Evaluation of reagent strips for ascitic fluid leukocyte determination: is it a possible alternative for spontaneous bacterial peritonitis rapid diagnosis?

• Main Authors: Tarsila C.R. Ribeiro, Mario Kondo, Ana Cristina C. Amaral, Edson Roberto Parise, Maurício A. Bragagnolo Júnior, Aécio Flávio Meirelles de Souza
• Format: Article
• Language: English
• Published: Elsevier
• Series: Brazilian Journal of Infectious Diseases
• Subjects: Ascitic fluid; rapid diagnosis; dipstick; bacterial peritonitis
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702007000100017&lng=en&tlng=en

In order to evaluate the accuracy of a urine reagent dipstick (Multistix 10SG®) to determine ascitic fluid leukocyte count, we prospectively studied 106 cirrhotic patients from April 2003 to December 2004, in two different centers (Federal University of São Paulo - UNIFESP-EPM and Federal University of Juiz de Fora - HU-UFJF) for the rapid bedside diagnosis of spontaneous bacterial peritonitis. The mean age 54 ± 12 years, there was a predominance of males (eighty-two patients, 77%), and alcohol was the most frequent etiology (43%). Forty-four percent of patients were classified as Child B and fifty-one as Child C (51%). Abdominal paracentesis was performed both in outpatient and inpatient settings and the Multistix 10SG® was tested. Eleven cases of spontaneous bacterial peritonitis were identified by means of polymorphonuclear count. If we considered the positive Multistix 10SG® result of 3 or more, the sensitivity, specificity, positive and negative predictive value were respectively 71%, 99%, 91% and 98%. With a positive reagent strip result taken as grade 2 (traces) or more, sensitivity was 86% and specificity was 96% with positive and negative predictive values of 60% and 99%, respectively. Diagnostic accuracy was 95%. We concluded that the use of a urine reagent dipstick (Multistix 10SG®) could be considered a quick, easy and cheap method for ascitic fluid cellularity determination in SBP diagnosis.