1887

Abstract

Markers of intestinal inflammation have been proposed for inclusion in diagnostic algorithms. Faecal calprotectin (f-Cp), a sensitive marker of intestinal inflammation, was evaluated for utility in diagnosis in the hospital setting. One hundred and twenty positive and 99 negative faecal samples of hospital-acquired diarrhoea were analysed for f-Cp using a quantitative ELISA. positivity was confirmed using ELISAs for either toxins ( = 45) or glutamate dehydrogenase (GDH) with toxin gene confirmation ( = 75). Non-parametric ANOVA (Kruskal–Wallis) was used for data analysis. positive samples had higher (<0.05) median (interquartile range) f-Cp levels; 336 µg g (208–536) for toxin and 249 µg g (155–498) for GDH and toxin gene positive compared with 106 µg g (46–176) for and culture-negative faecal samples. Five positive samples were f-Cp negative (<50 µg g). A f-Cp concentration >50 µg g was 96 % sensitive and 26 % specific for , with area under the ROC curve of 0.82. There is no role for f-CP alone in predicting infection in hospital-acquired diarrhoea due to its low specificity.

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2014-04-01
2021-03-05
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References

  1. Baker I., Leeming J. P., Reynolds R., Ibrahim I., Darley E. 2013; Clinical relevance of a positive molecular test in the diagnosis of Clostridium difficile infection. J Hosp Infect 84:311–315 [CrossRef][PubMed]
    [Google Scholar]
  2. Barbut F., Corthier G., Charpak Y., Cerf M., Monteil H., Fosse T., Trévoux A., De Barbeyrac B., Boussougant Y. other authors 1996; Prevalence and pathogenicity of Clostridium difficile in hospitalized patients. A French multicenter study. Arch Intern Med 156:1449–1454 [CrossRef][PubMed]
    [Google Scholar]
  3. Burnham C. A., Carroll K. C. 2013; Diagnosis of Clostridium difficile infection: an ongoing conundrum for clinicians and for clinical laboratories. Clin Microbiol Rev 26:604–630 [CrossRef][PubMed]
    [Google Scholar]
  4. Chen C. C., Huang J. L., Chang C. J., Kong M. S. 2012; Fecal calprotectin as a correlative marker in clinical severity of infectious diarrhea and usefulness in evaluating bacterial or viral pathogens in children. J Pediatr Gastroenterol Nutr 55:541–547 [CrossRef][PubMed]
    [Google Scholar]
  5. Crobach M. J., Dekkers O. M., Wilcox M. H., Kuijper E. J. 2009; European Society of Clinical Microbiology and Infectious Diseases (ESCMID): data review and recommendations for diagnosing Clostridium difficile-infection (CDI). Clin Microbiol Infect 15:1053–1066 [CrossRef][PubMed]
    [Google Scholar]
  6. Department of Health 2012 Updated guidance on the diagnosis and reporting of Clostridium difficile London: Department of Health; https://www.gov.uk/government/publications (Accessed 26 July 2013.)
    [Google Scholar]
  7. He M., Miyajima F., Roberts P., Ellison L., Pickard D. J., Martin M. J., Connor T. R., Harris S. R., Fairley D. other authors 2013; Emergence and global spread of epidemic healthcare-associated Clostridium difficile . Nat Genet 45:109–113 [CrossRef][PubMed]
    [Google Scholar]
  8. Healthcare Commission 2006 Investigation into outbreaks of Clostridium difficile at Stoke Mandeville Hospital, Buckinghamshire Hospitals NHS Trust London: Healthcare Commission; http://www.buckinghamshirehospitals.nhs.uk/healthcarecommision/HCC-Investigation-into-the-Outbreak-of-Clostridium-Difficile.pdf (Accessed on 9th August 2013.)
    [Google Scholar]
  9. Lamb C. A., Mansfield J. C. 2011; Measurement of faecal calprotectin and lactoferrin in inflammatory bowel disease. Frontline Gastroenterol 2:13–18 [CrossRef]
    [Google Scholar]
  10. LaSala P. R., Ekhmimi T., Hill A. K., Farooqi I., Perrotta P. L. 2013; Quantitative fecal lactoferrin in toxin-positive and toxin-negative Clostridium difficile specimens. J Clin Microbiol 51:311–313 [CrossRef][PubMed]
    [Google Scholar]
  11. Nielsen H. L., Engberg J., Ejlertsen T., Nielsen H. 2013; Evaluation of fecal calprotectin in Campylobacter concisus and Campylobacter jejuni/coli gastroenteritis. Scand J Gastroenterol 48:633–635 [CrossRef][PubMed]
    [Google Scholar]
  12. Poullis A., Foster R., Northfield T. C., Mendall M. A. 2002; Faecal markers in the assessment of activity in inflammatory bowel disease. Aliment Pharmacol Ther 16:675–681 [CrossRef][PubMed]
    [Google Scholar]
  13. Shastri Y. M., Bergis D., Povse N., Schäfer V., Shastri S., Weindel M., Ackermann H., Stein J. 2008; Prospective multicenter study evaluating fecal calprotectin in adult acute bacterial diarrhea. Am J Med 121:1099–1106 [CrossRef][PubMed]
    [Google Scholar]
  14. Sýkora J., Siala K., Huml M., Varvařovská J., Schwarz J., Pomahačová R. 2010; Evaluation of faecal calprotectin as a valuable non-invasive marker in distinguishing gut pathogens in young children with acute gastroenteritis. Acta Paediatr 99:1389–1395 [CrossRef][PubMed]
    [Google Scholar]
  15. Whitehead S. J., French J., Brookes M. J., Ford C., Gama R. 2013; Between-assay variability of faecal calprotectin enzyme-linked immunosorbent assay kits. Ann Clin Biochem 50:53–61 [CrossRef][PubMed]
    [Google Scholar]
  16. Wilcox M. H. 2012; Overcoming barriers to effective recognition and diagnosis of Clostridium difficile infection. Clin Microbiol Infect 18:Suppl. 613–20 [CrossRef][PubMed]
    [Google Scholar]
  17. Wren M. W., Kinson R., Sivapalan M., Shemko M., Shetty N. R. 2009; Detection of Clostridium difficile infection: a suggested laboratory diagnostic algorithm. Br J Biomed Sci 66:175–179[PubMed]
    [Google Scholar]
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