AIM: The aim of the study is to evaluate faecal calprotectin (f-CP) in children ≤3 years of age with acute gastroenteritis (AG) as an early predictor of bacterial inflammation. METHODS: We prospectively analysed f-CP levels and diagnostic workup in 107 consecutive children (66 AG, 41 controls). RESULTS: Children with bacterial AG (BAG) was found to have higher diarrheal frequency (p < 0.01), fever (p < 0.01), erythrocyte sedimentation rate (p < 0.001), white blood count (p < 0.01) and C-reactive protein (CRP) (p < 0.001) compared with viral AG (VAG). Vomiting was frequent in VAG (p < 0.001). f-CP negatively correlated with age in controls (r = -0.5998). BAG demonstrated significantly higher f-CP levels [median, 219 μg/g, interquartile range (IQR): 119-350.2] compared with VAG (49.3 μg/g, IQR: 8.8-131.1) as well as controls (26.5 μg/g, IQR: 14.9-55.1) (p < 0.001). VAG and control f-CP levels were similar. f-CP was the best-rated marker of BAG with a diagnostic accuracy of 92%. Receiver-operator characteristic analysis revealed an area under curve of 0.95 for identifying BAG; sensitivity and specificity of f-CP were 93% and 88%, respectively, at an adjusted cut-off point of 103.9 μg/g faeces. Combined f-CP and CRP yield improved diagnostic accuracy of 94% for BAG. CONCLUSION: f-CP facilitates early discrimination between bacterial and viral causes of AG in young children. Combining f-CP with CRP increases the diagnostic power of diagnosing BAG.

Charles University Prague Faculty of Medicine in Pilsen Faculty Hospital Department of Pediatrics Pilsen Czech Republic

Department of Paediatrics Faculty Hospital Faculty of Medicine in Pilsen Charles University Prague Pilsen Czech Republic

Department of Pediatrics Charles University Hospital Plzen Alej Svobody 80 304 60 Plzen Czech Republic

Department of Pediatrics Faculty Hospital Charles University Prague Faculty of Medicine in Pilsen Pilsen The Czech Republic

Institute of Science and Technology Austria Klosterneuburg Austria

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