title: [Usefulness of reagent strips for the diagnosis of spontaneous bacterial peritonitis].
abstract: OBJECTIVE
  Spontaneous bacterial peritonitis (SBP) is one of the potentially life-threatening complications for patients with liver cirrhosis, and it has a mortality rate of over 20%. Early diagnosis of SBP and immediate use of an adequate antibiotic therapy are very important for achieving a better prognosis. The aim of our study was to assess the usefulness of reagent strips for making the rapid diagnosis of SBP.
  
  
  METHODS
  A diagnostic paracentesis procedure was performed upon hospital admission in 257 cirrhotic patients (187 males, 70 females; mean age: 54 years) with ascites. Each fresh sample of ascitic fluid was tested using a reagent strip, and the result was scored as 0, 1+, 2+ or 3+. The leukocyte count, polymorphonuclear cell count, blood bottle culture, and chemistry of ascites were also done.
  
  
  RESULTS
  We diagnosed 79 cases of SBP and 2 cases of secondary bacterial peritonitis by means of the polymorphonuclear cell count and the classical criteria. When a reagent strip result of 3+ was considered positive, the test's sensitivity was 86% (70 of 81), the specificity was 100% (176 of 176), and the positive predictive value was 94%. Furthermore, when a reagent strip result of 2+ or more was considered positive, the test sensitivity was 100% (81 of 81), the specificity was 99% (174 of 176), and negative predictive value was 99%.
  
  
  CONCLUSIONS
  The use of reagent strips is a very sensitive and specific tool for the rapid diagnosis of SBP in cirrhotic patients. 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.
authors.affiliation: Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center.
authors.forename: Dae-Kyoum
authors.initials: DK
authors.lastname: Kim
authors.forename: Dong Jin
authors.initials: DJ
authors.lastname: Suh
authors.forename: Gi Deog
authors.initials: GD
authors.lastname: Kim
authors.forename: Won Beom
authors.initials: WB
authors.lastname: Choi
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Kim
authors.forename: Young-Suk
authors.initials: YS
authors.lastname: Lim
authors.forename: Han Chu
authors.initials: HC
authors.lastname: Lee
authors.forename: Yong-Hwa
authors.initials: YH
authors.lastname: Chung
authors.forename: Yung Sang
authors.initials: YS
authors.lastname: Lee
mesh_terms: D000368:Aged; D001202:Ascitic Fluid / Q000737:chemistry / Q000166:cytology; D001424:Bacterial Infections / Q000175:diagnosis* / Q000382:microbiology; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000175:diagnosis* / Q000209:etiology / Q000382:microbiology; D011237:Predictive Value of Tests; D011934:Reagent Strips; D012680:Sensitivity and Specificity
chemical_list: D011934:Reagent Strips