Sensitivity of a bedside reagent strip for the detection of spontaneous bacterial peritonitis in ED patients with ascites

Chinnock, Brian; Woolard, Robert; Hendey, Gregory W.; Crawford, Scott B.; Mainis, L.; Vo, Daniel; Wells, Radosveta; Ramirez, R.; Bengiamin, Deena

doi:10.1016/j.ajem.2019.01.044

Cited by 4 publications

(8 citation statements)

References 9 publications

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“…For the diagnosis of SBP among patients with liver cirrhosis, previous studies mostly suggest that the LERS of urine and peritoneal dialysate have relatively high NPV. The NPV of urine LERS ranges between 87 and 100% [18], whereas the NPV and sensitivity for peritoneal dialysate LERS range from 99 to 100% and from 91.7 to 100%, respectively [11–13]. These results indicate that when using LERS to diagnose SBP among patients with liver cirrhosis, the proportion of true-negative cases is relatively high.…”

Section: Discussionmentioning

confidence: 99%

“…The ascites samples were stored in clean and dry test tubes. The indicator pad of a periscreen strip (Serim Research Corporation, Elkhart, Indiana, USA) was completely immersed in 2 mL ascites samples and was immediately removed in less than 1 s. After 3 min, the color of the indicator pad was compared against a color chart [11][12][13]. The color of the strip was classified into the colorimetric graduations 'negative', 'trace', 'small', and 'large', which were denoted by colors ranging from light yellow to deep purple.…”

Section: Patient Enrollment and Measurements Of Leukocyte Esterase Re...mentioning

confidence: 99%

“…Two types of leukocyte esterase reagent strips (LERS) for urine and peritoneal dialysate have been examined in previous studies as presumptive indicators of SBP among patients with liver cirrhosis [10][11][12][13]. The granulocytic leukocyte esterase in ascites reacts with chemical compounds, thereby causing a color change in LERS.…”

Section: Introductionmentioning

confidence: 99%

“…However, the performance of urine LERS has attracted controversy due to several factors, including the positive definition of LERS, brand of strips, PMN cell count, and interference of hemorrhagic or chylous ascites [10,14]. As a promising alternative, periscreen strips, which are initially used for diagnosing infection in peritoneal dialysate [15], show high sensitivity and negative predictive value (NPV) for the rapid diagnosis of SBP among cirrhotic outpatients, inpatients, and emergency department patients [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

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The periscreen strip is an accurate and rapid method to diagnose spontaneous bacterial peritonitis among patients with acute-on-chronic liver failure

Su²,

Hu³

2020

European Journal of Gastroenterology &Amp; Hepatology

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Background Leukocyte esterase reagent strips may help diagnose spontaneous bacterial peritonitis (SBP), but their effective application among patients with acute-on-chronic liver failure (ACLF) remains unknown. Aim This study aimed to assess the performance of periscreen strips in the rapid diagnosis of SBP among patients with ACLF. Methods Periscreen strips were used to test 261 ascites samples taken from 251 inpatients with ACLF between January 2014 and June 2019. The colors of the reagent strip were divided into four colorimetric graduations (‘negative’, ‘trace’, ‘small’, and ‘large’), among which ‘trace’ is used as the SBP detection threshold. The polymorphonuclear neutrophils (PMN) of ascites ≥250/mm3 was used as the gold standard for SBP diagnosis. Results SBP was detected in 92 (35.2%) ascite samples. The ascites PMN count of ‘negative’ (32.5/mm3) was lower than those of ‘trace’ (248.2/mm3), ‘small’ (379.0/mm3), and ‘large’ (7426.0/mm3) (P < 0.001). The colorimetric graduations of the strips were positively correlated with ascites PMN count (r = 0.867, P < 0.001). Periscreen strips had 100% sensitivity, 91.1% specificity, 86.0% positive predictive value, 100% negative predictive value, 11.3 positive likelihood ratios, and 0 negative likelihood ratios. For patients with negative results judged by the gold standard, ascites white blood cells count [odds ratio (OR) = 1.007) and ascites PMN count (OR = 1.028) were independent predictors of false-positive cases. Conclusion Liver failure did not affect the diagnostic performance of periscreen strips. Therefore, these strips can efficiently and rapidly diagnose SBP among patients with ACLF.

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Section: Discussionmentioning

confidence: 99%

Section: Patient Enrollment and Measurements Of Leukocyte Esterase Re...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The periscreen strip is an accurate and rapid method to diagnose spontaneous bacterial peritonitis among patients with acute-on-chronic liver failure

Su²,

Hu³

2020

European Journal of Gastroenterology &Amp; Hepatology

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“…1) LE strip test was first employed for the rapid screening and diagnosis of urinary tract infections [14][15][16][17]. Thereafter, it has been widely used in the fields of the digestive system [18][19][20][21][22], gynecological system [23], nervous system [24][25][26], and otolaryngology system [27,28]. It detects body fluids, such as, ascites, gynecological secretions, cerebrospinal fluids and sputum.…”

Section: Introductionmentioning

confidence: 99%

Application of leukocyte esterase strip test in the screening of periprosthetic joint infections and prospects of high-precision strips

Zheng

Zhang

2020

Arthroplasty

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Periprosthetic joint infection (PJI) represents one of the most challenging complications after total joint arthroplasty (TJA). Despite the availability of a variety of diagnostic techniques, the diagnosis of PJI remains a challenge due to the lack of well-established diagnostic criteria. The leucocyte esterase (LE) strips test has been proved to be a valuable diagnostic tool for PJI, and its weight in PJI diagnostic criteria has gradually increased. Characterized by its convenience, speed and immediacy, leucocyte esterase strips test has a prospect of broad application in PJI diagnosis. Admittedly, the leucocyte esterase strips test has some limitations, such as imprecision and liability to interference. Thanks to the application of new technologies, such as machine reading, quantitative detection and artificial intelligence, the LE strips test is expected to overcome the limitations and improve its accuracy.

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Performance of Leukocyte Esterase Reagent Strips in the Detection of Spontaneous Bacterial Peritonitis in Cirrhotic Patients: A Systematic Review and Meta-analysis

Patel

Gallagher

Korbitz

et al. 2022

Journal of Clinical and Experimental Hepatology

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Background: Spontaneous bacterial peritonitis (SBP) is a bacterial infection associated with a high mortality rate in cirrhotic patients. The gold standard for the detection of SBP is a manual cell count from ascitic fluid; however, alternative screening methods are under investigation. In particular, leukocyte esterase reagent strips (LERS) has been studied as an alternative method to detect SBP with a low cost and instant turnaround time. Therefore, this study aims to evaluate the performance of LERS in the detection of SBP. Methods: A literature search was performed for studies evaluating LERS for the detection of SBP on PubMed, Embase, Scopus, Cochrane, and clinical trial registries. Summary sensitivity, specificity, log diagnostic odds ratio (LDOR), and the area under the summary receiver operating curve (AUC) were calculated according to the respective manufacturer.

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Sensitivity of a bedside reagent strip for the detection of spontaneous bacterial peritonitis in ED patients with ascites

Cited by 4 publications

References 9 publications

The periscreen strip is an accurate and rapid method to diagnose spontaneous bacterial peritonitis among patients with acute-on-chronic liver failure

The periscreen strip is an accurate and rapid method to diagnose spontaneous bacterial peritonitis among patients with acute-on-chronic liver failure

Application of leukocyte esterase strip test in the screening of periprosthetic joint infections and prospects of high-precision strips

Performance of Leukocyte Esterase Reagent Strips in the Detection of Spontaneous Bacterial Peritonitis in Cirrhotic Patients: A Systematic Review and Meta-analysis

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