Repository of Research and Investigative Information

Repository of Research and Investigative Information

Ilam University of Medical Sciences

Evaluation of Leukocyte Esterase Reagent Strips Test in the Diagnosis of Spontaneous Bacterial Peritonitis in Children with Cirrhosis

Mon Jun 17 01:52:18 2024

(2015) Evaluation of Leukocyte Esterase Reagent Strips Test in the Diagnosis of Spontaneous Bacterial Peritonitis in Children with Cirrhosis. Arquivos de gastroenterologia. pp. 195-9. ISSN 1678-4219 (Electronic) 0004-2803 (Linking)

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BACKGROUND: Spontaneous bacterial peritonitis is defined as an ascetic fluid infection without an evident intra-abdominal surgically treatable source. Spontaneous bacterial peritonitis is one of the severe complications in patients with cirrhosis and ascites. Without early antibiotic treatment, this complication is associated with high mortality rate; therefore, early diagnosis and treatment of spontaneous bacterial peritonitis is necessary for survival. Leukocyte esterase reagent can rapidly diagnose the spontaneous bacterial peritonitis. OBJECTIVE: This study aimed to find out the diagnostic accuracy of leukocyte esterase dipstick test for the diagnosis of spontaneous bacterial peritonitis. METHODS: A single centered hospital-based cross-sectional study was conducted during July 2013 to August 2014 on children with cirrhotic liver disease and ascites who were admitted in the Department of Pediatric Gastroenterology in Nemazee Hospital affiliated to Shiraz University of Medical Sciences (Iran). All patients underwent abdominal paracentesis, and the ascitic fluid was processed for cell count, leukocyte esterase reagent strip test (Combiscreen SL10) and culture. Spontaneous bacterial peritonitis was defined as having a polymorphonuclear count (PMN >/=250/m3) in ascitic fluid. Sensitivity, specificity, positive predictive value and negative predictive value of leukocyte esterase test were calculated according to the formula. RESULTS: Totally, 150 ascitic fluid sample of cirrhotic male patients (53.2) and their mean age (4.33+/-1.88 years) were analyzed. Biliary atresia (n=44, 29.4) and idiopathic neonatal hepatitis (n=29, 19.3) were the most frequent etiology of cirrhosis. Also, abdominal pain (68.6) and distension (64) were the most common presenting complaint. Of all cases, 41 patients (27.35) were diagnosed to have spontaneous bacterial peritonitis (PMN >/=250/mm3). Sensitivity and specificity of leukocyte esterase reagent test according to PMNs >/=250 mm3 were 87.80 and 91.74, also on ascitic fluid culture results were 88.23 and 77.44. Positive predictive value and negative predictive value of this test in PMNs >/=250 mm3 were 80 and 95.23 and in cases with positive culture 33.33 and 98.09 were obtained, respectively. Efficiency of leukocyte esterase reagent test in diagnosing spontaneous bacterial peritonitis, according to PMNs >/=250 mm3 and culture results were 90.66 and 78.66. CONCLUSION: The leukocyte esterase strip test may be used as rapid test for diagnosis of spontaneous bacterial peritonitis due to its high diagnostic validity.

Item Type: Article
Geramizadeh, B.UNSPECIFIED
Javaherizadeh, H.UNSPECIFIED
Keywords: Ascites/*complications/microbiology Ascitic Fluid Bacterial Infections/microbiology *Carboxylic Ester Hydrolases Cross-Sectional Studies Female Humans Liver Cirrhosis/*complications Male Peritonitis/*diagnosis/*etiology/microbiology *Reagent Strips Sensitivity and Specificity
Page Range: pp. 195-9
Journal or Publication Title: Arquivos de gastroenterologia
Journal Index: Pubmed
Volume: 52
Number: 3
Identification Number:
ISSN: 1678-4219 (Electronic) 0004-2803 (Linking)
Depositing User: مهندس مهدی شریفی

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