Diagnostic Laboratory Markers for Spontaneous Bacterial Peritonitis

Shizuma, Toru

doi:10.21767/2386-5180.1000131

Cited by 10 publications

(8 citation statements)

References 48 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: 98%

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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: 98%

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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“…high-sensitive C-reactive protein have been investigated for the diagnosis of SBP and their diagnostic usefulness is still limited and large-scale studies are needed [7].…”

Section: Figurementioning

confidence: 99%

Ascitic calprotectin as a diagnostic marker for spontaneous bacterial peritonitis in hepatitis C virus cirrhotic Egyptian patients

et al. 2018

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Background The gold standard for the diagnosis of spontaneous bacterial peritonitis (SBP) is a polymorphonuclear leukocyte (PMNL) count of 250/mm 3 or more. Accurate and early diagnosis of SBP is important to decrease the mortality and complications in patients with cirrhosis. Aims The aim of this study was to evaluate the accuracy of ascitic fluid calprotectin as a diagnostic marker for the detection of SBP. Patients and methods Seventy Egyptian patients with liver cirrhosis and ascites were enrolled; these patients were divided into two groups: 50 patients with SBP and 20 patients with no SBP on the basis of an elevated ascitic PMNL count of 250 cells/mm 3 or more. Ascitic samples were examined for PMNL count, culture, chemistry, and calprotectin concentrations in all patients. Results Calprotectin levels in ascitic fluid were correlated significantly with PMNLs and significantly higher in patients with SBP than non-SBP (P<0.001), with the best cutoff value for the detection of SBP of 783 ng/ml with a sensitivity, a specificity, a positive predictive value and negative predictive value, and an accuracy of 90, 100, 100, 80, and 92.9%, respectively. Conclusion Elevated ascitic calprotectin levels in cirrhotic patients are a diagnostic and reliable marker for the detection of SBP and considered a surrogate marker for PMNL.

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“…Therefore, these tests may also be performed at the first paracentesis in cases of suspected spontaneous peritonitis. Biomarkers, such as procalcitonin level and leukocyte esterase reagent strips, can help diagnose SBP [20] but may not distinguish between SFP and SBP.…”

Section: Diagnosis Of Sfp and Fungiascitesmentioning

confidence: 99%

Spontaneous Fungal Peritonitis in Patients with Liver Cirrhosis

Shizuma¹

2019

J Liver

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Although spontaneous peritonitis is a common infection in liver cirrhosis patients, little is known about the clinical characteristics and treatments of spontaneous fungal peritonitis (SFP) or fungiascites. Although diagnosis of SFP or fungiascites is made according to the cell counts and culture in ascitic fluid, delayed diagnosis has been associated with poor prognosis of SFP. Risk factors for SFP include severe underlying liver dysfunction, hospitalization and nosocomial infections. SFP mortality rates have been estimated as higher than those of spontaneous bacterial peritonitis. Although early administration of appropriate antifungal agents may be necessary, it remains uncertain whether antifungal therapies would decrease SFP's mortality rate.

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Diagnostic Laboratory Markers for Spontaneous Bacterial Peritonitis

Cited by 10 publications

References 48 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

Ascitic calprotectin as a diagnostic marker for spontaneous bacterial peritonitis in hepatitis C virus cirrhotic Egyptian patients

Spontaneous Fungal Peritonitis in Patients with Liver Cirrhosis

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