Department of Clinical Chemistry, New Cross Hospital, Wolverhampton, UK.
Microbiology, New Cross Hospital, Wolverhampton, UK.
J Med Microbiol. 2014 Apr;63(Pt 4):590-593. doi: 10.1099/jmm.0.067389-0. Epub 2014 Jan 25.
Markers of intestinal inflammation have been proposed for inclusion in Clostridium difficile diagnostic algorithms. Faecal calprotectin (f-Cp), a sensitive marker of intestinal inflammation, was evaluated for utility in C. difficile diagnosis in the hospital setting. One hundred and twenty C. difficile positive and 99 C. difficile negative faecal samples of hospital-acquired diarrhoea were analysed for f-Cp using a quantitative ELISA. C. difficile positivity was confirmed using ELISAs for either toxins (n = 45) or glutamate dehydrogenase (GDH) with toxin gene confirmation (n = 75). Non-parametric ANOVA (Kruskal-Wallis) was used for data analysis. C. difficile positive samples had higher (P<0.05) median (interquartile range) f-Cp levels; 336 µg g(-1) (208-536) for toxin and 249 µg g(-1) (155-498) for GDH and toxin gene positive compared with 106 µg g(-1) (46-176) for C. difficile and culture-negative faecal samples. Five C. difficile positive samples were f-Cp negative (<50 µg g(-1)). A f-Cp concentration >50 µg g(-1) was 96 % sensitive and 26 % specific for C. difficile, with area under the ROC curve of 0.82. There is no role for f-CP alone in predicting C. difficile infection in hospital-acquired diarrhoea due to its low specificity.
已提出将肠道炎症标志物纳入艰难梭菌诊断算法中。粪便钙卫蛋白（f-Cp）是一种敏感的肠道炎症标志物，用于评估其在医院环境中对艰难梭菌诊断的效用。对 120 份艰难梭菌阳性和 99 份艰难梭菌阴性的医院获得性腹泻粪便样本进行了 f-Cp 的定量 ELISA 分析。使用毒素 ELISA（n=45）或谷氨酸脱氢酶（GDH）ELISA （n=75）联合毒素基因确认，对艰难梭菌阳性进行了确认。使用非参数 ANOVA（Kruskal-Wallis）进行数据分析。艰难梭菌阳性样本的 f-Cp 水平更高（P<0.05）；毒素阳性样本的中位数（四分位距）为 336μg g(-1)（208-536），GDH 和毒素基因阳性样本为 249μg g(-1)（155-498），而艰难梭菌和培养阴性粪便样本分别为 106μg g(-1)（46-176）。5 份艰难梭菌阳性样本 f-Cp 为阴性（<50μg g(-1)）。f-Cp 浓度>50μg g(-1)时，对艰难梭菌的敏感性为 96%，特异性为 26%，ROC 曲线下面积为 0.82。由于其特异性低，f-CP 单独不能用于预测医院获得性腹泻中的艰难梭菌感染。
