Micros CRP200
(r ≧ 0.9967) as well as serum CRP obtained using
HITACHI 7600 (r ≧ 0.9967). Woolley evaluated the
correlation between whole blood CRP obtained using
Microsemi CRP and serum CRP with Cobas 6000
(Roche, West Sussex, UK) [16]. Such a previous
report also showed that whole blood CRP obtained
using Microsemi CRP was well excellently correlated
with serum CRP obtained using routine analyzers.
In conclusion, Microsemi CRP was the convenient
laboratory analyzer which could provide the clinically
reliable data about CBC including 3-Diff and CRP
using only 18 lL whole blood within approximately

© 2014 John Wiley & Sons Ltd, Int. Jnl. Lab. Hem.
 8 N. NOMURA ET AL. | EVALUATION OF THE MICROSEMI CRP

4 min. Therefore, Microsemi CRP seemed suitable in
the setting of point of care testing (POCT) for the
patients with inflammatory diseases such as bacterial
infection, especially for pediatric ones in whom suffi-
cient volume of samples necessary to simultaneous
measurement of CBC including WBC Diff and CRP
using the routine analyzers. Further study seemed
necessary to prove whether the rapid simultaneous
measurement of CBC including 3-Diff and CRP can
introduce clinical benefit.
CONFLICT OF INTEREST
Naoyuki Nomura, Manuela Pastore, Katsutoshi Ish-
izuka, Kazunori Yoshioka, Mayako Takahashi, Soichi
Yuasa, and Kensuke Saito are employed by Horiba Ltd.

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