title: Characteristics of ascitic fluid from patients with suspected spontaneous bacterial peritonitis in emergency units at a tertiary hospital.
abstract: OBJECTIVE
  Spontaneous bacterial peritonitis (SBP) is a complication of ascites, especially in cirrhosis. Ascitic fluid with 250 or more neutrophils/mm³ is an acceptable criterion for diagnosis, even when bacterial fluid cultures are negative. The aims here were to estimate SBP frequency among emergency room patients based on cellular criteria and evaluate the biochemical profile of these fluids.
  
  
  METHODS
  Retrospective study at a public tertiary hospital.
  
  
  METHODS
  Laboratory records of patients with ascites attended in emergency rooms between November 2001 and November 2006, from whom ascitic fluid samples were sent to the laboratory due to suspected SBP, were evaluated. The 691 samples included were divided into group A (presumed SBP: ≥ 250 neutrophils/mm³; n = 219; 31.7%) and group B (no presumed SBP: < 250 neutrophils/mm³; n = 472; 68.3%). Patients' sex and age; ascitic fluid characteristics (numbers of neutrophils, leukocytes and nucleated cells); bacteriological characteristics; and protein, lactate dehydrogenase, adenosine deaminase and glucose concentrations were evaluated.
  
  
  RESULTS
  Among group A cultured samples, 63 (33.8%) had positive bacterial cultures with growth of pathogens commonly associated with SBP. In total, the group A samples showed higher lactate dehydrogenase levels than seen in the group B samples. The latter presented predominance of lymphocytes and macrophages.
  
  
  CONCLUSIONS
  Among the ascitic fluid samples with clinically suspected SBP, 31.7% fulfilled the cellular diagnostic criteria. Positive bacterial isolation was found in 33.8% of the cultured samples from the presumed SBP group.
authors: Clinical Laboratory Division, Department of Pathology, LIM 03, Hospital das Clínicas-HC, Faculdade de Medicina da Universidade de São Paulo-FMUSP, São Paulo, Brazil.
authors: Thiago José Buer
authors: TJ
authors: Reginato
authors: Marcelo José Andrade
authors: MJ
authors: Oliveira
authors: Luiz César
authors: LC
authors: Moreira
authors: Antonieta
authors: A
authors: Lamanna
authors: Milena Marques Pagliarelli
authors: MM
authors: Acencio
authors: Leila
authors: L
authors: Antonangelo
mesh_terms: D000243:Adenosine Deaminase / Q000032:analysis; D000368:Aged; D001202:Ascitic Fluid / Q000737:chemistry* / Q000382:microbiology*; D001424:Bacterial Infections / Q000382:microbiology / Q000473:pathology; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology; D010538:Peritonitis / Q000382:microbiology / Q000473:pathology*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012737:Sex Factors; D018709:Statistics, Nonparametric
chemical_list: D000243:Adenosine Deaminase