title: Prospective multicenter study evaluating fecal calprotectin in adult acute bacterial diarrhea.
abstract: BACKGROUND
  Every year, about 2.2 million deaths occur worldwide due to diarrhea. Reliable diagnosis of patients with acute infectious diarrhea remains a formidable challenge to the clinicians. This is the first study reporting use of fecal calprotectin in diagnosing acute diarrhea. The aim was to compare the diagnostic accuracy of fecal calprotectin, fecal lactoferrin, and guaiac-based fecal occult blood test in a diverse group of consecutive patients with acute diarrhea in which routine bacterial stool cultures and cytotoxins for Clostridium difficile were performed.
  
  
  METHODS
  This was a prospective case-control multicenter study from January 2004 until October 2007 in 2383 consecutive patients with acute diarrhea. They provided stool samples for performing cultures. Patients with positive cultures and an equal number of matched controls with negative cultures underwent fecal occult blood test and calprotectin and lactoferrin assays.
  
  
  RESULTS
  Calprotectin, lactoferrin, and fecal occult blood tests demonstrated sensitivity and specificity of 83% and 87%, 78% and 54%, and 38% and 85%, respectively, for diagnosing acute bacterial diarrhea.
  
  
  CONCLUSIONS
  Calprotectin showed high correlation with bacteriologically positive infectious diarrhea compared with lactoferrin and fecal occult blood test. It may potentially revolutionize management algorithm for patients with acute diarrhea. As a screening test, calprotectin can generate results within hours to support presumptive diagnosis of infectious diarrhea, which can decide suitability of stool samples for culture.
authors.affiliation: Department of Gastroenterology and Clinical Nutrition, Katharina Kasper Hospitals, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany. drshastri@gmail.com
authors.forename: Yogesh M
authors.initials: YM
authors.lastname: Shastri
authors.forename: Dominik
authors.initials: D
authors.lastname: Bergis
authors.forename: Nada
authors.initials: N
authors.lastname: Povse
authors.forename: Volker
authors.initials: V
authors.lastname: Schäfer
authors.forename: Sarika
authors.initials: S
authors.lastname: Shastri
authors.forename: Martin
authors.initials: M
authors.lastname: Weindel
authors.forename: Hans
authors.initials: H
authors.lastname: Ackermann
authors.forename: Jürgen
authors.initials: J
authors.lastname: Stein
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections; D016022:Case-Control Studies; D003967:Diarrhea / Q000382:microbiology*; D005243:Feces / Q000737:chemistry*; D006801:Humans; D007781:Lactoferrin / Q000032:analysis; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis*; D008875:Middle Aged; D009780:Occult Blood; D011446:Prospective Studies
chemical_list: D039841:Leukocyte L1 Antigen Complex; D007781:Lactoferrin