Fecal calprotectin outperforms procalcitonin at flagging silent gut infections in cirrhotic patients.
Mandip Singh Bhatia, Devarakonda Uday Teja, Nipun Verma, et al.
In a prospective study of 137 cirrhosis patients with ascites, researchers compared several biomarkers for detecting spontaneous bacterial peritonitis against the standard ascitic fluid neutrophil count. Fecal calprotectin emerged as the strongest single marker, correctly distinguishing infected from non-infected patients far more often than serum procalcitonin, and combining the two improved accuracy further. The authors suggest these relatively simple, non-invasive tests could help clinicians flag SBP earlier, particularly where prompt paracentesis is not always feasible.
- The question: Which biomarker catches spontaneous bacterial peritonitis earliest?
- The study: Researchers studied 137 cirrhosis patients with ascites, testing biomarkers against the standard fluid neutrophil count.
- The finding: Fecal calprotectin emerged as the strongest single marker, clearly outperforming serum procalcitonin at spotting the infection.
- The nuance: Combining both biomarkers improved accuracy further, and these simple, non-invasive tests could flag infection before paracentesis is possible.
Takeaway: fecal calprotectin is a strong, non-invasive flag for SBP, and it gets even better paired with procalcitonin.
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