Fecal Calprotectin as a Biomarker Distinguishing Infectious Cause in Acute Intestinal Infections, Comparing Different Age Groups of Children

Abstract

BackgroundFecal calprotectin (FC) measurement has a potential in distinguishing the cause of acute intestinal infections, but its distribution is age dependent.ObjectivesWith this study we wanted to investigate FC values in different age groups of children with acute intestinal infections.MethodsOne hundred and three children with acute intestinal infections were enrolled in this study. Seventy two had viral pathogens, 31 bacterial test subjects were divided into 3 groups: ≤ 1 y, 1 - 3 y, 3 - 7 y. Stool samples from test and control subjects (n = 17) were tested for FC with fluorescence enzyme immunoassay.ResultsViral and bacterial pathogen groups had significantly greater FC concentrations, compared to healthy controls. Overall, bacterial pathogen group presented with greater FC values, compared to viral pathogen group (1299.0 mg/kg vs 297.0 mg/kg, P = 0.002). The cut-off value for acute viral intestinal infections was > 70.0 mg/kg (78.2% sensitivity and 100% specificity), bacterial intestinal infections: > 201.0 mg/kg (88% sensitivity and 100% specificity). There was no difference in FC concentration between bacterial and viral pathogen groups in children under one-year-old (391.0 mg/kg vs 399.5 mg/kg, P = 0.945). Differences were significant comparing bacterial and viral pathogen groups of children from 1 to 3 (316.0 mg/kg vs 1799.75 mg/kg, P = 0.001) and from 3 to 7 years old (99.0 mg/kg vs1299.0 mg/kg, P = 0.04).ConclusionsFC is a valuable biomarker for distinguishing bacterial and viral pathogens, except for children under one-year-old.