Diagnosis of spontaneous bacterial peritonitis in cirrhotic patients in northeastern Brazil by use of rapid urine-screening test
CONTEXT AND OBJECTIVE: Spontaneous bacterial peritonitis (SBP) is a frequent and severe complication of cirrhotic patients with ascites. It has been proposed that the reagent strip for leukocyte esterase designed for the testing of urine (Combur test® UX) could be a useful tool for diagnosing SPB. T...
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| Format: | Article |
| Language: | English |
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Associação Paulista de Medicina
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| Series: | São Paulo Medical Journal |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802006000300006&lng=en&tlng=en |
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| author | Lucia Libanez Bessa Campelo Braga Marcellus Henrique Loiola Ponte de Souza Alzira Maria de Castro Barbosa Felipe Magalhães Furtado Paula Andréa Maia Campelo Antônio Haroldo de Araújo Filho |
| author_facet | Lucia Libanez Bessa Campelo Braga Marcellus Henrique Loiola Ponte de Souza Alzira Maria de Castro Barbosa Felipe Magalhães Furtado Paula Andréa Maia Campelo Antônio Haroldo de Araújo Filho |
| author_sort | Lucia Libanez Bessa Campelo Braga |
| collection | DOAJ |
| description | CONTEXT AND OBJECTIVE: Spontaneous bacterial peritonitis (SBP) is a frequent and severe complication of cirrhotic patients with ascites. It has been proposed that the reagent strip for leukocyte esterase designed for the testing of urine (Combur test® UX) could be a useful tool for diagnosing SPB. The aim of this study was to assess the sensitivity and specificity of urine test strips for diagnosing SBP in cirrhotic patients with ascites. DESIGN AND SETTING: Prospective study, at a university hospital in northeastern Brazil. METHODS: Forty-two unselected consecutive cirrhotic patients (32 males; mean age: 51.7 ± years) were included, and a total of 100 paracenteses were performed. All ascitic fluid samples were analyzed using the reagent strip and cytology, neutrophils, lymphocyte count, appropriate biochemical tests and culturing. The strips were considered positive if the color became purple on a colorimetric scale. RESULTS: Nine patients were diagnosed with SBP using cytology (> 250 neutrophils/mm³), and the strips were positive for all these nine patients with SBP. In one sample, the strip was positive but the neutrophil count was less than 250 cells/mm³. For 86 samples, both the strips and cytology were negative. At the threshold of 250 neutrophils/mm³ in ascitic fluid, the sensitivity, specificity, positive predictive value and negative predictive value for the strips were respectively 100%, 98.9%, 92.3% and 100%. CONCLUSION: The Combur test® UX urine screening test is a very sensitive and specific method for diagnosing SBP in cirrhotic patients with ascites. |
| first_indexed | 2024-12-10T18:20:56Z |
| format | Article |
| id | doaj.art-ecd45eafe44c41fea2ac8b3b8676c786 |
| institution | Directory Open Access Journal |
| issn | 1806-9460 |
| language | English |
| last_indexed | 2024-12-10T18:20:56Z |
| publisher | Associação Paulista de Medicina |
| record_format | Article |
| series | São Paulo Medical Journal |
| spelling | doaj.art-ecd45eafe44c41fea2ac8b3b8676c7862022-12-22T01:38:13ZengAssociação Paulista de MedicinaSão Paulo Medical Journal1806-9460124314114410.1590/S1516-31802006000300006S1516-31802006000300006Diagnosis of spontaneous bacterial peritonitis in cirrhotic patients in northeastern Brazil by use of rapid urine-screening testLucia Libanez Bessa Campelo Braga0Marcellus Henrique Loiola Ponte de Souza1Alzira Maria de Castro Barbosa2Felipe Magalhães Furtado3Paula Andréa Maia Campelo4Antônio Haroldo de Araújo Filho5Universidade Federal do CearáUniversidade Federal do CearáUniversidade Federal do CearáUniversidade Federal do CearáUniversidade Federal do CearáUniversidade Federal do CearáCONTEXT AND OBJECTIVE: Spontaneous bacterial peritonitis (SBP) is a frequent and severe complication of cirrhotic patients with ascites. It has been proposed that the reagent strip for leukocyte esterase designed for the testing of urine (Combur test® UX) could be a useful tool for diagnosing SPB. The aim of this study was to assess the sensitivity and specificity of urine test strips for diagnosing SBP in cirrhotic patients with ascites. DESIGN AND SETTING: Prospective study, at a university hospital in northeastern Brazil. METHODS: Forty-two unselected consecutive cirrhotic patients (32 males; mean age: 51.7 ± years) were included, and a total of 100 paracenteses were performed. All ascitic fluid samples were analyzed using the reagent strip and cytology, neutrophils, lymphocyte count, appropriate biochemical tests and culturing. The strips were considered positive if the color became purple on a colorimetric scale. RESULTS: Nine patients were diagnosed with SBP using cytology (> 250 neutrophils/mm³), and the strips were positive for all these nine patients with SBP. In one sample, the strip was positive but the neutrophil count was less than 250 cells/mm³. For 86 samples, both the strips and cytology were negative. At the threshold of 250 neutrophils/mm³ in ascitic fluid, the sensitivity, specificity, positive predictive value and negative predictive value for the strips were respectively 100%, 98.9%, 92.3% and 100%. CONCLUSION: The Combur test® UX urine screening test is a very sensitive and specific method for diagnosing SBP in cirrhotic patients with ascites.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802006000300006&lng=en&tlng=enCirrhosisAscitesDiagnosisPeritonitisReagent stripsUrinalysis |
| spellingShingle | Lucia Libanez Bessa Campelo Braga Marcellus Henrique Loiola Ponte de Souza Alzira Maria de Castro Barbosa Felipe Magalhães Furtado Paula Andréa Maia Campelo Antônio Haroldo de Araújo Filho Diagnosis of spontaneous bacterial peritonitis in cirrhotic patients in northeastern Brazil by use of rapid urine-screening test São Paulo Medical Journal Cirrhosis Ascites Diagnosis Peritonitis Reagent strips Urinalysis |
| title | Diagnosis of spontaneous bacterial peritonitis in cirrhotic patients in northeastern Brazil by use of rapid urine-screening test |
| title_full | Diagnosis of spontaneous bacterial peritonitis in cirrhotic patients in northeastern Brazil by use of rapid urine-screening test |
| title_fullStr | Diagnosis of spontaneous bacterial peritonitis in cirrhotic patients in northeastern Brazil by use of rapid urine-screening test |
| title_full_unstemmed | Diagnosis of spontaneous bacterial peritonitis in cirrhotic patients in northeastern Brazil by use of rapid urine-screening test |
| title_short | Diagnosis of spontaneous bacterial peritonitis in cirrhotic patients in northeastern Brazil by use of rapid urine-screening test |
| title_sort | diagnosis of spontaneous bacterial peritonitis in cirrhotic patients in northeastern brazil by use of rapid urine screening test |
| topic | Cirrhosis Ascites Diagnosis Peritonitis Reagent strips Urinalysis |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802006000300006&lng=en&tlng=en |
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