Rapid diagnosis of spontaneous bacterial peritonitis by use of reagent strips.
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.
Castellote
José
J
Servicio de Aparato Digestivo y Servicio de Hematología, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain. jcastellote@csub.scs.es
López
Carmen
C
Gornals
Joan
J
Tremosa
Gemma
G
Fariña
Eva Rodríguez
ER
Baliellas
Carmen
C
Domingo
Alicia
A
Xiol
Xavier
X
D000368:Aged; D001201:Ascites / Q000150:complications / Q000201:enzymology / Q000382:microbiology / Q000652:urine; D001424:Bacterial Infections / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D002265:Carboxylic Ester Hydrolases / Q000652:urine; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology; D019152:Paracentesis; D010538:Peritonitis / Q000382:microbiology*; D011237:Predictive Value of Tests; D011934:Reagent Strips; D012680:Sensitivity and Specificity; D013997:Time Factors
D011934:Reagent Strips; C021443:leukocyte esterase; D002265:Carboxylic Ester Hydrolases