Accuracy of Leukocyte Esterase Reagent Strip (LERS) test for rapid bedside screening of spontaneous bacterial peritonitis: An observational study

Khairnar, Harshad; Ingle, Meghraj; Pandey, Vikas; Kolhe, Kailash; Chauhan, Shamsher; Sawant, Prabha; Walke, Swapnil; Chaudhary, Vipul

doi:10.4103/jfmpc.jfmpc_1207_19

Cited by 3 publications

(1 citation statement)

References 10 publications

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“…In a study by Khairnar et al 14 done in 64 patients, 17 with SBP, using multistix 10SG (Siemens India), had shown the sensitivity, specifi city, PPV, NPV and accuracy of 100, 94, 57, 100 and 94.5 percent with cut-off grade 2 (:125 PMNL/ mm 3 ) and 76.4, 100, 100, 92.1 and 93.7 percent respectively with grade 3 (:500PMNL/mm 3 ) as cut-off. The fi nding in this study showed high sensitivity and NPV with low specifi city for grade 2 as cut-off and specifi city and PPV improved at cost of sensitivity for grade 3 as cut-off and these fi nding are similar to our study.…”

Section: Discussionmentioning

confidence: 98%

Evaluation of leukocyte esterase reagent strip test for rapid bedside diagnosis of spontaneous bacterial peritonitis

Khanal¹,

Khanal²,

Shrestha³

et al. 2023

Nep. Med. Coll. J.

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Spontaneous bacterial peritonitis (SBP) is a common complication of cirrhosis with high morbidity and mortality. Early diagnosis and treatment improve survival. Diagnosis is made by ascitic fluid Polymorphoneuclear leukocytes (PMNL) count of >250/mm3 which takes hours and may not be available in rural settings. Leukocyte esterase reagent strips (LERS) test have shown high sensitivity, specificity, and negative predictive value in the diagnosis of SBP. This study was conducted to find the utility of the LERS test for the diagnosis of SBP. This was a prospective hospital-based study conducted at the National Academy of Medical Sciences, Bir Hospital, Nepal. LERS test was performed on ascitic fluid from 140 cirrhotic patients. Colorimetric grading was compared with PMNL count for diagnosing SBP. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for diagnosing SBP calculated for grade 3 and grade 4 as cut-offs. Among 140 patients, SBP was diagnosed in 27. Grade 3 as cut-off, sensitivity, specificity, PPV, and NPV for the LERS test were 96.3, 90.2, 70.3, and 99 percent respectively. For grade 4 as cut-off, sensitivity, specificity, PPV, and NPV were 81.5, 99.1, 95.6, and 95.7 percent respectively. Accuracy were 91.4 and 95.2 percent for grade 3 and 4 as cut-off respectively. LERS test has shown high sensitivity, specificity, and negative predictive value for the diagnosis of SBP in cirrhotic ascitis. Being simple, rapid, and cost-effective, it can be useful at bedside to start early antibiotic therapy before availability of the PMNL count report.

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Section: Discussionmentioning

confidence: 98%

Evaluation of leukocyte esterase reagent strip test for rapid bedside diagnosis of spontaneous bacterial peritonitis

Khanal¹,

Khanal²,

Shrestha³

et al. 2023

Nep. Med. Coll. J.

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A simplified fecal leukocyte esterase strip test results as a low cost, widely available, alternative bowel inflammation biomarker

Tsai,

Weng,

Chang

et al. 2024

Journal of the Formosan Medical Association

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Diagnostic Accuracy of Leucocyte Esterase Dipstick Test for The Diagnosis of Spontaneous Bacterial Peritonitis in Children with Nephrotic Syndrome

Din¹,

Rehman²,

Adnan³

et al. 2023

PJHS

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Spontaneous bacterial peritonitis (SBP), which has a high fatality rate if antibiotics are not given promptly, is one of the most serious side effects of nephrotic syndrome and ascites. Therefore, it is essential for survival to diagnose and treat SBP early. A quick dipstick test for leukocyte esterase can identify the SBP. Objective: To determine the diagnostic accuracy in detection of SBP using leucocyte esterase dipstick test in children with nephrotic syndrome taking ascitic fluid neutrophil count as gold standard. Methods: A Cross Sectional Study was carried out Khyber teaching hospital and LRH Peshawar Pakistan. This research covered patients of either gender with nephrotic syndrome and ascites. On admission, diagnostic paracentesis was performed. The ascitic fluid collected at the bedside was examined immediately using a reagent strip. The PMN cell count in ascitic fluid was then determined. A positive +3 result on a leukocyte esterase dipstick was declared positive for SBP while absolute neutrophil count more than 250 cells per mm3 was considered confirmatory. Results: A total of 107 patients were enrolled. Age of the patients ranged from 4 to 14 years. Mean age of the patients was 6.68 ± 1.239 years. Male to female ratio was 1.7: 1. The sensitivity, specificity, positive and negative predictive value of leucocyte esterase dipstick test were 86.4%, 92.0%, 73.1% and 96.4% respectively. Conclusion: It is concluded that reagent strips are quick, practical, and low-cost diagnostics with good sensitivity and specificity for identifying SBP in children with nephrotic syndrome

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Accuracy of Leukocyte Esterase Reagent Strip (LERS) test for rapid bedside screening of spontaneous bacterial peritonitis: An observational study

Cited by 3 publications

References 10 publications

Evaluation of leukocyte esterase reagent strip test for rapid bedside diagnosis of spontaneous bacterial peritonitis

Evaluation of leukocyte esterase reagent strip test for rapid bedside diagnosis of spontaneous bacterial peritonitis

A simplified fecal leukocyte esterase strip test results as a low cost, widely available, alternative bowel inflammation biomarker

Diagnostic Accuracy of Leucocyte Esterase Dipstick Test for The Diagnosis of Spontaneous Bacterial Peritonitis in Children with Nephrotic Syndrome

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