Session Title: Category 2b. CIRRHOSIS AND ITS COMPLICATIONS: b. CLINICAL ASPECTS
BEDSIDE REAGENT STRIP ANALYSIS OF ASCITES CAN RELIABLY RULE OUT SPONTANEOUS BACTERIAL PERITONITIS AND IS A COST-EFFECTIVE STRATEGY
J.J. Kuiper*, H.R. van Buuren, R.A. de Man
Background/aims: Spontaneous bacterial peritonitis (SBP) is a serious complication in patients with decompensated cirrhosis of the liver. Timely diagnosis of SBP is essential to prevent complications like sepsis and hepatorenal syndrome. The golden standard for diagnosis of SBP is an ascitic polymorphonuclear (PMN) count ≥ 250/mm3, but this test is time-consuming and is not uniformly available, especially during after-office hours. Reagent strip testing of ascites for diagnosing SBP may be a promising bedside diagnostic tool. The aim of this study was to assess the reliability of reagent strip testing for diagnosing or excluding SBP and to assess its clinical implication.
Conclusion: In this population with a relatively low prevalence of SPB a negative reagent strip result reliably ruled out SBP. A positive test should be followed by conventional work-up (PMN-count and culture). Using an automated analyzer was not superior to standard visual reading of the strips. Using reagent strips would have obviated the need for more laborious and expensive laboratory studies in more than 90 cases. This suggests that using this simple and quick bedside test may result in a significant lowering of costs.