Publication:

Study comparing rapid diagnostic test with conventional method in diagnosis of spontaneous bacterial peritonitis in liver cirrhosis

Background Spontaneous bacterial peritonitis (SBP) is a severe and frequent complication of liver cirrhosis with ascites. Conventional diagnostic methods such as manual polymorphonuclear leukocyte (PMN) count and ascitic fluid culture are time-consuming, delaying treatment. Rapid diagnostic tests based on leukocyte esterase activity offer a simple bedside alternative. This study aimed to assess the diagnostic accuracy of a rapid reagent strip test compared with the conventional method in detecting SBP.

Methods A hospital-based observational study was conducted among 104 patients with liver cirrhosis and new-onset ascites admitted to a tertiary care center between August 2022 and August 2024. Ascitic fluid from each patient was analyzed by both conventional PMN count and leukocyte esterase reagent strip testing. Diagnostic parameters including sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated using SPSS v24.

Results SBP was detected in 15 (14.4%) patients by the conventional method and in 23 (22.1%) using the rapid test. The rapid diagnostic test demonstrated a sensitivity of 100%, specificity of 91.01%, PPV of 65.21% and NPV of 100%.

Conclusions The leukocyte esterase reagent strip test provides a rapid, inexpensive and reliable alternative for early bedside diagnosis of SBP in cirrhotic patients. Its excellent sensitivity and high NPV make it particularly useful in resource-limited and emergency settings for timely initiation of treatment.