EFFICACY OF ASCITIC ACID DIPSTICK LEUKOCYTE ESTERASE ACTIVITY IN EARLY DIAGNOSIS OF SPONTANEOUS BACTERIAL PERITONITIS

Background: Spontaneous bacterial peritonitis is serious medical complication associated with advanced stage of hepatic cirrhosis and requires quick diagnosis for initiating appropriate antibiotics. Leukocyte esterase reagent dipstick works upon esterase activity of activated granulocytes. This enzyme functions by undergoing reaction with an ester‑releasing hydroxyphenylpyrrole which causes color changes in azo dye coated reagent strip. Aim:The aim of present study was to assess the diagnostic importance of leukocyte esterase reagent dipstick in ascitic fluid for diagnosis of SBP. Materials and Methods: Ascitic fluid sample were obtained from 100 hospitalized patients with liver cirrhosis. PMNL cell count was performed and results were compared with Leukocyte Esterase Dipstick strip test. The strips were observed in 90 seconds by comparing with colorimetric grade scale (from 0 to 4). Results: 99.1% specificity, 100% sensitivity, 93% PPV and 100% NPV were obtained for diagnosing SBP. Conclusion: Leukocytic esterase reagent (dipstick test) is a specific, quick, less expensive as well as simple bed-side method for arriving at diagnosis of spontaneous bacterial peritonitis. Negative strip test can be used for excluding a SBP diagnosis.