DIAGNOSTIC VALIDITY OF LEUKOCYTE ESTERASE DIPSTICK TEST FOR DIAGNOSIS OF SPONTANEOUS BACTERIAL PERITONITIS IN CIRRHOTIC PATIENTS
AbstractBackground: Spontaneous bacterial peritonitis (SBP) is defined as an ascitic fluid infection without anevident intra-abdominal surgically treatable source. Spontaneous bacterial peritonitis (SBP) is one ofthe severe complications in patients with cirrhosis and ascites. Without early antibiotic treatment, thiscomplication is associated with high mortality rate, so early diagnosis and treatment of SBP is thereforenecessary for survival. Leukocyte esterase dipstick test can rapidly diagnose the SBP. Objectives wereto find out the diagnostic accuracy of leukocyte esterase dipstick test for the diagnosis of spontaneousbacterial peritonitis. Methods: This cross-sectional, validation study was conducted from January 2009to June 2009 at Medical Unit-II, Chandka Medical College Hospital Larkana. All the Patients withcirrhosis and ascites of either gender were included in this study. Paracentesis were performed onadmission. The ascitic fluid obtained at bedside was immediately tested with reagent strip Multistix® 10SG. Ascitic fluid was then analysed for PMN cell count. The result of reagent strip was compared withascitic fluid PMN cell count for determination of sensitivity, specificity, PPV and NPV of the test,while taking ascitic fluid PMN count ≥250/mm3 as standard for diagnosis of SBP. Leukocyte esterasedipstick read positive from +1 to +3 reaction while negative and trace reaction regarded as negative testresult. Results: Total ninety four patients were enrolled in this study. Ninety-four Ascitic fluid sampleswere obtained. SBP was diagnosed in 52 (55.3%) patients, 42 (44.7%) patients were negative for SBPby manual cell count. The sensitivity, specificity, PPV, NPV of leukocyte esterase dipstick test todiagnose SBP were 92%, 95%, 96%, 90% respectively. Conclusion: The leukocyte esterase dipsticktest can be used as rapid test for diagnosis of SBP due to its high diagnostic validity.Keywords: spontaneous bacterial peritonitis, ascites, cirrhosis, validity, leukocyte esterase.
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