Fecal calprotectin in management of Clostridium difficile infection: a longitudinal study

Background: Clostridium difficile infection (CDI) is characterized by a relevant intestinal neutrophil infiltrate. So far, role of fecal calprotectin in CDI, has been investigated only in few studies, mainly focused on diagnosis of the disease. Aim: By a longitudinal design, we assess fecal calprotectin concentrations (FCCs) in subjects with CDI, evaluating the correlation between fecal marker and response to therapy. Methods: Clinical (diarrhea scoring) and laboratory (FCCs and leucocytes count) evaluation was performed in 56 subjects with CDI at time of diagnosis (T0) and after a week from starting of therapy (T1). Clinical response to therapy at T1was related with both T0and T1FCC values. FCCs were also related to all-cause 30-day mortality, recurrence and death, both of them within 90 days. Results: FCCs at T1were significantly increased in subjects with persistence of diarrhea in respect to the other ones (285.5 ± 270 µg/g vs 150.7 ± 147 µg/g, respectively; p