Fecal calprotectin levels and presence of helicobacter pylori co-infection in individuals with enterobiasis

Enterobiasis, caused by the nematode Enterobius vermicularis, is the most common parasitic infection in Bulgaria and worldwide. It causes damage to the colonic mucosa and impaired local immunity, which can lead to a predisposition to other intestinal infections. Faecal calprotectin is a non-invasive biomarker that can be used to distinguish between inflammatory and non-inflammatory bowel diseases. Scientific data show varying degrees of increase in some bacterial and viral infections, but data on parasitic infections are extremely scarce. Helicobacter pylori is a Gram-negative bacterium that colonises the intestinal mucosa. It is one of the most common bacteria, with infection mostly occurring during childhood and remaining undiagnosed for a long time. This can lead to severe damage to the gastric mucosa. This study aimed to determine the levels of fecal calprotectin in patients with enterobiasis, and to assess its significance as a marker for intestinal inflammation caused by E. vermicularis, as well as the presence of concomitant infection with H. pylori. The study included 124 people with confirmed Enterobius vermicularis, aged between 1 and 49 years. Calprotectin levels were determined using a commercial kit (LIAISON®, DiaSorin). The Helicobacter pylori test was performed using an automated immunoassay to qualitatively determine the presence of H. pylori antigen in fecal samples (LIAISON®, DiaSorin). Fecal samples from 20 healthy individuals were also tested in parallel to serve as a control group. H. pylori was detected in fecal samples from 14.5% (n = 18) of Enterobius-infected individuals (compared to none of the healthy individuals), suggesting an increased susceptibility to co-infection with this bacteria among susceptible individuals. Significant elevated fecal calprotectin values were found in three individuals with enterobiasis and borderline values in 16 individuals, indicating the presence of moderate intestinal inflammation in some patients with enterobiasis.