Tow Minutes to Exclude or Diagnose SBP Using Leucocyte Esterase Reagent Strip
Journal Title: Journal of Medical Science And clinical Research - Year 2017, Vol 5, Issue 6
Abstract
Background: spontaneous bacterial peritonitis is the most frequent complication in HCV related liver cirrhosis causing significant mortality especially if there is a delay in diagnosis; the gold standard to diagnose spontaneous bacterial peritonitis (SBP) is a polymorphonuclear neutrophil count ≥ 250 cells/mm3 in ascitic fluid. This test is laborious and expensive. Urine reagent strips measuring leukocyte esterase activity have been proposed as a rapid and inexpensive alternative. Aims: Is to emphasize the diagnostic accuracy of the Combi Stik leucocyte esterase reagent strips for rapid diagnosing SBP and to calculate the sensitivity, specificity, positive, and negative predictive values. Methods and Material: The present study included 70 ascitic patients on top of Hepatitis C virus over a period of 5 months from June 2016 to October 2016. Patients with hepatitis B virus, cirrhosis due to any other cause or receiving antibiotics two weeks before the study were excluded. The included patient were then divided into SBP group including 50 patients and non SBP group including 20 patients according to the gold standard to diagnose SBP which is PMNLs ≥ 250 cells/ mm3 . The Combi stik reagent strips dipped in 5ml of each sample of ascitic fluid and read visually to compare the color. Results: In comparable with the gold standard for diagnosing SBP which is PMNL≥ 250 cells/mm3 the using of Combi Stik leukocyte esterase reagent strips taking grade 3 as cutoff showed sensitivity, specificity, positive predictive value, negative predictive value and accuracy (100%) with a very high statistically significance (P=<0.001) with a highly positive correlation. A negative result of leukocyte esterase test excludes SBP with a high degree of certainty. Conclusions: The diagnostic accuracy of leukocyte esterase reagent strips, comparable with the gold standard test, was excellent for excluding and diagnosing SBP in an emergency, it can be used as an easy and rapid bedside test for diagnosing SBP sitting.
Authors and Affiliations
Dr Ahmed A. Heikal
Keywords
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