الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Spontaneous bacterial peritonitis is diagnosed when there is an elevated AF absolute PMN count (i.e. ≥ 250 cells /mm3) with or without a positive AF culture. Using bedside, rapid, easy to use, and inexpensive methods for diagnosis of SBP will help in early diagnosis and appropriate intervention.
The aim of this work was to assess the utility of GE latex immunoassay and LE reagent strips for the rapid diagnosis of SBP in hepatic patients with ascites.
This study included 80 AF samples from 45 children with chronic liver diseases divided into 2 groups, SBP (40 AF samples) and non SBP (40 AF samples) groups. AF samples were investigated as follows: culture & sensitivity, TLC, PMN leukocyte, cholesterol, triglycerides, bilirubin, albumin, LDH, total protein, glucose, amylase, lipase and testing by use of a reagent strips for LE enzyme and GE latex immunoassay.
On analysis of our results we found that:
1. 20% of our patients were Budd Chiari syndrome and 22.2% were biliary atresia.
2. Fever, abdominal pain and tenderness were significantly higher in SBP than non SBP group.
3. On analysis of ascitic samples, TLC and neutrophils are higher in SBP group while lymphocytes are higher in non SBP group. 60% of TLC of the SBP group were neutrophils while 97.5% of TLC of the non SBP group were lymphocytes.
Summary and conclusion
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4. 20% of SBP were ascitic sample culture positive while non of the other group were positive.
5. GE was significantly higher in SBP (3073.6± 7082.78) than non SBP group (430±1029.1).
6. The diagnostic performance of GE in differentiating SBP and non SBP were assessed and showed sensitivity, specifity, PPV, NPV and accuracy of 70% for each at cutoff value of 123.5 ng/ml.
7. On doing LE dipstick strips, all non SBP group gives no coloration with LE strips while 62% 0f SBP group give coloration. 17.5% of SBP gave positive+, 22.5% gave positive ++ and 22.5% gave positive +++.
8. LE strips in differentiating SBP and non SBP has sensitivity 62.5%, specifity 100%, PPV 100%, NPV 72.5% and accuracy of 86.25%.
9. By use of the color grade of LE strips in predicting TLC count in ascitic sample. No coloration indicates that TLC count < 750 cell/ml with accuracy of 86.75%. Color grade+ indicates TLC> 750 cell/ml with accuracy 86.75%. Color grade++ indicates TLC > 950 cell/ml with accuracy 83.35%. Color grade +++ indicates TLC > 1950 cell/ml with accuracy 75.5%.
10. By use of the color grade of LE strips in predicting PMN cell count in ascitic sample, we found that: No coloration detect PMN count < 310 cell/ml with accuracy of 85.05%. Color grade+ detect PMN > 310 cell/ml with accuracy 85.05%. Color grade++ detect PMN > 691 cell/ml with accuracy 89.15%. Color grade +++ detect PMN > 1577 cell/ml with accuracy 82.15%.