Gad, A., El-Nemr, N., Saad, M. (2019). The Diagnostic Value of Leukocyte Esterase Reagent Dip-stick in Spontaneous Bacterial Peritonitis Diagnosis in Patients with Liver Cirrhosis. Suez Canal University Medical Journal, 22(1), 56-63. doi: 10.21608/scumj.2019.49262
Amal Gad; Nader El-Nemr; Mohamed Saad. "The Diagnostic Value of Leukocyte Esterase Reagent Dip-stick in Spontaneous Bacterial Peritonitis Diagnosis in Patients with Liver Cirrhosis". Suez Canal University Medical Journal, 22, 1, 2019, 56-63. doi: 10.21608/scumj.2019.49262
Gad, A., El-Nemr, N., Saad, M. (2019). 'The Diagnostic Value of Leukocyte Esterase Reagent Dip-stick in Spontaneous Bacterial Peritonitis Diagnosis in Patients with Liver Cirrhosis', Suez Canal University Medical Journal, 22(1), pp. 56-63. doi: 10.21608/scumj.2019.49262
Gad, A., El-Nemr, N., Saad, M. The Diagnostic Value of Leukocyte Esterase Reagent Dip-stick in Spontaneous Bacterial Peritonitis Diagnosis in Patients with Liver Cirrhosis. Suez Canal University Medical Journal, 2019; 22(1): 56-63. doi: 10.21608/scumj.2019.49262
The Diagnostic Value of Leukocyte Esterase Reagent Dip-stick in Spontaneous Bacterial Peritonitis Diagnosis in Patients with Liver Cirrhosis
1Department of Internal Medicine, Faculty of Medicine, Suez Canal University, Egypt
2Department of Endemic and Infectious Diseases, Faculty of Medicine, Suez Canal University, Egypt
3Department of Internal Medicine, Ismailia General Hospital, Egypt
Abstract
Background: Spontaneous bacterial peritonitis (SBP) is a serious complication of advanced liver cirrhosis which requires rapid diagnosis for the initiation of proper antibiotic therapy. Manual examination of ascetic fluid is a rather time-consuming procedure. The leukocyte esterase (LE) reagent dipstick is based on the esterase activity of activated granulocytes which reacts with an ester‑releasing hydroxyphenylpyrrole causing a color change in the azo dye of reagent strip.Aim: the aim of this study was to evaluate the diagnostic value of leukocyte esterase reagent dipstick in SBP diagnosis in patients with liver cirrhosis attending Suez Canal University Hospital. Methods: ascetic fluid cell count using the counting chamber method was compared to Leucocyte Esterase strip rapid test in two groups of patients (65 ABP vs 65 non-SBP). The strips were read in 120 seconds using colorimetric 5-grade scale (from 0 to 4). The grades (0-2) were considered a negative test while grades (3-4) were considered a positive one. Results: Comparison of the SBP +ve and -ve groups showed a sensitivity of LE strips of (82%) with a high specificity (94 %), PPV (93 %) and NPV (84 %) for the diagnosis of SBP. A good correlation between the LE strip color grade and the ascetic fluid PMNL cell count number (P<0.05) Conclusion: the leukocyte esterase reagent dipstick test is a rather specific, rapid, inexpensive and simple bedside method for diagnosis of SBP method for. A negative LE test result excludes SBP with a high accuracy.
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