Fecal calprotectin excretion in preterm infants during the neonatal period.
BACKGROUND
Fecal calprotectin has been proposed as a non-invasive marker of intestinal inflammation in inflammatory bowel disease in adults and children. Fecal calprotectin levels have been reported to be much higher in both healthy full-term and preterm infants than in children and adults.


OBJECTIVE
To determine the time course of fecal calprotectin (f-calprotectin) excretion in preterm infants from birth until hospital discharge and to identify factors influencing f-calprotectin levels in the first weeks of life, including bacterial establishment in the gut.


METHODS
F-calprotectin was determined using an ELISA assay in 147 samples obtained prospectively from 47 preterm infants (gestational age, and birth-weight interquartiles 27-29 weeks, and 880-1320 g, respectively) at birth, and at 2-week intervals until hospital discharge.


RESULTS
Although median f-calprotectin excretion was 138 microg/g, a wide range of inter- and intra-individual variation in f-calprotectin values (from day 3 to day 78) was observed (86% and 67%, respectively). In multivariate regression analysis, f-calprotectin correlated negatively with ante and per natal antibiotic treatment (p = 0.001), and correlated positively with the volume of enteral feeding (mL/kg/d) (p = 0.009), the need to interrupt enteral feeding (p = 0.001), and prominent gastrointestinal colonization by Clostridium sp (p = 0.019) and Staphylococcus sp (p = 0.047).


CONCLUSIONS
During the first weeks of life, the high f-calprotectin values observed in preterm infants could be linked to the gut bacterial establishment.
Rougé
Carole
C
INRA UMR 1280, Physiologie des Adaptations Nutritionnelles, Université de Nantes, CRNH, Nantes, IMAD, CHU de Nantes, Nantes, France.
Butel
Marie-José
MJ
Piloquet
Hugues
H
Ferraris
Laurent
L
Legrand
Arnaud
A
Vodovar
Michel
M
Voyer
Marcel
M
de la Cochetière
Marie-France
MF
Darmaun
Dominique
D
Rozé
Jean-Christophe
JC
D001419:Bacteria / Q000145:classification / Q000302:isolation & purification; D015415:Biomarkers; D004797:Enzyme-Linked Immunosorbent Assay; D005243:Feces / Q000737:chemistry*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007422:Intestines / Q000382:microbiology; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis*; D011446:Prospective Studies; D013045:Species Specificity
D015415:Biomarkers; D039841:Leukocyte L1 Antigen Complex