Fecal calprotectin: can be used to distinguish between bacterial and viral gastroenteritis in children?

Duman, Murat; Gençpınar, Pınar; Biçmen, Meral; Arslan, Nur; Özden, Ömer; Üzüm, Özlem; Çelik, Durgül; Sayıner, Abdullah; Gülay, Zeynep

doi:10.1016/j.ajem.2015.07.007

Cited by 25 publications

(16 citation statements)

References 14 publications

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“…Bacterial pathogens can cause invasive diarrhea. Such pathogens have been reported to possess the capability to invade the mucosa of the distal small intestine and colon, as well as stimulate local and systemic inflammatory responses[ 23 ]. Fecal calprotectin is a well-known significant marker of intestinal mucosal inflammation, and thus, many researchers have investigated its efficacy.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of stool multiplex polymerase chain reaction assay in adult patients with acute infectious diarrhea

Ahn¹,

Seo²,

Kim³

et al. 2020

WJCC

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BACKGROUND Recently, stool multiplex polymerase chain reaction (PCR) tests have been developed for identifying diarrhea-causing bacterial pathogens. Furthermore, fecal calprotectin is a well-known effective marker for intestinal mucosal inflammation. AIM To evaluate the efficacy of stool multiplex PCR and fecal calprotectin in acute infectious diarrhea. METHODS Overall, 400 patients with acute infectious diarrhea were enrolled from Kangdong Sacred Heart Hospital (January 2016 to December 2018). Multiplex PCR detected 7 enteropathogenic bacteria including Salmonella , Campylobacter , Shigella , Escherichia coli O157:H7, Aeromonas , Vibrio , and Clostridium difficile . We reviewed clinical and laboratory findings using stool multiplex PCR. RESULTS Stool multiplex PCR test detected considerably more bacterial pathogens than stool culture (49.2% vs 5.2%), with Campylobacter as the most common pathogen (54%). Patients with positive stool PCR showed elevated fecal calprotectin expression compared to patients with negative stool PCR (1124.5 ± 816.9 mg/kg vs 609 ± 713.2 mg/kg, P = 0.001). C-reactive protein (OR = 1.01, 95%CI: 1.001-1.027, P = 0.034) and sigmoidoscopy-detected colitis (OR = 4.76, 95%CI: 1.101-20.551, P = 0.037) were independent factors in stool PCR-based detection of bacterial pathogens. Sensitivity and specificity of calprotectin were evaluated to be 70.5% and 60.9%, respectively (adjusted cut-off value = 388 mg/kg). CONCLUSION Stool multiplex PCR test has increased sensitivity in detecting pathogens than conventional culture, and it is correlated with calprotectin expression. Stool multiplex PCR and calprotectin may be effective in predicting clinical severity of infectious diarrhea.

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Section: Discussionmentioning

confidence: 99%

Efficacy of stool multiplex polymerase chain reaction assay in adult patients with acute infectious diarrhea

Ahn¹,

Seo²,

Kim³

et al. 2020

WJCC

View full text Add to dashboard Cite

show abstract

“…In children, there is also another possible application. A previous study has indicated that fecal calprotectin could be used as a tool for distinguishing between viral and bacterial gastroenteritis with a specificity of 88.9%, and specificity of 76.0% for a cut-off of 710 mg/l [10].…”

Section: Discussionmentioning

confidence: 99%

“…For example, high calprotectin values have been linked to the development of other immune-mediated diseases, such as atopic dermatitis and asthma [9]. Further, higher fecal calprotectin levels have been found in children with bacterial gastroenteritis compared to children with viral disease [10].…”

Section: Introductionmentioning

confidence: 99%

Normal values for calprotectin in stool samples of infants from the population-based longitudinal born into life study

Peura

Fall

Almqvist

et al. 2017

Scandinavian Journal of Clinical and Laboratory Investigation

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Faecal calprotectin is a protein used as a diagnostic marker for inflammatory bowel diseases. We determined upper limits for normal calprotectin values for neonatal, 6, 12 and 24 months old children using a turbidimetric immunoassay in a cohort of Swedish children. The advantage of the method is that opposite to previously used enzyme-linked immunosorbent assay (ELISA) method, it enables measuring single samples, and thus, shortens the analysis time significantly. There were 72 samples (41.7% female) collected neonatally, 63 samples (34.9% female) at 6 months, 60 samples (40.0% female) at 12 months and 51 samples (43.1% female) at 24 months. The upper limits for normal values were 233, 615, 136 and 57 µg mg for infants aged 0, 6, 12 and 24 months, respectively.

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“…18 Bacterial and fungal infections are known to cause a predominant neutrophilic response compared with other infections. 19,20 Calprotectin has been studied with success as a marker of infection with potential to differentiate between bacterial and viral causes in gut infections, [21][22][23][24] and also as a diagnostic marker for prosthetic joint infections. 25 Calprotectin has been measured from throat swabs in a previous physiological study, 26 but has not been assessed in patients presenting with sore throat.…”

Section: Introductionmentioning

confidence: 99%

The feasibility of measuring calprotectin from a throat swab as a marker of infections caused by group A streptococcus: a case–control feasibility study

et al. 2020

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BackgroundMost people with sore throat do not benefit from antibiotic treatment, but nearly three-quarters of those presenting in primary care are prescribed antibiotics. A test that is predictive of bacterial infection could help guide antibiotic prescribing. Calprotectin is a biomarker of neutrophilic inflammation, and may be a useful marker of bacterial throat infections.AimTo assess the feasibility of measuring calprotectin from throat swabs, and assess whether individuals with sore throats likely to be caused by streptococcal infections have apparently higher throat calprotectin levels than other individuals with sore throat and healthy volunteers.Design & settingA proof of concept case–control study was undertaken, which compared primary care patients with sore throats and healthy volunteers.MethodBaseline characteristics and throat swabs were collected from 30 primary care patients with suspected streptococcal sore throat, and throat swabs were taken from 10 volunteers without sore throat. Calprotectin level determination and rapid antigen streptococcal testing were conducted on the throat swab eluents. Calprotectin levels in the following groups were compared: volunteers without a sore throat; all patients with a sore throat; patients with a sore throat testing either negative or positive for streptococcal antigen; and those with lower and higher scores on clinical prediction rules for streptococcal sore throat.ResultsCalprotectin was detected in all throat swab samples. Mean calprotectin levels were numerically higher in patients with sore throat compared with healthy volunteers, and sore throat patients who had group A streptococci antigen detected compared with those who did not.ConclusionCalprotectin can be measured from throat swab samples and levels are consistent with the hypothesis that streptococcal infection leads to higher throat calprotectin levels. This hypothesis will be tested in a larger study.

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Fecal calprotectin: can be used to distinguish between bacterial and viral gastroenteritis in children?

Cited by 25 publications

References 14 publications

Efficacy of stool multiplex polymerase chain reaction assay in adult patients with acute infectious diarrhea

Efficacy of stool multiplex polymerase chain reaction assay in adult patients with acute infectious diarrhea

Normal values for calprotectin in stool samples of infants from the population-based longitudinal born into life study

The feasibility of measuring calprotectin from a throat swab as a marker of infections caused by group A streptococcus: a case–control feasibility study

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