Table 3.

Sensitivity and Specificity of Lactoferrin, Calprotectin, or Myeloperoxidase in Stool to Identify Shigella and Other Bacterial Causes of Diarrhea in Systematically Reviewed Studies (n = 19 Studies)

Setting and Study	Study Location	Biomarker Cutoff	No. With Diarrhea	No. With Shigella	Sensitivity for Shigella, %	Specificity for Shigella, %	No. With Combined Bacterial Outcome	Sensitivity for Combined Bacterial Outcome, %	Specificity for Combined Bacterial Outcome, %
Lactoferrin (n = 13)
Aly 2005 [75]	Egypt	1:50	40	20	80	…	…	…	25
Ashraf 2007 [73]	Bangladesh	1:50	594	18	61	…	73	52	68
Bouckenooghe 2000 [65]	USA	1:50	227	…	…	…	56	27	79
Choi 1996 [20]	USA	1:50	46	3	…	…	28	93	83
Huicho 1997 [21]	Peru	1:50	125	6	…	…	29	97	15
McIver 2001 [64]	Australia	NS	412	…	…	…	30	95	40
Mercado 2011 [18]	Peru	NS	935	…	…	…	200	95	…
Miller 1994 [69]	USA	1:50	55	9	100	…	43	60	8
Park 2019 [31]	South Korea	22.8 µg/mL	62	…	…	…	19a	78	71
Scerpella 1994 [70]	USA	1:50	92	32	94	…	36	94	47
Shastri 2008 [26]	Germany	1:400	200	2	…	…	107	78	54
Tribble 2008 [72]	USA	1:50	182	…	…	…	177	93	56
Venkataraman 2003 [53]	India	1:50	262	27	…	…	42	83	28
Calprotectin (n = 8)
Ahn 2020 [76]	South Korea	388 mg/kg	400	7a	…	…	197a	71	61
Berger 2010 [77]	Unknown	>50 µg/mL	168	…	…	…	108	80	89
Czub 2014 [78]	Poland	15 µg/mL	50	…	…	…	21	100	45
Duman 2015 [23]	Turkey	710 mg/L	84	7	78	…	9	89	76
Kim 2022 [79]	South Korea	815 µg/g	80	…	…	…	16a	75b	40
Park 2019 [31]	South Korea	74.0 µg/g	62	…	…	…	19a	94	39
Shastri 2008 [26]	Germany	14.9 mg/L	200	2	…	…	107	83	87
Sýkora 2010 [27]	Czech Republic	103.9 µg/g	66	…	…	…	31	93	88
Myeloperoxidase (n = 1)
Park 2019 [31]	South Korea	4.14 ng/mL	62	…	…	…	19a	78	57

Abbreviations: NS, not specified; USA, United States.

^aIncludes detection by polymerase chain reaction; otherwise, detection by culture (see Supplementary Table 1 for details).

^bEstimated from manuscript figure.