Spontaneous bacterial peritonitis screening
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shivani Chaparala M.B.B.S [2]
Overview
Screening
- 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. [1]
- Fecal calprotectin is a useful screening parameter for spontaneous bacterial peritonitis in cirrhosis. It is helpful in grading the severity of hepatic encephalopathy.[2][3][4]
- 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.
- In outpatients, the performance of this strip was optimal with a sensitivity- 100% and negative predictive value-100%.
- Periscreen strip is considered to be a good screening test in outpatients as it identified all patients with SBP.
- Further studies are needed to better understand pre-analytical conditions leading to the failure to recognize SBP among inpatients.[5]
- 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.[6]
References
- ↑ Mendler MH, Agarwal A, Trimzi M, Madrigal E, Tsushima M, Joo E; et al. (2010). "A new highly sensitive point of care screen for spontaneous bacterial peritonitis using the leukocyte esterase method". J Hepatol. 53 (3): 477–83. doi:10.1016/j.jhep.2010.04.011. PMID 20646775.
- ↑ Gundling F, Schmidtler F, Hapfelmeier A, Schulte B, Schmidt T, Pehl C; et al. (2011). "Fecal calprotectin is a useful screening parameter for hepatic encephalopathy and spontaneous bacterial peritonitis in cirrhosis". Liver Int. 31 (9): 1406–15. doi:10.1111/j.1478-3231.2011.02577.x. PMID 22093455.
- ↑ Fernandes, Samuel Raimundo; Santos, Patrícia; Fatela, Narcisa; Baldaia, Cilénia; Tato Marinho, Rui; Proença, Helena; Ramalho, Fernando; Velosa, José (2016). "Ascitic Calprotectin is a Novel and Accurate Marker for Spontaneous Bacterial Peritonitis". Journal of Clinical Laboratory Analysis. 30 (6): 1139–1145. doi:10.1002/jcla.21994. ISSN 0887-8013.
- ↑ Lutz, Philipp; Pfarr, Kenneth; Nischalke, Hans Dieter; Krämer, Benjamin; Goeser, Felix; Glässner, Andreas; Wolter, Franziska; Kokordelis, Pavlos; Nattermann, Jacob; Sauerbruch, Tilman; Hoerauf, Achim; Strassburg, Christian P.; Spengler, Ulrich (2015). "The ratio of calprotectin to total protein as a diagnostic and prognostic marker for spontaneous bacterial peritonitis in patients with liver cirrhosis and ascites". Clinical Chemistry and Laboratory Medicine (CCLM). 53 (12). doi:10.1515/cclm-2015-0284. ISSN 1437-4331.
- ↑ Thévenot, Thierry; Briot, Charline; Macé, Vincent; Lison, Hortensia; Elkrief, Laure; Heurgué-Berlot, Alexandra; Bureau, Christophe; Jézéquel, Caroline; Riachi, Ghassan; Louvet, Alexandre; Pauwels, Arnaud; Ollivier-Hourmand, Isabelle; Anty, Rodolphe; Carbonell, Nicolas; Labadie, Hélène; Aziz, Karim; Grasset, Denis; Nguyen-Khac, Eric; Kaassis, Mehdi; Hermann, Sofia; Tanné, Florence; Mouillot, Thomas; Roux, Olivier; Le Thuaut, Aurélie; Cervoni, Jean-Paul; Cadranel, Jean-François; Schnee, Matthieu; Bardou-Jacquet, Edouard; Belouchrani, Yasmina; Bernard-Chabert, Brigitte; Canivet, Clémence; Dao, Thong; Di Martino, Vincent; Faroux, Roger; Medmoun, Mourad; Nousbaum, Jean-Baptiste; Riche, Valéry-Pierre; Robic, Marie Angèle; Si Nafa, Si Ahmed; Si Nafa, Si Ahmed; Thiéfin, Gérard; Weil, Delphine (2016). "The Periscreen Strip Is Highly Efficient for the Exclusion of Spontaneous Bacterial Peritonitis in Cirrhotic Outpatients". The American Journal of Gastroenterology. 111 (10): 1402–1409. doi:10.1038/ajg.2016.344. ISSN 0002-9270.
- ↑ Oey RC, Kuiper JJ, van Buuren HR, de Man RA (2016). "Reagent strips are efficient to rule out spontaneous bacterial peritonitis in cirrhotics". Neth J Med. 74 (6): 257–61. PMID 27571723.