Association between molecularly detected Entamoeba species and fecal calprotectin level among a cohort of diarrheic patients

Background: Differentiation between Entamoeba species can be molecularly achieved, especially since E. histolytica has been linked to high morbidity and mortality. Fecal calprotectin (FC) as an inflammatory marker may be linked to amoebiasis. Objective: The present study aimed at investigating the association of calprotectin in amoebiasis. Patients and Methods: Stool samples were collected from 294 patients attending Internal Medicine Outpatient Clinic in Kafrelsheikh University, Egypt; suffering from diarrhea with or without other gastrointestinal manifestations. Samples were subjected to coproscopy, quantification of fecal calprotectin level and multiplex nested PCR for Entamoeba species differentiation. Results: Detection rate of E. histolytica complex was 16.6% by microscopic examination and only 14.6% proved to be positive by nested multiplex polymerase chain reaction (PCR): E. histolytica (3.7%), E. dispar (6.4%) and E. moshkovskii (4.5%). Statistical analysis including several variables showed no significance except for the presence of blood and mucus. Fecal calprotectin was positive in 10.5% of the study population and 81.8% in association with E. histolytica indicating intestinal inflammation. Frequency of males infected with E. histolytica and E. dispar was higher than in females who showed a higher infection rates with E. moshkovskii. Conclusion: The association between E. histolytica and positivity of FC level is a crucial indicator for disease severity and efficacy of therapeutic regimen.