Bedside diagnosis of spontaneous bacterial peritonitis using reagent strips.

OBJECTIVE

To determine the efficacy of reagent strip for bedside diagnosis of spontaneous bacterial peritonitis (SBP).

DESIGN

Cross-sectional analytical study.

PLACE AND DURATION OF STUDY

Shaikh Zayed Postgraduate Medical Institute from November 2003 to August 2004.

PATIENTS AND METHODS

Patients with cirrhosis and ascites underwent diagnostic paracentesis. Fluid was checked for leukocyte esterase released by PMN by using Combur 10 urine strip and graded for color change from 0-3. Fluid was also analyzed by cytology for PMN count. Results of both methods were compared to determine sensitivity, specificity and accuracy of strip for diagnosis of SBP.

RESULTS

Of 214 paracentesis performed, SBP was diagnosed in 38 patients whereas 176 were negative for infection. Strip test was 97.7% sensitive and 89.4% specific with positive predictive value of 90%, negative predictive value of 97.7% and accuracy of 96.2%, when reagent strip grade 3 was considered as positive for diagnosis.

CONCLUSION

Reagent strip is a quick bedside test, highly sensitive and specific for the diagnosis of SBP, based on polymorphonuclear count in ascitic fluid, to initiate early treatment, thus improving patient's outcome.