Predictors of Ascetic Fluid Infection in Cirrhotic Patients

Galal, Ghada Moustafa; Elsharkawy, Ramy; Sayed, Sherif Abdel Aziz; Alkadi, M.

doi:10.21608/smj.2019.40608

Cited by 2 publications

(3 citation statements)

References 7 publications

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“…As regards acute inflammatory marker C reactive protein (CRP) in serum, the current study showed a significant increase in SBP versus none SBP group. This result matched with previous results 7,9,[12][13][14][15] .…”

Section: Discussionsupporting

confidence: 93%

“…The present study showed that both CRP and ascitic fluid MIP-1β were strong independent predictors of SBP. Another study found that CRP was an independent variable in SBP prediction 12,16 while others found that CRP act as a prognostic marker in cases of cirrhotic ascites with SBP 9,14 . In this study, there was a positive correlation with total leucocyte count, serum CRP and ascitic fluid LDH in the SBP group.…”

Section: Discussionmentioning

confidence: 99%

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Macrophage Inflammatory Protein Type 1 Beta as a Novel Diagnostic Marker for Diagnosis of Spontaneous Bacterial Peritonitis

Mahmoud

El-gharabawy

Elhelaly

et al. 2021

Medical Journal of Viral Hepatitis

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Background: Spontaneous bacterial peritonitis (SBP) is a severe complication of cirrhotic ascites. SBP diagnosis is based on the count of ascitic fluid neutrophils (>250/mm 3). This procedure is an invasive maneuver with many complications. This study aimed to find a sensitive diagnostic tool for SBP by examining ascitic fluid Macrophage Inflammatory Protein type 1 beta (MIP-1β) as a rapid bedside test for diagnosis of SBP. Materials and methods: The study included 53 cirrhotic ascitic patients (33 with and 20 without SBP). Patients were subjected to thorough medical history taking, clinical examination, and laboratory investigation. Two ascitic fluid samples were taken, the first at admission time for cell count and culture, and the second sample was taken 48 hours after treatment in patients with SBP. Ascitic MIP-1β was measured using ELISA technique at admission in both groups and 48 hours after treatment in the SBP group. Results: Ascitic MIP-1β and CRP levels were significantly higher in the SBP group versus non-SBP patients. There was a significant positive correlation between ascitic fluid MIP-1β and WBCs and serum CRP. Ascitic fluid MIP-1β at a cutoff value ≥ of 31.95 pg/ml had 79% sensitivity and 75% specificity for the diagnosis of SBP. Combined ascetic fluid MIP-1β at the cutoff value ≥31.95 pg/ml and CRP in serum at a cutoff value ≥of 36 mg/L had 61% sensitivity and 100% specificity. There was a significant decrease of both, ascitic MIP-1β and ascetic fluid PMN after treatment of SBP. Conclusions: Ascitic fluid MIP-1β is highly sensitive and specific in the diagnosis of SBP-especially when combined with CRP. Patients and methods This is a prospective case-control study that included 53 cirrhotic patients with ascites. The patients were classified into two groups; Group (1) included 33 patients with ascitic fluid PMN > 250/mm 3 (SBP group), and group (2) included 20 patients with an ascitic neutrophil count below 250 cells/mm 3 and-ve culture (Non-SBP group). Our patients were admitted to Specialized Medical Hospital, Mansoura University from January 2016 till the end of January 2017. All patients were above 18 years. Patients who had hepatocellular carcinoma, extrahepatic malignancy, recent abdominal surgery, hemoperitoneum, recent antibiotic therapy (within 48 hours before admission) chronic dialysis, acute pancreatitis, autoimmune diseases, organ transplant, HIV infections, or having other infections were excluded from the study. All patients underwent a thorough clinical evaluation (history taking, general and systemic examination). Laboratory tests, including complete CBC, serum creatinine, liver function tests, serum CRP, and urine analysis, radiological investigations (abdominal ultrasound, chest-X ray, and Triphasic CT when indicated) were done. Ascitic fluid analysis and culture were done at index

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Macrophage Inflammatory Protein Type 1 Beta as a Novel Diagnostic Marker for Diagnosis of Spontaneous Bacterial Peritonitis

Mahmoud

El-gharabawy

Elhelaly

et al. 2021

Medical Journal of Viral Hepatitis

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“…Culture examination of ascitic fluid takes 24-48 hours which causes a delay in the diagnosis and initiation of treatment. 4 Hence, for the early diagnosis of SBP the evaluation of clinical and laboratory parameters are of great clinical importance. SBP is an ascitic fluid infection without any surgically treatable intra-abdominal cause.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of diagnostic accuracy of C-Reactive protein as a biomarker of spontaneous bacterial peritonitis in patients having decompensated chronic liver disease.

Raja

Kiyani²,

Rehman

et al. 2021

TPMJ

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Objective: The objective of this study was to evaluate the diagnostic accuracy of C Reactive Protein (CRP) in diagnosing spontaneous bacterial peritonitis (SBP) in patients with decompensated chronic liver disease. Study Design: Cross Sectional study. Setting: Department of Medicine Sheikh Khalifa Bin Zayed Hospital Rawalakot Azad Kashmir. Period: Feb 2018 to Dec 2018. Material & Methods: One hundred subjects with decompensated liver disease were recruited in this study after fulfilling inclusion criteria. The patients’ medical record number, age and gender was recorded upon admission. Baseline investigations including complete blood count, urine examination and chest X ray were done. Abdominal ultrasound was performed for detecting the presence of ascitic fluid. SBP was diagnosed if > 250 mm3 neutrophils are detected in the ascitic fluid. Serum CRP was detected and reported in mg/L. Results: SBP was detected in 32.8% of the patients having decompensated chronic liver disease. CRP levels were > 29.5mg/L in 36% of the patients while in 64% patients the CRP levels were < 29.5mg/L. The sensitivity of CRP for the diagnosis of SBP was calculated as 83.61% while the specificity was calculated as 87.2%. A positive predictive value was estimated as 76.12% and a negative predictive value was 91.59% while the diagnostic accuracy was calculated as 86.02% from the given data. Conclusion: CRP is a reliable diagnostic biomarker for spontaneous bacterial peritonitis in subjects having complications of chronic liver disease.

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Predictors of Ascetic Fluid Infection in Cirrhotic Patients

Abstract: AIM:The aim of this study is to evaluate the diagnostic and prognostic value of serum Hs-CRP and platelet indices (mean platelet volume and platelet distribution width) in cirrhotic patients with clinical suspicion of spontaneous bacterial peritonitis.

Cited by 2 publications

References 7 publications

Macrophage Inflammatory Protein Type 1 Beta as a Novel Diagnostic Marker for Diagnosis of Spontaneous Bacterial Peritonitis

Macrophage Inflammatory Protein Type 1 Beta as a Novel Diagnostic Marker for Diagnosis of Spontaneous Bacterial Peritonitis

Evaluation of diagnostic accuracy of C-Reactive protein as a biomarker of spontaneous bacterial peritonitis in patients having decompensated chronic liver disease.

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