Premium
Rapid diagnosis of spontaneous bacterial peritonitis by use of Reagent Strips
Author(s) -
Castellote José,
López Carmen,
Gornals Joan,
Tremosa Gemma,
Fariña Eva Rodríguez,
Baliellas Carmen,
Domingo Alicia,
Xiol Xavier
Publication year - 2003
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1053/jhep.2003.50120
Subject(s) - spontaneous bacterial peritonitis , leukocyte esterase , ascites , medicine , paracentesis , ascitic fluid , hepatology , reagent , predictive value , gastroenterology , peritonitis , urine , urinalysis , chemistry
We studied the use of reagent strips for diagnosis of spontaneous bacterial peritonitis (SBP) in cirrhotic patients with ascites. A reagent strip for leukocyte esterase designed for the testing of urine with a colorimetric 5‐grade scale (0 to 4) was used to evaluate ascitic fluid in 228 nonselected paracentesis performed in 128 cirrhotic patients. We diagnosed 52 SBP and 5 secondary bacterial peritonitis by means of polymorphonuclear cell count and classical criteria. When we considered positive a reagent strip result of 3 or 4, sensitivity was 89% (51 of 57), specificity was 99% (170 of 171), and positive predictive value was 98%. When we considered positive a reagent strip result of 2 or more, sensitivity was 96% (55 of 57), specificity was 89% (152 of 171), and negative predictive value was 99%. In conclusion, the use of reagent strips is a rapid, easy to use, and inexpensive tool for diagnosis of ascitic fluid infection. A positive result should be an indication for empirical antibiotic therapy, and a negative result may be useful as a screening test to exclude SBP. (Hepatology 2003;37:893‐896.)