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Colon Ascendens Stent Peritonitis CASP - a Standardized Model for Polymicrobial Abdominal Sepsis
Published on: December 18, 2010
Ascitic Calprotectin is a Novel and Accurate Marker for Spontaneous Bacterial Peritonitis
Samuel Raimundo Fernandes1, Patrícia Santos2, Narcisa Fatela2
1Serviço de Gastrenterologia e Hepatologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal. Samuelrmfernandes@gmail.com.
Background:
Spontaneous bacterial peritonitis (SBP) is a known complication of advanced cirrhosis and presents a high mortality rate. A polymorphonuclear (PMN) cell count >250/μl in the ascitic fluid is the current gold standard for diagnosing SBP.
Aim:
We evaluated the accuracy of a point-of-care test (POCT) for ascitic calprotectin in diagnosing patients with SBP.
Methods:
Eighty-eight patients admitted with decompensation of liver cirrhosis were studied including 41 patients (46.6%) with SBP. Ascitic calprotectin was measured using a quantitative POCT developed by Bühlmann® .
Results:
Calprotectin levels correlated with PMN cell count and other inflammatory markers and were significantly higher in patients with SBP. An optimal cutoff of calprotectin above 1.57 μg/ml presented high sensitivity (87.8%), specificity (97.9%), and positive (97.3%) and negative (90.2%) predictive values for diagnosing SBP. Using calprotectin selectively in patients with a serum albumin-ascites gradient above 11 g/l further increased the sensitivity and negative predictive values of the test.
Conclusion:
Ascitic calprotectin appears to be a reliable method for diagnosing SBP in patients with liver cirrhosis. It may present an alternative to other conventional diagnostic methods.
Insights
A new point-of-care test for ascitic calprotectin accurately diagnoses spontaneous bacterial peritonitis (SBP) in cirrhosis patients. This reliable method offers a promising alternative to conventional diagnostic approaches for SBP.
Area of Science:
- Hepatology
- Gastroenterology
- Clinical Diagnostics
Background:
- Spontaneous bacterial peritonitis (SBP) is a severe complication of advanced cirrhosis with high mortality.
- Diagnosis relies on ascitic fluid polymorphonuclear (PMN) cell count >250/μl, the current gold standard.
- There is a need for rapid and accurate diagnostic methods for SBP.
Purpose of the Study:
- To evaluate the diagnostic accuracy of a point-of-care test (POCT) for ascitic calprotectin in patients with SBP.
- To compare the efficacy of ascitic calprotectin POCT with the traditional PMN cell count method.
Main Methods:
- Eighty-eight patients with decompensated liver cirrhosis were studied.
- Ascitic calprotectin was measured using a quantitative POCT.
- Patients were categorized based on the presence or absence of SBP.
Main Results:
- Ascitic calprotectin levels were significantly higher in SBP patients and correlated with PMN counts.
- An optimal calprotectin cutoff of 1.57 μg/ml showed high sensitivity (87.8%) and specificity (97.9%).
- Using calprotectin in patients with a serum albumin-ascites gradient >11 g/l enhanced diagnostic values.
Conclusions:
- Ascitic calprotectin POCT is a reliable method for diagnosing SBP in liver cirrhosis patients.
- This test offers a potential alternative to conventional diagnostic methods.
- The POCT provides rapid and accurate results for SBP diagnosis.
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