PURPOSE:
The aim of this study was to evaluate the
clinical significance of inflammatory
biomarkers in acute infectious
diarrhea among
children.
METHODS:
Clinical
parameters including
fever, bacterial and viral
etiology based on stool
culture and
multiplex polymerase chain reaction, and nine
biomarkers including
C-reactive protein (CRP),
erythrocyte sedimentation rate (ESR) and
leukocytes in
blood and
calprotectin,
lactoferrin,
myeloperoxidase, polymorphonuclear
elastase,
leukocytes, and
occult blood in
feces were evaluated in
children who were hospitalized due to acute
diarrhea without underlying
disease.
RESULTS:
A total of 62
patients were included. Among these
patients, 33 had
fever, 18 showed
bacterial infections, and 40
patients were infected with 43
viruses. Of all the
biomarkers, CRP was significantly correlated with
fever (p<0.001). CRP, ESR,
calprotectin,
lactoferrin,
myeloperoxidase, fecal
leukocytes, and
occult blood were significantly associated with
infection with bacterial pathogens (p<0.001, p=0.04, p=0.03, p=0.003, p=0.02, p=0.03, p=0.002, respectively). The combination of CRP and fecal
lactoferrin at their best cut-off values (13.7 mg/L and 22.8 µg/mL, respectively) yielded a
sensitivity of 72.2%, and a
specificity of 95.5% for bacterial
etiology compared with their individual use.
CONCLUSION:
Blood CRP is a useful diagnostic marker for both
fever and bacterial
etiology in acute pediatric
diarrhea. The combination of CRP and fecal
lactoferrin yields better diagnostic capability for bacterial
etiology than their use alone for acute
diarrhea in
children without underlying
gastrointestinal disease.