Study of Leucocyte Esterase Reagent Strips as a screening test for Spontaneous Bacterial Peritonitis

Background: Spontaneous bacterial peritonitis (S B P) is a severe and frequent complication of cirrhosis with a high mortality rate. A bacteriological laboratory is not always available for all departments admitting cirrhotic patients with ascitis. It follows that alternative methods for rapid diagnosis of SBP are an urgent requirement. Objective: This study was planned to compare between leucocyte esterase reagent strips as a bed side test and standard manual polymorphnuclear leucocytes (PMN) counting in the ascitic fluid as regards efficacy and rapidity in diagnosis of SBP. Subjects \& methods: The study included 100 patients with liver cirrhosis resulting from chronic hepatitis C infection complicated by ascites and SBP. All patients were subjected to complete clinical examination, laboratory investigation that include CBC, PT, INR, LFT, s., creatinine and blood urea, pancreatic enzymes (amylase \& lipase), ESR, tuberculin test, radiological investigations including CXR, pelvi-abdominal US and CT, in addition to specific investigations that include cytological, bacteriological and biochemical examination of ascitic fluid as well as examination of ascitic fluid by leucocyte esteras strips. Results: There was a highly statistically significance of leucocyte esterase reagent strips in diagnosis of SBP with high specificity 91.5\%, sensitivity 83\% and accuracy 88\%. There was positive correlation (r = + 0.56) between ascitic fluid PMN counts and the corresponding result of leucocyte esterase reagent strip test which was statistically of high significance (P value = 0.000). Conclusion: It's concluded that the reagent strip testing of ascitic fluid is a very sensitive and specific method for diagnosis of SBP in cirrhotic patients with ascites. It can be used at the patient's bedside and is rapid, easy, inexpensive and results are available within a maximum of 120 seconds. {[}Khaled M. Hadhoud; Mahmoud A. A. Ashsour; Osama M. Basha; Fawzy A. El-Messallamy and Alaa Anwar. Study of Leucocyte Esterase Reagent Strips in Spontaneous Bacterial Peritonitis. Life Sci J 2012;9(4):5369-5375] (ISSN: 1097-8135). http://www.lifesciencesite.com. 797