Utility of Fecal Biomarkers to Predict Invasive Nature of Acute Infectious Diarrhea in Indian Children

Area of Science:

• Pediatric Gastroenterology
• Clinical Diagnostics
• Infectious Diseases

Background:

• Acute diarrhea is a common pediatric illness with diverse etiologies.
• Differentiating invasive from non-invasive diarrhea is crucial for appropriate management.
• Biomarkers like fecal calprotectin (FC) and fecal lactoferrin (FL) are being investigated for diagnostic utility.

Purpose of the Study:

• To evaluate the diagnostic role of fecal calprotectin (FC) and fecal lactoferrin (FL) in identifying invasive diarrhea among children.
• To compare FC and FL levels in children with invasive versus non-invasive acute diarrhea.

Main Methods:

• Stool samples were collected from 75 children (≤12 years) presenting with acute diarrhea.
• Analyses included microscopy, culture, PCR, rapid viral tests, and quantitative ELISA for FC and FL.
• Children were categorized into invasive and non-invasive diarrhea groups.

Main Results:

• Mean FC and FL levels were significantly higher in children with invasive diarrhea compared to non-invasive diarrhea (P < 0.001 and P = 0.004, respectively).
• Proposed cut-off values for FC (>243 μg/g) and FL (>6.02 μg/g) demonstrated diagnostic potential with good sensitivity and specificity.
• Area Under the Curve (AUC) values suggest moderate to good diagnostic accuracy for both biomarkers.

Conclusions:

• Fecal calprotectin (FC) and fecal lactoferrin (FL) can serve as valuable non-invasive tools to aid in the diagnosis of acute invasive diarrhea in children.
• These biomarkers may help clinicians differentiate between infectious causes of diarrhea, guiding treatment strategies.