Rapid Diagnosis of Infected Ascitic Fluid Using Leukocyte Esterase Dipstick Testing

Butani, Raj C.; Shaffer, Richard T.; Szyjkowski, Ronald; Weeks, Barbara E.; Speights, Linda G.; Kadakia, Shailesh C.

doi:10.1111/j.1572-0241.2004.04084.x

Cited by 49 publications

(44 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…24 Our study showed less sensitivity but high specificity and NPV ( Table 2). The result of our study was nearly similar to studies published by Butani et al and Ribeiro et al 14,20 Our study expands previous findings of the potential utility of the LERS test as a simple, rapid and inexpensive means for testing in settings involving SBP. If we compare two cut-offs ($++ and +++) used by us, both had performed fairly well for the diagnosis of SBP.…”

Section: Uriscansupporting

confidence: 82%

“…Compared with the manual PMN count ('gold standard'), LERS were found to have sensitivity ranging from 45 to 100%, specificity ranging from 81 to 100%, PPV value ranging from 42 to 100% and NPV ranging from 87 to 100%. [4][5][6][11][12][13][14][15][16][17][18][19][20][21][22][23][24] Similarly, the published studies in which Multistix reagent strips were used have also shown widely variable test results (Table 3). 4,[12][13][14][17][18][19][20]24 In an only study from India, authors have shown the Multistix strip's sensitivity, specificity, PPV and NPV of 97%, 89%, 87% and 83% respectively using a cut-off of grade 2.…”

Section: Uriscanmentioning

confidence: 99%

See 1 more Smart Citation

Multistix 10 SG Leukocyte Esterage Dipstick Testing in Rapid Bedside Diagnosis of Spontaneous Bacterial Peritonitis: A Prospective Study

Jha

Kumawat

Bolya

et al. 2012

Journal of Clinical and Experimental Hepatology

View full text Add to dashboard Cite

Background and Aims: Spontaneous bacterial peritonitis (SBP) requires rapid diagnosis and the initiation of antibiotics. Diagnosis of SBP is usually based on cytobacteriological examination of ascitic fluid. These tests require good laboratory facilities and reporting time of few hours to 1-2 day. However, the 24 h laboratory facilities not widely available in country like India. We evaluated the diagnostic utility of reagent strip (Multistix 10 SG Ò ) for

show abstract

Section: Uriscansupporting

confidence: 82%

Section: Uriscanmentioning

confidence: 99%

Multistix 10 SG Leukocyte Esterage Dipstick Testing in Rapid Bedside Diagnosis of Spontaneous Bacterial Peritonitis: A Prospective Study

Jha

Kumawat

Bolya

et al. 2012

Journal of Clinical and Experimental Hepatology

View full text Add to dashboard Cite

show abstract

“…The first study [36] , published in 2002, involved 72 cirrhotic patients, nine of whom had SBP, reported a sensitivity and a specificity of 100% for the urinary strips in the diagnosis of SBP. After this successful result, in the following years a number of reports [37][38][39][40][41][42][43][44][45][46][47][48][49][50][51] evaluated the urine strip test for the diagnosis of SBP (Table 2). These studies reported promising and encouraging results, with the sensitivity of urinary strips for the diagnosis of SBP ranging between 85% and 100% and the specificity between 90 and 100%.…”

Section: The Determination Of Pmn Cells In the Ascitic Fluidmentioning

confidence: 99%

Ascitic fluid analysis for diagnosis and monitoring of spontaneous bacterial peritonitis

Riggio¹,

Angeloni²

2009

WJG

View full text Add to dashboard Cite

Polymorphonuclear (PMN) cell count in the ascitic fluid is essential for the diagnosis and management of spontaneous bacterial peritonitis (SBP). To date, PMN cell count is routinely performed by traditional manual counting. However, this method is time-consuming, costly, and not always timely available. Therefore, considerable efforts have been made in recent years to develop an alternative test for a more rapid diagnosis and monitoring of SBP. The use of urinary reagent strips was proposed to achieve an "instant" bedside diagnosis of SBP. A series of reports evaluated the urine strip test for SBP diagnosis and reported promising results. However, a recent large multicenter study revealed a surprising lack of diagnostic efficacy of the urine screening test for SBP diagnosis. Another method, more recently proposed as an alternative to the manual PMN count, is the measurement of lactoferrin in ascitic fluid, but the data available on the diagnostic value of this test are limited to a single study. However, both urinary reagent strips and ascitic lactoferrin tests are qualitative methods and need, therefore, to be further confirmed by standard cytology of the ascitic fluid. To date, the only quantitative method proposed as a valid alternative to manual PMN counting is automated blood cell counters, commonly used in all laboratories for blood cell counting. Data available in the literature on the diagnostic performance of this method are limited but very promising, and this tool seems to have the potential to replace the manual counting method.

show abstract

“…In these cases, some guidelines recommend antibiotic treatment only if the patient shows signs of infection [8] . Leukocyte reagent strips have been suggested as a rapid screening test for the diagnosis of SBP at the bedside [23][24][25][26] . However, sensitivity varying between 45% and 100%, makes this method suboptimal for the diagnosis of SBP.…”

Section: Diagnosis Of Spontaneous Bacterial Peritonitismentioning

confidence: 99%

Diagnosis and management of bacterial infections in decompensated cirrhosis

Pleguezuelo

Benítez²,

Jurado³

et al. 2013

WJH

View full text Add to dashboard Cite

Bacterial infections are one of the most frequent complications in cirrhosis and result in high mortality rates. Patients with cirrhosis have altered and impaired immunity, which favours bacterial translocation. Episodes of infections are more frequent in patients with decompensated cirrhosis than those with compensated liver disease. The most common and life-threatening infection in cirrhosis is spontaneous bacterial peritonitis followed by urinary tract infections, pneumonia, endocarditis and skin and soft-tissue infections. Patients with decompensated cirrhosis have increased risk of developing sepsis, multiple organ failure and death. Risk factors associated with the development of infections are severe liver failure, variceal bleeding, low ascitic protein level and prior episodes of spontaneous bacterial peritonitis (SBP). The prognosis of these patients is closely related to a prompt and accurate diagnosis. An appropriate treatment decreases the mortality rates. Preventive strategies are the mainstay of the management of these patients. Empirical antibiotics should be started immediately following the diagnosis of SBP and the first-line antibiotic treatment is third-generation cephalosporins. However, the efficacy of currently recommended empirical antibiotic therapy is very low in nosocomial infections including SBP, compared to community-acquired episodes. This may be associated with the emergence of infections caused by Enterococcus faecium and extended-spectrum β-lactamaseproducing Enterobacteriaceae, which are resistant to the first line antimicrobial agents used for treatment. The emergence of resistant bacteria, underlines the need to restrict the use of prophylactic antibiotics to patients with the greatest risk of infections. Nosocomial infections should be treated with wide spectrum antibiotics. Further studies of early diagnosis, prevention and treatment are needed to improve the outcomes in patients with decompensated cirrhosis.

show abstract

Rapid Diagnosis of Infected Ascitic Fluid Using Leukocyte Esterase Dipstick Testing

Abstract: The Multistix leukocyte esterase test is useful for the prompt detection of an elevated ascitic fluid PMN count, and represents a convenient new method for the rapid diagnosis of infected ascitic fluid.

Cited by 49 publications

References 22 publications

Multistix 10 SG Leukocyte Esterage Dipstick Testing in Rapid Bedside Diagnosis of Spontaneous Bacterial Peritonitis: A Prospective Study

Multistix 10 SG Leukocyte Esterage Dipstick Testing in Rapid Bedside Diagnosis of Spontaneous Bacterial Peritonitis: A Prospective Study

Ascitic fluid analysis for diagnosis and monitoring of spontaneous bacterial peritonitis

Diagnosis and management of bacterial infections in decompensated cirrhosis

Contact Info

Product

Resources

About