Predictive value of fecal calprotectin and lactoferrin levels for negative outcomes in Clostridioides difficile infection
Purpose We investigated the role of fecal calprotectin (FC) and lactoferrin (FL) as predictive biomarkers in Clostridioides difficile infection (CDI). Methods We assembled a prospective cohort including all patients with a laboratory-confirmed CDI diagnosis between January and December 2017. FL and FC levels were measured at diagnosis by commercial ELISA and EIA kits. We investigated the diagnostic accuracy of FC and FL to predict CDI recurrence and severity (study outcomes) and explored optimal cut-off values in addition to those proposed by the manufacturers (200 µg/g and 7.2 µg/mL, respectively). Results We included 170 CDI cases (152 first episodes and 18 recurrences). The rates of recurrence (first episodes only) and severity (entire cohort) were 9.2% (14/152) and 46.5% (79/170). Both FL and FC levels were significantly higher in patients who developed study outcomes. Optimal cut-off values for FC and FL to predict CDI recurrence were 1052 µg/g and 6.0 µg/mL. The optimal cut-off value for FC yielded higher specificity (60.9%) and positive predictive value (PPV) (16.9%) than that proposed by the manufacturer. Regarding CDI severity, the optimal cut-off value for FC (439 µg/g) also provided higher specificity (43.9%) and PPV (54.1%) than that of the manufacturer, whereas the optimal cut-off value for FL (4.6 µg/mL) resulted in an improvement of PPV (57.5%). Conclusion By modifying the thresholds for assay positivity, the measurement of FC and FL at diagnosis is useful to predict recurrence and severity in CDI. Adding these biomarkers to current clinical scores may help to individualize CDI management..
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:43 |
|---|---|
| Enthalten in: |
European journal of clinical microbiology & infectious diseases - 43(2023), 2 vom: 11. Dez., Seite 313-324 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Ágreda Fernández, Mario [VerfasserIn] |
|---|
| Links: |
Volltext [lizenzpflichtig] |
|---|
| Themen: |
|---|
| Anmerkungen: |
© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
|---|
| doi: |
10.1007/s10096-023-04729-z |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
SPR054542979 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | SPR054542979 | ||
| 003 | DE-627 | ||
| 005 | 20240128070225.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240128s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s10096-023-04729-z |2 doi | |
| 035 | |a (DE-627)SPR054542979 | ||
| 035 | |a (SPR)s10096-023-04729-z-e | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Ágreda Fernández, Mario |e verfasserin |0 (orcid)0000-0001-7663-9554 |4 aut | |
| 245 | 1 | 0 | |a Predictive value of fecal calprotectin and lactoferrin levels for negative outcomes in Clostridioides difficile infection |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a Computermedien |b c |2 rdamedia | ||
| 338 | |a Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. | ||
| 520 | |a Purpose We investigated the role of fecal calprotectin (FC) and lactoferrin (FL) as predictive biomarkers in Clostridioides difficile infection (CDI). Methods We assembled a prospective cohort including all patients with a laboratory-confirmed CDI diagnosis between January and December 2017. FL and FC levels were measured at diagnosis by commercial ELISA and EIA kits. We investigated the diagnostic accuracy of FC and FL to predict CDI recurrence and severity (study outcomes) and explored optimal cut-off values in addition to those proposed by the manufacturers (200 µg/g and 7.2 µg/mL, respectively). Results We included 170 CDI cases (152 first episodes and 18 recurrences). The rates of recurrence (first episodes only) and severity (entire cohort) were 9.2% (14/152) and 46.5% (79/170). Both FL and FC levels were significantly higher in patients who developed study outcomes. Optimal cut-off values for FC and FL to predict CDI recurrence were 1052 µg/g and 6.0 µg/mL. The optimal cut-off value for FC yielded higher specificity (60.9%) and positive predictive value (PPV) (16.9%) than that proposed by the manufacturer. Regarding CDI severity, the optimal cut-off value for FC (439 µg/g) also provided higher specificity (43.9%) and PPV (54.1%) than that of the manufacturer, whereas the optimal cut-off value for FL (4.6 µg/mL) resulted in an improvement of PPV (57.5%). Conclusion By modifying the thresholds for assay positivity, the measurement of FC and FL at diagnosis is useful to predict recurrence and severity in CDI. Adding these biomarkers to current clinical scores may help to individualize CDI management. | ||
| 650 | 4 | |a Calprotectin |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Lactoferrin |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Prediction |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Biomarkers |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Origüen, Julia |0 (orcid)0000-0002-6507-0363 |4 aut | |
| 700 | 1 | |a Rodriguez-Goncer, Isabel |0 (orcid)0000-0003-2150-5748 |4 aut | |
| 700 | 1 | |a San Juan, Rafael |0 (orcid)0000-0003-3446-1991 |4 aut | |
| 700 | 1 | |a López-Medrano, Francisco |0 (orcid)0000-0001-5333-7529 |4 aut | |
| 700 | 1 | |a Parra, Patricia |0 (orcid)0000-0002-5852-5884 |4 aut | |
| 700 | 1 | |a Ruiz-Merlo, Tamara |0 (orcid)0000-0002-8261-6057 |4 aut | |
| 700 | 1 | |a Redondo, Natalia |0 (orcid)0000-0001-9356-8102 |4 aut | |
| 700 | 1 | |a Orellana, María Ángeles |0 (orcid)0000-0002-2696-8613 |4 aut | |
| 700 | 1 | |a Aguado, José María |0 (orcid)0000-0002-9520-8255 |4 aut | |
| 700 | 1 | |a Fernández-Ruiz, Mario |0 (orcid)0000-0002-0315-8001 |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t European journal of clinical microbiology & infectious diseases |d Berlin : Springer, 1982 |g 43(2023), 2 vom: 11. Dez., Seite 313-324 |w (DE-627)SPR008661995 |w (DE-600)1459049-9 |x 1435-4373 |7 nnns |
| 773 | 1 | 8 | |g volume:43 |g year:2023 |g number:2 |g day:11 |g month:12 |g pages:313-324 |
| 856 | 4 | 0 | |u https://dx.doi.org/10.1007/s10096-023-04729-z |z lizenzpflichtig |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_SPRINGER | ||
| 951 | |a AR | ||
| 952 | |d 43 |j 2023 |e 2 |b 11 |c 12 |h 313-324 | ||