Correlation between gut pathogens and fecal calprotectin levels in young children with acute diarrhea

Abstract

Background In cases of acute diarrhea, it is difficult to distinguish between bact erial and non-bacterial causes . Increased fecal calprotectin (f-CP) level is a marker of neutrophil migration in the intestinal lumen and is associated with intes tinal inflammation. Previous studies reported an increase in f-CP levels in children with acute diarrhea, which is caused by bacteria, but only few have studied the relationship between intestinal pathogens with f-CP levels in acute diarrhea. Objective To assess for a correlation between gut pathogens and fecal calprotectin levels in children with acute diarrhea. Methods We conducted a cross-sectional study between July to November 2012 on children aged 1-5 ye ars with acute diarrhea, and underwent routine blood tests, stool microscopy, f-CP tests, and stool cultures. We used a simple linear regression and correlation analysis with a significance level of P< 0.05. Results Forty-two children enrolled in this study. The mean age of subjects was 2.27 (SD 134) years. Theirmeanf-CP level was 93.88 (SD 14.68) μg/g. On microscopic stool examination, 26 patients ( 61.9%) had positive leukocytes, 1 had Ancy lo stoma duodenale, 1 had Ascaris lumbricoides, and 2 had Blastocystis hominis. Positive stool cultures were found in 14 children (33.3%) with acute diarrhea. There was a significant positive correlation between gut pathogens and f-CP levels (r=0.605; P< 0.0001). Conclusion In young children with acute diarrhea, the average f-CP levels are higher in those with positive intestinal pathogens.

Keywords

• intestinal pathogens, fecal calprotectin, acute diarrhea, children