Volume : V, Issue : X, October - 2015

Efficiency Assessment of Leucocyte Esterase Reagent strips in rapid bedside diagnosis of Spontaneous Bacterial Peritonitis – a comparison study with the gold standard Absolute Neutrophil Counts in ascitic fluid

Dr. Swathy Moorthy, Dr. S. R. Ramakrishnan, Dr. Vamsi Chalasani, Dr. K. Vasanthan

Abstract :

 BACKGROUND Spontaneous Bacterial Peritonitis(SBP) is a well known complication of cirrhotic ascites. An early diagnosis is essential to reduce the morbidity and mortality. Identifying a rapid and affordable bedside tool which can help in diagnosis of SBP was the objective of our study. METHODS A prospective study of 200 patients admitted with ascites in a tertiary care teaching hospital during a two year period was done. The incidence of SBP in those patients and its diagnosis based on ascitic fluid neutrophil counts and cultures were recorded. We compared the LER strips colour change with the absolute neutrophil counts in the ascitic fluid which is the gold standard. RESULTS 180 out of 200 patients with ascites were cirrhotic in nature. 89% of the study group were males. Ethanol induced chronic liver disease was the commonest etiology. SBP was seen in 17.8% cases and fever was the commonest presentation. 5 out of 32 cases of SBP were culture positive. The sensitivity and specificity of LER strip when grade 3 (>125 PMN?cu mm) was taken as cut off were 87.5% and 95.3% respectively with a positive predictive value of 80% and negative predictive value of 97.2%. The sensitivity and specificity of LER strip when grade 4 (>500PMN?cu mm) was taken as cut off were 53.1% and 100% respectively with a positive predictive value of 100% and negative predictive value of 90.8%. CONCLUSION LER strips usage in ascitic fluid seems to be a promising tool in diagnosis of spontaneous bacterial peritonitis at the bedside. It is a rapid, cost effective diagnostic tool with a 100% positive predictive value when grade 3 and above is taken as a cut off point.

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Article: Download PDF   DOI : 10.36106/ijar  

Cite This Article:

Dr. Swathy Moorthy, Dr. S. R. Ramakrishnan, Dr. Vamsi Chalasani, Dr. K. Vasanthan Efficiency Assessment of Leucocyte Esterase Reagent strips in rapid bedside diagnosis of Spontaneous Bacterial Peritonitis‾a comparison study with the gold standard Absolute Neutrophil Counts in ascitic fluid Indian Journal of Applied Research, Vol.5, Issue : 10 October 2015

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