Diagnosis of Spontaneous Bacterial Peritonitis in Children by Reagent Strips
Abstract
This study was aimed to evaluate the efficacy of dipstick tests (leukocyte esterase and nitrite) in diagnosis of spontaneous bacterial peritonitis (SBP) in cirrhotic patients. Forty six children with ascites hospitalized between 2009 and 2010 in Children Medical Center were enrolled in this study. Reagent strip assays for leukocyte esterase and nitrite were performed on ascetic fluid and the results were compared to manual cell counting and ascitic fluid culture. SBP was defined as having a polymorphonuclear ascites count of ≥ 250/mm3. Twenty children were female and twenty six were male with mean age of 3±3.9 years. The sensitivity specificity, positive and negative predictive values of the leukocyte esterase reagent strips were all 100%. The sensitivity, specificity, positive and negative predictive value of the nitrite reagent strip test were 100%, 97%, 90% and 100% respectively. Leukocyte esterase reagent strips may provide a rapid, bedside diagnostic test for the diagnosis of SBP.
Rimola A. Infections in liver disease. In: McIntyre N, Benhamou JP, Bircher J, Rizetto M, Rodes J, editors.Oxford Textbook of Clinical Hepatology. Oxford: Oxford University Press; 1991: 1272–84.
Garcia-Tsao G. Spontaneous bacterial peritonitis. Gastroenterol Clin North Am 1992; 21(1):257-75.
Caly WR, Strauss E. A prospective study of bacterial infections in patients with cirrhosis. J Hepatol 1993; 18(3):353-8.
Pinzello G, Simonetti R, Camma C, Dino O, Miazzo G, Pagliano L. Spontaneous bacterial peritonitis: an update.Gastroenterol Int 1993; 6:54-60.
Bac DJ, Siersema PD, Mulder PGH, DeMarie S, Wilson,JHP. Spontaneous bacterial peritonitis: outcome and predictive factors. Eur J Gastroenterol Hepatol 1993; 5:635.
Llovet JM, Planas R, Morillas R, Quer JC, Cabré E, Boix J, Humbert P, Guilera M, Doménech E, Bertrán X, et al. Short-term prognosis of cirrhotics with spontaneous bacterial peritonitis: multivariate study. Am J Gastroenterol 1993; 88(3):388-92.
Runyon BA, McHutchison JG, Antillon MR, Akriviadis EA, Montano AA. Short-course versus long-course antibiotic treatment of spontaneous bacterial peritonitis.A randomized controlled study of 100 patients. Gastroenterol 1991; 100(6):1737-42.
Toledo C, Salmerón JM, Rimola A, Navasa M, Arroyo V, Llach J, Ginès A, Ginès P, Rodés J. Spontaneous bacterialperitonitis in cirrhosis: predictive factors of infection resolution and survival in patients treated with cefotaxime. Hepatol 1993; 17(2):251-7.
Thuluvath PJ, Morss S, Thompson R. Spontaneous bacterial peritonitis--in-hospital mortality, predictors of survival, and health care costs from 1988 to 1998. Am J Gastroenterol 2001; 96(4):1232-6.
Rimola A, García-Tsao G, Navasa M, Piddock LJ, Planas R, Bernard B, Inadomi JM. Diagnosis, treatment and prophylaxis of spontaneous bacterial peritonitis: a consensus document. International Ascites Club. J Hepatol 2000; 32(1):142-53.
Lejeune B, Baron R, Guillois B, Mayeux D. Evaluation of a screening test for detecting urinary tract infection in newborns and infants. J Clin Pathol 1991; 44(12):1029-30.
Kutter D, Figueiredo G, Klemmer L. Chemical detection of leukocytes in urine by means of a new multiple test strip. J Clin Chem Clin Biochem 1987; 25(2):91-4.
Hiscoke C, Yoxall H, Greig D, Lightfoot NF. Validation of a method for the rapid diagnosis of urinary tract infection suitable for use in general practice. Br J Gen Pract 1990; 40(339):403-5.
Castellote J, Lopez C, Gornals J, Tremosa G, Farina ER, Baliellas C, Domingo A, Xiol X. Rapid diagnosis of spontaneous bacterial peritonitis by use of reagent strips. Hepatology 2003; 37(4):893-6.
Butani RC, Shaffer RT, Szyjkowski RD, Weeks BE, Speights LG, Kadakia SC. Rapid diagnosis of infected asciticfluid using leukocyte esterase dipstick testing. Am J Gastroenterol 2004; 99(3):532-7.
Thevenot T, Cadranel JF, Nguyen-Khac E, Tilmant L, Tiry C, Welty S, Merzoug N. Diagnosis of spontaneous bacterial peritonitis in cirrhotic patients by use of two reagent strips. Eur J Gastroenterol Hepatol 2004; 16(6):579-83.
Rerknimitr R, Rungsangmanoon W, Kongkam P, Kullavanijaya P. Efficacy of leukocyte esterase dipstick test as a rapid test in diagnosis of spontaneous bacterial peritonitis. World J Gastroenterol 2006; 12(44):7183-7.
Torun S, Dolar E, Yilmaz Y, Keskin M, Kiyici M, Sinirtas M, Sarandol E,Gurel S, Nak SG, Gulten M. Evaluation of leukocyte esterase and nitrite strip tests to detect spontaneous bacterial peritonitis in cirrhotic patients. World J Gastroenterol 2007; 13(45):6027-30.
Bories PN, Campillo B, Azaou L, Scherman E. Longlasting NO overproduction in cirrhotic patients with spontaneous bacterial peritonitis. Hepatology 1997;25(6):1328-33.
Viinikka L. Nitric oxide as a challenge for the clinical chemistry laboratory. Scand J Clin Lab Invest 1996;56(7):577-81.
Wang J, Brown MA, Tam SH, Chan MC, Whitworth JA. Effects of diet on measurement of nitric oxide metabolites. Clin Exp Pharmacol Physiol 1997;24(6):418-20.
Baylis C, Vallance P. Measurement of nitrite and nitrate levels in plasma and urine--what does this measure tell us about the activity of the endogenous nitric oxide system? Curr Opin Nephrol Hypertens 1998;7(1):59-62.
Files | ||
Issue | Vol 51, No 2 (2013) | |
Section | Original Article(s) | |
Keywords | ||
Ascetic fluid Children Leukocyte esterase Nitrite Spontaneous bacterial peritonitis |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |