USE OF URINARY DIPSTICK (LEUCOCYTE ESTERASE) FOR DIAGNOSIS OF SPONTANEOUS BACTERIAL PERITONITIS

Spontaneous bacterial peritonitis (SBP) a life-threatening complication of ascites needs rapid diagnosis and initiation of antibiotics. Diagnosis of SBP employs cytobacteriological analysis of ascitic uid which requires good laboratory facilities that can take few hours to 1–2 days to report the results . 24 hr laboratory facilities are not widely available in India . We evaluated the diagnostic utility of reagent strip (Multistix 10 SG®) for rapid diagnosis of SBP. Ours was a cross-sectional diagnostic accuracy study prospectively carried out on patients of cirrhosis with ascites admitted in a tertiary care referral centre. Multistix 10SG strip testing was done on ascitic uid. Cell count as determined by colorimetric scale of reagent strip was compared with counting chamber method. Sensitivity, specicity, positive and negative predictive values were calculated. Of the 100 patients with cirrhotic ascites, [7 females:93 males] 52 subjects were diagnosed as having SBP by the counting chamber method as compared to 51 patients detected to have SBP by Multistix 10 SG test ( 3+ positive). The sensitivity, specicity, positive and negative predictive values of reagent strip 3+ positive were 98%,100%, 100% and 97.9% respectively compared to counting chamber method. Multistix 10SG is very specic and sensitive when compared to counting chamber method in diagnosis of SBP. This can be done easily and rapidly giving the result in 2 minutes which allows its use as a diagnostic tool for SBP and permits rapid initiation of antibiotic therapy