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Fecal calprotectin excretion in preterm infants during the neonatal period
Carole Rougé1, Marie-José Butel, Hugues Piloquet
1INRA UMR 1280, Physiologie des Adaptations Nutritionnelles, Université de Nantes, CRNH, Nantes, IMAD, CHU de Nantes, Nantes, France.
Insights
High fecal calprotectin in preterm infants is linked to gut bacterial establishment. This study tracked fecal calprotectin levels from birth to discharge, identifying key influencing factors in early life.
Area of Science:
- Neonatal Medicine
- Gastroenterology
- Microbiology
Background:
- Fecal calprotectin is a non-invasive marker for intestinal inflammation.
- Infant fecal calprotectin levels are significantly higher than in adults.
- Preterm infants exhibit particularly elevated fecal calprotectin.
Purpose of the Study:
- To track fecal calprotectin (f-calprotectin) excretion in preterm infants until hospital discharge.
- To identify factors influencing f-calprotectin levels in early life.
- To explore the role of gut bacterial establishment in f-calprotectin levels.
Main Methods:
- Prospective collection of 147 fecal samples from 47 preterm infants (27-29 weeks gestation).
- ELISA assay used to quantify f-calprotectin levels.
- Sampling occurred from birth at 2-week intervals until hospital discharge.
Main Results:
- Median f-calprotectin was 138 microg/g, with wide inter- and intra-individual variation.
- Antibiotic treatment correlated negatively with f-calprotectin.
- Enteral feeding volume, interruptions, and colonization by Clostridium and Staphylococcus species correlated positively with f-calprotectin.
Conclusions:
- Elevated f-calprotectin in preterm infants during early life is associated with gut bacterial establishment.
- Gut microbiome composition and feeding practices influence f-calprotectin levels in neonates.
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.
Methodology:
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.
Principal Findings:
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).
Conclusion:
During the first weeks of life, the high f-calprotectin values observed in preterm infants could be linked to the gut bacterial establishment.
