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

Abstract

The literature on the prevalence of spontaneous bacterial peritonitis (SBP) in cirrhotic outpatients who visited the hospital for therapeutic abdominal paracentesis was reviewed in order to assess the usefulness of urinary strips in this setting. The authors reviewed the studies published as peer-reviewed articles on the prevalence of SBP in ambulatory outpatients who visited the hospital for therapeutic paracentesis. Five such studies were available in the literature. It was found that the prevalence of SBP was in the range of 0%-3.5%. In regard to the use of reagent strips, Multistix8 SG is not useful in this setting, while the Periscreen TM strip is a consistent screening tool for the rapid detection of SBP, particularly in the outpatients' setting (negative predictive value: 99.4%-100%). In asymptomatic cirrhotic outpatients undergoing a large volume of paracentesis with low risks of infection, the prevalence of spontaneous bacterial peritonitis is low. In this setting, a systematic analysis of ascitic fluid could be avoided. The use of reagent strips may serve as an alternative. Among the reagent strips tested so far, the Periscreen TM strip has exhibited the highest diagnostic performance with a high negative predictive value.