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Diagnostic validity of flow cytometry vs manual counting of polymorphonuclear leukocytes in spontaneous bacterial

Heba Ahmed Osman1, Sanaa Shaker Aly2, Eman M Salah-Eldin3

  • 1Tropical Medicine and Gastroenterology Department, Faculty of Medicine, South Valley University, Qena, Egypt.

Journal of Clinical Laboratory Analysis
|February 1, 2018
PubMed
Abstract

Insights

Flow cytometry offers a highly accurate and rapid method for diagnosing spontaneous bacterial peritonitis (SBP) in liver cirrhosis patients. This technique surpasses traditional manual counting of ascitic fluid polymorphonuclear leukocytes (PMNL) in reliability and speed.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Clinical Diagnostics

Background:

  • Spontaneous bacterial peritonitis (SBP) is a common infection in liver cirrhosis patients.
  • Diagnosis is typically based on ascitic fluid polymorphonuclear (PMN) counts ≥250 cells/mm³.

Purpose of the Study:

  • To compare the diagnostic accuracy of flow cytometry versus manual counting of ascitic fluid PMNL.
  • To evaluate these methods in cirrhotic patients with suspected SBP.

Main Methods:

  • A cross-sectional study involved 320 cirrhotic patients with suspected SBP.
  • Ascitic fluid was analyzed using both manual microscopy and flow cytometry for PMNL enumeration.
  • Flow cytometry utilized monoclonal antibodies (anti-HLA-DR, anti-CD15, anti-CD16, anti-CD45).

Main Results:

  • Flow cytometry demonstrated 100% sensitivity and specificity for diagnosing SBP.
  • Manual PMNL counting showed 65.52% sensitivity and 90% specificity.
  • The difference in diagnostic performance was statistically significant (P < .05).

Conclusions:

  • Flow cytometry is a more reliable and rapid method for PMNL counting in diagnosing SBP.
  • Manual counting is less accurate and more time-consuming for suspected SBP.
  • Flow cytometry enhances diagnostic efficiency in cirrhotic patients.
Keywords:
flow cytometrypolymorphonuclear leukocytesspontaneous bacterial peritonitis

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