title: Multistix 10 SG Leukocyte Esterage Dipstick Testing in Rapid Bedside Diagnosis of Spontaneous Bacterial Peritonitis: A Prospective Study.
abstract: OBJECTIVE
  Spontaneous bacterial peritonitis (SBP) requires rapid diagnosis and the initiation of antibiotics. Diagnosis of SBP is usually based on cytobacteriological examination of ascitic fluid. These tests require good laboratory facilities and reporting time of few hours to 1-2 day. However, the 24 h laboratory facilities not widely available in country like India. We evaluated the diagnostic utility of reagent strip (Multistix 10 SG(®)) for rapid diagnosis of SBP.
  
  
  METHODS
  The study was prospectively carried out on patients of cirrhosis with ascites. Bedside leukocyte esterase reagent strip testing was performed on ascitic fluid. Cell count as determined by colorimetric scale of reagent strip was compared with counting chamber method. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated.
  
  
  RESULTS
  Out of 100 patients with cirrhotic ascites, [72 males: 28 female; mean age 44.34 (SD 13.03) years] 18 patients were diagnosed to have SBP by counting chamber method as compared to 14 patients detected to have SBP by reagent strip test ≥++ positive. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of reagent strip ≥++ positive were 77.77%, 95.12%, 77.77%, 95.12% and 92% respectively compared to counting chamber method.
  
  
  CONCLUSIONS
  Reagent strip to diagnose SBP is very specific but less sensitive as compared to counting chamber method. This can be performed rapidly, easily and efficiently even in remote area of developing countries. This bedside test could be a useful tool for the diagnosis of SBP in country like India.
authors.affiliation: Institute of Gastro Sciences, Apollo Gleneagles Hospital, 58 CC Road, Kolkata, India.
authors.forename: Ashish K
authors.initials: AK
authors.lastname: Jha
authors.affiliation: Department of Medicine, Rabindra Nath Tagore Medical College, Udaipur, India.
authors.forename: Dal C
authors.initials: DC
authors.lastname: Kumawat
authors.affiliation: Department of Medicine, Rabindra Nath Tagore Medical College, Udaipur, India.
authors.forename: Yasvant K
authors.initials: YK
authors.lastname: Bolya
authors.affiliation: Institute of Gastro Sciences, Apollo Gleneagles Hospital, 58 CC Road, Kolkata, India.
authors.forename: Mahesh K
authors.initials: MK
authors.lastname: Goenka
keywords: AF, ascitic fluid; LERS, leukocyte esterase reagent strips; Multistix 10 SG® reagent strips; NPV, negative predictive values; PMN, polymorphonuclear leukocyte; PPV, positive predictive values; SAAG, serum-ascites albumin gradient; SBP, spontaneous bacterial peritonitis; leukocyte esterase dipstick test; spontaneous bacterial peritonitis