Fecal Calprotectin Level in Patients With Nosocomial Diarrhea
Fecal Calprotectin Level in Patients With Nosocomial Diarrhea
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.
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.
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