title: Diagnostic Value of Leukocyte Esterase Test Strip Reagents for Rapid Clinical Diagnosis of Spontaneous Bacterial Peritonitis in Patients Admitted to Hospital Emergency Departments in Iran.
abstract: BACKGROUND
  Spontaneous bacterial peritonitis (SBP) is a common and important clinical problem and is life-threatening in decompensated liver disease. Ascites fluid test by leukocyte esterase test strip has been recently proposed as an effective and rapid method to diagnose SBP in patients with cirrhosis.
  
  
  OBJECTIVE
  This study aimed to evaluate sensitivity and specificity of leukocyte esterase test strip in the diagnosis of SBP.
  
  
  METHODS
  The population of this research was all patients with cirrhosis and ascites admitted to the emergency room at Imam Reza (AS) hospital, Mashhad. A written consent was taken for inclusion in the study. 50 mL ascites sample was taken from all patients for use in a urine test strip (LER) (Urine Test Strips Convergys®Urine Matrix 11). The patient's ascites samples were evaluated for cell counting. Positive dipstick test for LER in this study considered as grade 3 +. The values of WBC > 500 cell/mm(3) or PMN > 250 cell/mm(3) considered as positive result of the gold standard method for the diagnosis of SBP.
  
  
  RESULTS
  In this study, 100 patients with ascites due to cirrhosis, with an average age of 38.9 ± 6.54 years were evaluated. Twenty cases had positive results, of whom 17 cases were also detected based on the standard diagnostic criteria and other three cases were healthy individuals. Thus, sensitivity, specificity, positive and negative predictive values, and accuracy of the method were 95%, 96.3%, 85%, 97.5% and 95%, respectively.
  
  
  CONCLUSIONS
  The use of leukocyte esterase urine dipstick test can be a quick and easy method in early diagnosis of SBP to start the treatment until preparation of SBP-cell count results.
authors.affiliation: Department of Emergency Medicine, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran.
authors.forename: Amir Masoud
authors.initials: AM
authors.lastname: Hashemian
authors.affiliation: Department of Emergency Medicine, Alborz University of Medical Sciences, Karaj, IR Iran.
authors.forename: Koorosh
authors.initials: K
authors.lastname: Ahmadi
authors.affiliation: Department of Emergency Medicine, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Zamani Moghaddam
authors.affiliation: Department of Emergency Medicine, Hasheminejad Hospital, Faculty of Medicine, Mashhad University of Medical Sciences , Mashhad, IR Iran.
authors.forename: Hosein
authors.initials: H
authors.lastname: Zakeri
authors.affiliation: Emergency Medicine Specialist, Help Hospital of Sabzevar, Sabzevar, IR Iran.
authors.forename: Seyed Akbar
authors.initials: SA
authors.lastname: Davoodi Navakh
authors.affiliation: Department of Emergency Medicine, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran.
authors.forename: Mohammad Davood
authors.initials: MD
authors.lastname: Sharifi
authors.affiliation: Department of Internal Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran.
authors.forename: Abdollah
authors.initials: A
authors.lastname: Bahrami
keywords: Leukocyte Esterase Reagent Strip; Liver Cirrhosis; Spontaneous Bacterial Peritonitis