Diagnostic value of fecal calprotein combined with serum C-reactive protein in severe Clostridium difficile infection

Objective To investigate the diagnostic value of fecal calprotein (FCP) combined with C-reactive protein (CRP) in severe Clostridium difficile infection (CDI) in order to provide a reference for improving the diagnostic strategy of severe CDI. Methods A case-control trial was conducted on 73 patients diagnosed with CDI and treated in our hospital from January 2020 to December 2022. They were divided into mild-moderate CDI group and severe CDI group. Demographic information and severity-related factors were selected as variables, univariate and multivariate logistic regression analyses were employed to analyze the risk factors for severe CDI, and receiver operating characteristic (ROC) curve was plotted to determine diagnostic values of CRP and FCP. Results Comparison of clinical data between the 2 groups showed that more patients having fever (P=0.028), higher serum CRP (P < 0.001) and FCP levels (P < 0.001) were observed in the severe CDI group. Multifactorial analysis indicated that both serum CRP level (P=0.005, OR=1.028, 95%CI: 1.008-1.049) and FCP level (P < 0.001, OR=1.023, 95%CI: 1.010-1.036) were independent risk factors for severe CDI. ROC curve analysis revealed that both serum CRP level (AUC: 0.753, 95%CI: 0.626-0.880) and FCP level (AUC: 0.794, 95%CI: 0.671-0.917) had a moderate predictive value for severe CDI, and their combination had a high predictive value for severe CDI (AUC: 0.923, 95%CI: 0.865-0.982). Conclusion FCP is an independent risk factor for severe CDI, and FCP combined with CRP shows more accurate diagnosis for severity of CDI, which provides a basis for choosing an appropriate antibiotic regimen.