• Thierry Sapey, Edward Mena, Eric Fort, Christine Laurin, Denis Kabissa, Bruce A Runyon, and Michel-Henry Mendler.
• Service Hepatogastroenterologie, Center Hospitalier General de Chateauroux, 216 Avenue de Verdun, 36000 Chateauroux, France. thierrysapey@hotmail.com
• J. Gastroenterol. Hepatol. 2005 Feb 1; 20 (2): 187-92.

BackgroundTimely diagnosis and treatment of spontaneous bacterial peritonitis (SBP) are essential to survival. The purpose of the present paper was to evaluate leukocyte esterase reagent strips (Nephur-Test and MultistixSG10) in the bedside diagnosis of SBP.MethodsPatients with cirrhotic ascites were prospectively included in France (center 1) and in the USA (center 2). Paracenteses were performed on admission and repeated as indicated. Bedside reagent strip testing was performed on the ascitic fluid and compared to manual cell count with differential and ascitic fluid culture. In center 1, the Nephur-Test was tested in all cases, with dual testing with MultistixSG10 in a subgroup. In center 2, all cases had dual testing. Spontaneous bacterial peritonitis was defined as a polymorphonuclear ascites count > or =250/microL.ResultsA total of 184 samples was obtained in 76 patients. Center 1 included 151 samples from 53 patients. Seven samples had SBP, obtained in six patients. Center 2 included 33 samples from 23 patients. Six samples had SBP, obtained in five patients. The sensitivity, specificity, positive and negative predictive value of the reagent strips were as follows. Center 1/Nephur-Test: 86%, 100%, 100%, 99%; center 1/MultistixSG10: 100%, 100%, 100%, 100%; center 2/Nephur-Test: 100%, 92.5%, 75%, 100%; center 2/MultistixSG10: 83%, 96%, 83%, 96%.ConclusionLeukocyte esterase reagent strips may provide a rapid bedside diagnosis of SBP.

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