Fecal calprotectin in management of Clostridium difficile infection: a longitudinal study.
BACKGROUND
Clostridium difficile infection (CDI) is characterized by a relevant intestinal neutrophil infiltrate. So far, role of fecal calprotectin in CDI, has been investigated only in few studies, mainly focused on diagnosis of the disease.


AIM
By a longitudinal design, we assess fecal calprotectin concentrations (FCCs) in subjects with CDI, evaluating the correlation between fecal marker and response to therapy.


METHODS
Clinical (diarrhea scoring) and laboratory (FCCs and leucocytes count) evaluation was performed in 56 subjects with CDI at time of diagnosis (T0) and after a week from starting of therapy (T1). Clinical response to therapy at T1 was related with both T0 and T1 FCC values. FCCs were also related to all-cause 30-day mortality, recurrence and death, both of them within 90 days.


RESULTS
FCCs at T1 were significantly increased in subjects with persistence of diarrhea in respect to the other ones (285.5 ± 270 µg/g vs 150.7 ± 147 µg/g, respectively; p < .05). Patients who did not respond to therapy showed higher, but not significative, FCCs at T0 than patients who responded. No correlation was found among FCCs, both at T0 and T1, and the other outcomes.


CONCLUSIONS
Longitudinal evaluation of FCCs in patients with CDI could support physicians in clinical management of disease, for example in term of duration (10 vs 14 days) or type (first vs second line therapy). Further and larger studies could confirm the eventual role of this marker in prognostic algorithms, mainly in prediction of recurrence.
['Gallo|Antonella|A|', 'Vallone|Carla|C|', 'Sabatelli|Ludovico|L|', 'Ventura|Giulio|G|', 'Covino|Marcello|M|', 'Cammarota|Giovanni|G|', 'Gasbarrini|Antonio|A|', 'Landolfi|Raffaele|R|', 'Montalto|Massimo|M|']
D000368:Aged D000369:Aged, 80 and over D000900:Anti-Bacterial Agents D015415:Biomarkers D016360:Clostridioides difficile D003015:Clostridium Infections D003967:Diarrhea D005243:Feces D005260:Female D006801:Humans D007249:Inflammation D039841:Leukocyte L1 Antigen Complex D008137:Longitudinal Studies D008297:Male D008875:Middle Aged D054328:Proton Pump Inhibitors D012008:Recurrence D012720:Severity of Illness Index D013997:Time Factors
Calprotectin clostridium diarrhea antibiotics