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| ==Overview== | | ==Overview== |
| There is no definitive screening test for [[spontaneous bacterial peritonitis]]. According to European Journal of Gastroenterology & Hematology a positive Multistix8SG rapid urine screening test result in ascitic fluid in cirrhotic patients with [[ascites]] appears to be an indication for [[antibiotic]] treatment. According to Liver International journal, it has been demonstrated that fecal calprotectin concentrations (FCCs) are significantly elevated in cirrhotic patients and are dependent on the severity of liver disease. Assessing FCCs may help to identify cirrhotic patients with [[hepatic encephalopathy]] and [[SBP]] as a significant correlation emerged between elevated fecal calprotection and these complications.<ref name="GundlingSchmidtler2011">{{cite journal|last1=Gundling|first1=Felix|last2=Schmidtler|first2=Fabian|last3=Hapfelmeier|first3=Alexander|last4=Schulte|first4=Benjamin|last5=Schmidt|first5=Thomas|last6=Pehl|first6=Christian|last7=Schepp|first7=Wolfgang|last8=Seidl|first8=Holger|title=Fecal calprotectin is a useful screening parameter for hepatic encephalopathy and spontaneous bacterial peritonitis in cirrhosis|journal=Liver International|volume=31|issue=9|year=2011|pages=1406–1415|issn=14783223|doi=10.1111/j.1478-3231.2011.02577.x}}</ref>. However, there is insufficient evidence to recommend routine screening for [[SBP]].
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| ==Screening==
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| * '''Leukocyte esterase strip''' calibrated to an ascitic fluid neutrophil count 250/microl is an effective screening tool when the strip turns to any hue of brown at 3 min. <ref name="pmid20646775">{{cite journal| author=Mendler MH, Agarwal A, Trimzi M, Madrigal E, Tsushima M, Joo E et al.| title=A new highly sensitive point of care screen for spontaneous bacterial peritonitis using the leukocyte esterase method. | journal=J Hepatol | year= 2010 | volume= 53 | issue= 3 | pages= 477-83 | pmid=20646775 | doi=10.1016/j.jhep.2010.04.011 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20646775 }} </ref>
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| * '''Fecal calprotectin''' is a useful screening parameter for [[spontaneous bacterial peritonitis]] in [[cirrhosis]]. It is helpful in grading the severity of [[hepatic encephalopathy]].<ref name="pmid22093455">{{cite journal| author=Gundling F, Schmidtler F, Hapfelmeier A, Schulte B, Schmidt T, Pehl C et al.| title=Fecal calprotectin is a useful screening parameter for hepatic encephalopathy and spontaneous bacterial peritonitis in cirrhosis. | journal=Liver Int | year= 2011 | volume= 31 | issue= 9 | pages= 1406-15 | pmid=22093455 | doi=10.1111/j.1478-3231.2011.02577.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22093455 }} </ref><ref name="FernandesSantos2016">{{cite journal|last1=Fernandes|first1=Samuel Raimundo|last2=Santos|first2=Patrícia|last3=Fatela|first3=Narcisa|last4=Baldaia|first4=Cilénia|last5=Tato Marinho|first5=Rui|last6=Proença|first6=Helena|last7=Ramalho|first7=Fernando|last8=Velosa|first8=José|title=Ascitic Calprotectin is a Novel and Accurate Marker for Spontaneous Bacterial Peritonitis|journal=Journal of Clinical Laboratory Analysis|volume=30|issue=6|year=2016|pages=1139–1145|issn=08878013|doi=10.1002/jcla.21994}}</ref><ref name="LutzPfarr2015">{{cite journal|last1=Lutz|first1=Philipp|last2=Pfarr|first2=Kenneth|last3=Nischalke|first3=Hans Dieter|last4=Krämer|first4=Benjamin|last5=Goeser|first5=Felix|last6=Glässner|first6=Andreas|last7=Wolter|first7=Franziska|last8=Kokordelis|first8=Pavlos|last9=Nattermann|first9=Jacob|last10=Sauerbruch|first10=Tilman|last11=Hoerauf|first11=Achim|last12=Strassburg|first12=Christian P.|last13=Spengler|first13=Ulrich|title=The ratio of calprotectin to total protein as a diagnostic and prognostic marker for spontaneous bacterial peritonitis in patients with liver cirrhosis and ascites|journal=Clinical Chemistry and Laboratory Medicine (CCLM)|volume=53|issue=12|year=2015|issn=1437-4331|doi=10.1515/cclm-2015-0284}}</ref>
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| * A new Prescreen strip, is highly effective and cost-saving procedure for the exclusion of SBP in cirrhotic outpatients (due to its excellent NPV) without the need to perform standard ascitic cytology.
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| ** In outpatients, the performance of this strip was optimal with a sensitivity- 100% and negative predictive value-100%.
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| ** Prescreen strip is considered to be a good screening test in outpatients as it identified all patients with SBP.
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| ** Further studies are needed to better understand pre-analytical conditions leading to the failure to recognize SBP among inpatients.<ref name="ThévenotBriot2016">{{cite journal|last1=Thévenot|first1=Thierry|last2=Briot|first2=Charline|last3=Macé|first3=Vincent|last4=Lison|first4=Hortensia|last5=Elkrief|first5=Laure|last6=Heurgué-Berlot|first6=Alexandra|last7=Bureau|first7=Christophe|last8=Jézéquel|first8=Caroline|last9=Riachi|first9=Ghassan|last10=Louvet|first10=Alexandre|last11=Pauwels|first11=Arnaud|last12=Ollivier-Hourmand|first12=Isabelle|last13=Anty|first13=Rodolphe|last14=Carbonell|first14=Nicolas|last15=Labadie|first15=Hélène|last16=Aziz|first16=Karim|last17=Grasset|first17=Denis|last18=Nguyen-Khac|first18=Eric|last19=Kaassis|first19=Mehdi|last20=Hermann|first20=Sofia|last21=Tanné|first21=Florence|last22=Mouillot|first22=Thomas|last23=Roux|first23=Olivier|last24=Le Thuaut|first24=Aurélie|last25=Cervoni|first25=Jean-Paul|last26=Cadranel|first26=Jean-François|last27=Schnee|first27=Matthieu|last28=Bardou-Jacquet|first28=Edouard|last29=Belouchrani|first29=Yasmina|last30=Bernard-Chabert|first30=Brigitte|last31=Canivet|first31=Clémence|last32=Dao|first32=Thong|last33=Di Martino|first33=Vincent|last34=Faroux|first34=Roger|last35=Medmoun|first35=Mourad|last36=Nousbaum|first36=Jean-Baptiste|last37=Riche|first37=Valéry-Pierre|last38=Robic|first38=Marie Angèle|last39=Si Nafa|first39=Si Ahmed|last40=Si Nafa|first40=Si Ahmed|last41=Thiéfin|first41=Gérard|last42=Weil|first42=Delphine|title=The Periscreen Strip Is Highly Efficient for the Exclusion of Spontaneous Bacterial Peritonitis in Cirrhotic Outpatients|journal=The American Journal of Gastroenterology|volume=111|issue=10|year=2016|pages=1402–1409|issn=0002-9270|doi=10.1038/ajg.2016.344}}</ref>
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| * The diagnostic accuracy of leucocyte esterase reagent strips read out by a photospectrometer was comparable with the gold standard test and was excellent for excluding SBP. Our results support implementation of reagent strips in the diagnostic work-up of ascitic fluid. The sensitivity, specificity, positive predictive value and negative predictive value of the reagent strip according to the photospectrometer were 100%, 93%, 55% and 100% respectively, and 75%, 99%, 82% and 98%, respectively, for visual interpretation.<ref name="pmid27571723">{{cite journal| author=Oey RC, Kuiper JJ, van Buuren HR, de Man RA| title=Reagent strips are efficient to rule out spontaneous bacterial peritonitis in cirrhotics. | journal=Neth J Med | year= 2016 | volume= 74 | issue= 6 | pages= 257-61 | pmid=27571723 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27571723 }} </ref>
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| ==References== | | ==References== |
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| [[Category:Emergency medicine]] | | [[Category:Emergency medicine]] |
| [[Category:Infectious disease]] | | [[Category:Infectious disease]] |
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