Related Experiment Video
Updated: Aug 14, 2026
Colorimetric Paper-based Detection of Escherichia coli, Salmonella spp., and Listeria monocytogenes from Large Volumes of Agricultural Water
Published on: June 9, 2014
Diagnosing bacterial peritonitis made easy by use of leukocyte esterase dipsticks
Kiran Chugh1, Yuthika Agrawal1, Vipin Goyal2
1Department of Biochemistry, Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.
Introduction:
Spontaneous bacterial peritonitis (SBP) requires rapid diagnosis for the initiation of antibiotics. Its diagnosis is usually based on manual examination of ascitic fluid (AF) having long reporting time. AF infection is diagnosed when the fluid polymorphonuclear leukocyte (PMNL) concentration ≥250 cells/mm(3).
Aims And Objectives:
Aim was to evaluate the diagnostic utility of leukocyte esterase (LE) reagent strip for rapid diagnosis of SBP in patients who underwent abdominal paracentesis and to calculate the sensitivity, specificity, positive, and negative predictive values.
Materials And Methods:
The study was carried out on 103 patients with ascites. Cell count of AF as determined by colorimetric scale of Multistix 10 SG reagent strip was compared with counting chamber method (PMNL count ≥250 cells/mm(3) was considered positive).
Results And Observations:
Of the 103 patients SBP was diagnosed in 20 patients, 83 patients were negative for SBP by manual cell count. The sensitivity and specificity of the LE test for detecting neutrocytic SBP taking grade 2 as cut off were 95% and 96.4% respectively, with a positive predictive value of 86.4% and a negative predictive value of 98.8%. Diagnostic accuracy of LE test was 96.1%.
Discussion:
There was a good correlation between the reagent strip result and PMNL count. The LE strip test is based on the esterase activity of activated granulocytes which reacts with an ester-releasing hydroxyphenylpyrrole causing a colour change in the azo dye of reagent strip. It is a very sensitive and specific method for the prompt detection of elevated PMNL count, and represents a convenient, inexpensive, simple, and bedside method for diagnosis of SBP. A negative LE test result excludes SBP with a high degree of certainty.
Insights
The leukocyte esterase (LE) reagent strip offers a rapid, sensitive, and specific method for diagnosing spontaneous bacterial peritonitis (SBP). This bedside test provides accurate results, aiding prompt antibiotic initiation for SBP patients.
Area of Science:
- Medical Diagnostics
- Gastroenterology
- Infectious Diseases
Background:
- Spontaneous bacterial peritonitis (SBP) diagnosis relies on polymorphonuclear leukocyte (PMNL) counts in ascitic fluid (AF), often involving lengthy manual examination.
- Rapid SBP diagnosis is crucial for timely antibiotic treatment initiation.
Purpose of the Study:
- To assess the diagnostic utility of the leukocyte esterase (LE) reagent strip for the rapid diagnosis of SBP.
- To determine the sensitivity, specificity, and predictive values of the LE test compared to manual PMNL counts.
Main Methods:
- The study involved 103 patients with ascites undergoing abdominal paracentesis.
- Ascitic fluid (AF) cell counts using the Multistix 10 SG reagent strip's colorimetric scale were compared against manual counting chamber methods.
- A PMNL count of ≥250 cells/mm³ in AF was considered diagnostic for SBP.
Main Results:
- SBP was diagnosed in 20 out of 103 patients via manual cell count.
- The LE test demonstrated high diagnostic accuracy (96.1%) for SBP.
- Sensitivity was 95%, specificity 96.4%, positive predictive value 86.4%, and negative predictive value 98.8% for the LE test.
Conclusions:
- The LE reagent strip test shows excellent correlation with manual PMNL counts for SBP diagnosis.
- The LE strip test is a sensitive, specific, convenient, inexpensive, and simple bedside method for prompt SBP detection.
- A negative LE test result reliably excludes SBP, facilitating faster clinical decisions.
Related Concept Videos
01:30Serum Laboratory Studies, Stool Test, Breath Test
01:26Urine Studies II: Urine Culture and Sensitivity Test
01:26Differential Staining Technique