Fecal Calprotectin Level in Patients With Nosocomial Diarrhea

Study Overview
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Brief Summary
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Nosocomial diarrhea is a common problem.There are multiple ethiologies of nosocomial diarrhea in which can be divided into inflammatory and non inflammatory diarrhea. Fecal calprotectin is a good marker to identify inflammatory diarrhea in outpatient setting; for example, differentiating inflammatory bowel disease and irritable bowel syndrome. Its performance in inpatient setting has not been well established. This study aim to determine the efficacy of fecal calprotectin in distinguishing inflammatory nosocomial diarrhea from non-inflammatory nosocomial diarrhea.

Detailed Description
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This is a prospective, cross-sectional, and observational study. The patients with nosocomial diarrhea whose stool samples are sent for stool examination and Clostridium difficile toxin by their treating physicians will be recruited. Their leftover stool samples will be kept at - 80 c and will be measured for calprotectin level at the end of study. The patients will be treated by their treating physicians. They will be classified into 2 groups - inflammatory and non-inflammatory diarrhea. The inflammatory diarrhea will be defined if 1) positive for C. difficile toxin or 2) stool WBC more than 5/HPF or 3) inflammatory mucosa or ulceration noted on colonoscopy. The noninflammatory diarrhea will be defined if 1)negative for C. difficile toxin and 2) no WBC on stool examination and 3) dramatic response to diet adjustment or 4) no mucosal inflammation or ulceration if colonoscopy is performed The patients who do not respond to diet modification, but do not undergo colonoscopy will be excluded because the definite diagnosis cannot be made.

Official Title
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Fecal Calprotectin Level in Differentiating Between Inflammatory and Non-inflammatory Diarrhea in Patients With Nosocomial Diarrhea

Conditions
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Diarrhea, Calprotectin

Intervention / Treatment
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* Diagnostic Test: Fecal calprotectin


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age more than 18 hear Diarrhea more than 3 time per day after admitted in hospital more than 72 hours Exclusion Criteria: intraabdominal pressure more than 12 mmHg patient on chemotherapy with neutropenia ,ANC less than 1,000/mm3 patients whose definite diagnosis cannot be obtained

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Nosocomial diarrhea<br>Patients who are hospitalized and develop diarrhea after 72 hours of hospitalization. | Diagnostic Test: Fecal calprotectin<br>* Fecal calprotectin is a protein found in human neutrophils, and it is released during active periods of inflammation of intestine. The sensitivity and specificity has been reported at 93% and 96%, respectively in differentiating inflammatory bowel disease from irritable bowel syndrome in outpatient setting.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Fecal calprotectin levels | Compare fecal calprotectin levels in patients with inflammatory nosocomial diarrhea and non-inflammatory nosocomial diarrhea | 1 day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prognosis of hospitalized patients with nosocomial diarrhea. | Correlation of fecal calprotectin levels and prognosis of hospitalized patients with nosocomial diarrhea. | 30 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Nosocomial diarrhea, Fecal calprotectin