assessment of leucocyte esterase reagent strips in diagnosis of spontaneous bacterial peritonitis

liver cirrhosis is the end-stage of chronic liver disease; its main causes are chronic viral hepatitis B and C and alcohol abuse, results in major complications such as portal hypertension with variceal bleeding, ascites, or liver failure leading to renal failure and coma. Spontaneous bacterial peritonitis is a severe and frequent complication of cirrhosis with a high mortality rate. Spontaneous bacterial peritonitis is probably related to several impaired defense mechanisms, such as depressed reticuloendothelial system phagocytic activity, leukocyte dysfunction, reduced serum complement, and low bacterial activity of ascitic fluid.Aim of the work: was to compare between leucocyte esterase reagent strips as a bed side test and standard manual PMN counting in the ascetic fluid regarding efficacy and rapidity in diagnosis of SBP.Patient &methods: The study was conducted on 100 patients with liver cirrhosis complicated by ascites and spontaneous bacterial peritonitis (SBP) which was diagnosed by:*Clinical presentation: Fever, generalized abdominal pain and tenderness.* Laboratory investigation: (PMN in ascetic fluid ≥ 250/mL).*examination of ascetic fluid by leukocyte esterase reagent strips.Results: the studied patints were 73% male and 27% females with mean age 50.46±11.27. 48% of patients had Child-Pugh B, 44% patients had Child-Pugh C .The test of ascetic fluid by leukocyte esterase reagent strips showed that Specificity =91.5% and Sensitivity = 83% Positive predictive value (PPV) = 87.2%. Negative predictive value (NPV) =88.5%.Accuracy = 88%.