Usefulness of Reagent Strips for the Diagnosis of Spontaneous Bacterial Peritonitis.
- Author:
Dae Kyoum KIM
1
;
Dong Jin SUH
;
Gi Deog KIM
;
Won Beom CHOI
;
Sung Hoon KIM
;
Young Suk LIM
;
Han Chu LEE
;
Yong Hwa CHUNG
;
Yung Sang LEE
Author Information
1. Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Korea. djsuh@amc.seoul.kr
- Publication Type:Original Article ; English Abstract
- Keywords:
Peritonitis;
Reagent strips;
Ascites;
Liver cirrhosis
- MeSH:
Aged;
Ascitic Fluid/chemistry/cytology;
Bacterial Infections/*diagnosis/microbiology;
English Abstract;
Female;
Humans;
Liver Cirrhosis/complications;
Male;
Middle Aged;
Peritonitis/*diagnosis/etiology/microbiology;
Predictive Value of Tests;
*Reagent Strips;
Sensitivity and Specificity
- From:The Korean Journal of Hepatology
2005;11(3):243-249
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: 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.
