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Am J Emerg Med. 2015 Oct;33(10):1436-9. doi: 10.1016/j.ajem.2015.07.007. Epub 2015 Jul 6.

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

Author information

1
Department of Pediatric Emergency Care, Faculty of Medicine, Dokuz Eylul University, İzmir, Turkey. Electronic address: mduman@deu.edu.tr.
2
Department of Pediatric Neurology, Tepecik Training and Research Hospital, İzmir, Turkey.
3
Department of Medical Microbiology, Dokuz Eylul University, İzmir, Turkey.
4
Department of Pediatrics, Faculty of Medicine, Dokuz Eylul University, İzmir, Turkey.
5
Department of Pediatric Emergency Care, Faculty of Medicine, Dokuz Eylul University, İzmir, Turkey.

Abstract

OBJECTIVE:

Fecal calprotectin is used as a good indicator of intestinal mucosal inflammation. The aim of this study is to evaluate the diagnostic value of fecal calprotectin (f-CP) for the etiology of acute gastroenteritis in children.

MATERIALS AND METHODS:

All patients presenting with acute diarrhea (<18 years) who had 3 or more soft or watery stools per day were enrolled in this study. Stool microscopic examination and cultures for bacteria and parasites were performed. Polymerase chain reaction test was also applied to stool samples for viruses (Rotavirus, Adenovirus, Norwalk, and Astrovirus). The level of f-CP was carried out by using enzyme-linked immunosorbent assay test.

RESULTS:

Eighty-four patients with diarrhea were enrolled. The f-CP level was higher in patients with microscopic examination positive (n=17) (median with interquartile range, 1610.0 [908.8-2100] mg/L) than in patients with microscopic examination negative (n=67) (123.8 [25.0-406.3] mg/L) (P<.001). Concentrations of f-CP in patients with stool culture positive (1870.0 [822.5-2100] mg/L) were significantly elevated compared with the concentrations of the patient with virus detected in stool (95.0 [21.3-240.9] mg/L) (P<.001). In the diagnosis for bacterial acute gastroenteritis, the area under the receiver operating characteristic curve for f-CP was 0.867 (95% confidence interval, 0.763-0.971), sensitivity was 88.9%, and specificity was 76.0% if the threshold was taken as 710 mg/L.

CONCLUSION:

We conclude that f-CP, which is useful, valuable, noninvasive, easily and rapidly measured laboratory test along with simple microscopic examination of stool, can be used as an indicator of intestinal inflammation and to distinguish the bacterial gastroenteritis from the viral gastroenteritis.

PMID:
26233616
DOI:
10.1016/j.ajem.2015.07.007
[Indexed for MEDLINE]

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