The Periscreen Strip Is Highly Efficient for the Exclusion of Spontaneous Bacterial Peritonitis in Cirrhotic Outpatients

Abstract

The Periscreen strip is a rapid and highly efficient tool for excluding SBP in the outpatient setting.

Retinol-binding protein-4 expression marks the short-term mortality of critically ill patients with underlying liver disease: Lipid, but not glucose, matters

“…Esophageal bleeding was determined using a fiberoptic panendoscope. Spontaneous bacterial peritonitis was defined as an ascitic fluid infection without an evident intra-abdominal surgically treatable source 40 and was diagnosed according to the clinical manifestations and ascitic fluid findings as described previously 41 . Severe acute exacerbation of chronic hepatitis B was defined as an abrupt ALT elevation >5 × the upper limit of the normal range associated with jaundice and a prolonged prothrombin time in patients with chronic hepatitis B 42 .…”

Low Prevalence of Spontaneous Bacterial Peritonitis in Ambulatory Asymptomatic Cirrhotic Patients: Consequences in Patients’ Care

“…The prevalence of SBP in asymptomatic outpatients was less than 1.5% in a large series [12], while it was greater than 8% in the symptomatic outpatients. On the contrary, in the series by Thevenot et al on the usefulness of Periscreen TM® strip [11], the prevalence of SBP in outpatients was significantly lower than that in the inpatients (2.1% vs. 11.2%; p < 0.001). Differences in the SBP prevalence between inpatients and outpatients were elucidated in a study conducted by Cadranel et al [9], who reported that in the inpatients, the cause of cirrhosis was more frequently alcoholrelated, the Child-Pugh score was higher and more often C than B, the platelet count was lower, and the serum total bilirubin concentration was higher.…”

“…A double-blind search of studies published in Medline until July, 2019 on the topic of prevalence and the associated factors of spontaneous bacterial peritonitis in asymptomatic outpatients having therapeutic paracenteses was performed using the following keywords: ascites, spontaneous bacterial peritonitis, outpatient procedures, asymptomatic patients, cirrhosis, and urinary reagent strips. Six studies, including those conducted on cirrhotic outpatients, have been published as full papers on this topic [5][6][7][8][9]11]. One of these studies was an ancillary study [9] of the multicenter study that aimed at evaluating the reagent strip Multistix as a diagnostic tool for SBP [12].…”

“…The prevalence of SBP was in the range of 0%-3.5%, according to the six studies, including several cases of paracenteses ranging from 118 to 976 (Table 1). Table 2 presents the diagnostic performance of reagent strips in a large series of cirrhotic inpatients [12] or outpatients [11,12] undergoing paracentesis. The diagnostic performance of Periscreen strip in cirrhotic outpatients was good, with negative predictive values of 100% (95% CI: 99.0-100) and 99.4% (95% CI: 98.5-99.8) using "Trace" and "Small" thresholds, respectively.…”

“…However, due to the low sensitivity of most of the strips, their use could not be recommended. Recently, it was demonstrated that a novel strip named the Periscreen strip was efficient in excluding SBP in the outpatient setting [11]. The present review focuses on the rarity of SBP in ambulatory outpatients and on the application of urinary strips for avoiding time consuming and expensive systematic bacteriological analyses.…”