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Article Dans Une Revue Hepatology Année : 2007

Diagnostic accuracy of the Multistix 8 SG reagent strip in diagnosis of spontaneous bacterial peritonitis.

Eric Nguyen Khac
Richard Moreau
  • Fonction : Auteur
Christine Silvain
Olivier Nouel
  • Fonction : Auteur
Christophe Pilette
  • Fonction : Auteur
Thierry Paupard
  • Fonction : Auteur
Geoffroy Vanbiervliet
  • Fonction : Auteur
Thierry Davion
  • Fonction : Auteur
Vincent Jouannaud
  • Fonction : Auteur
Bruno Roche
  • Fonction : Auteur
Sandrine Beaulieu
  • Fonction : Auteur
Odile Danne
  • Fonction : Auteur
Dominique Thabut
  • Fonction : Auteur
Carinne Chagneau-Derrode
  • Fonction : Auteur
Arnaud Pauwels
  • Fonction : Auteur
François Habersetzer
  • Fonction : Auteur
Armand Abergel
Jean-Christian Audigier
  • Fonction : Auteur
Thierry Sapey
  • Fonction : Auteur
Jean-Didier Grangé
  • Fonction : Auteur
Albert Tran
  • Fonction : Auteur
Non Renseigné
  • Fonction : Auteur

Résumé

Recent studies have shown that the diagnosis of spontaneous bacterial peritonitis (SBP) can be rapidly obtained using leukocyte esterase reagent strips. However, published studies were restricted to one or two centers, and the number of patients with SBP was thus limited. The aims of the current prospective multicenter study were: (1) to assess the diagnostic accuracy of the Multistix 8SG urine test for the diagnosis of SBP; and (2) to assess the prevalence of SBP. From January to May 2004, 2 reactive strips were tested independently in inpatients with cirrhosis and in outpatients undergoing paracentesis. Cultures of ascitic fluid were performed at the bedside using aerobic and anaerobic blood culture bottles. Two thousand one hundred twenty-three paracenteses were performed in 1,041 patients from 70 centers. One hundred seventeen samples, obtained from 91 patients, had ascites polymorphonuclear cell (PMN) counts>or=250/microl (range, 250-34,000), among which 56 were associated with positive ascitic fluid cultures. The prevalence of SBP was 5.5% in the whole population, 9% in inpatients, and 1.3% in outpatients (P<0.0001). The prevalence of SBP was 0.57% in asymptomatic outpatients versus 2.4% in symptomatic outpatients (P=0.04). Using a threshold of 2+ for positivity of the reagent strip, sensitivity was 45.3% for the diagnosis of SBP, specificity was 99.2%, positive predictive value was 77.9%, and negative predictive value was 96.9%. CONCLUSION: This study confirms the low prevalence of SBP in asymptomatic outpatients according to a priori defined criteria, and indicates an absence of diagnostic efficacy for this specific strip test.

Dates et versions

hal-00515734 , version 1 (07-09-2010)

Identifiants

Citer

Jean-Baptiste Nousbaum, Jean-François Cadranel, Pierre Nahon, Eric Nguyen Khac, Richard Moreau, et al.. Diagnostic accuracy of the Multistix 8 SG reagent strip in diagnosis of spontaneous bacterial peritonitis.. Hepatology, 2007, 45 (5), pp.1275-81. ⟨10.1002/hep.21588⟩. ⟨hal-00515734⟩
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