Ascitic Fluid Calprotectin and Serum C-Reactive Protein as Diagnostic Markers for Spontaneous Bacterial Peritonitis

2014 ◽  
Vol 4 (3) ◽  
pp. 117-125
Author(s):  
Ehsan Rizk ◽  
Rasha Elzehery ◽  
Sahar Zakaria ◽  
Ahmed Abdel-Razik ◽  
Dina Elhammady
Keyword(s):  
Ascitic Fluid ◽  
Spontaneous Bacterial Peritonitis ◽  
Diagnostic Markers ◽  
C Reactive Protein ◽  
Bacterial Peritonitis ◽  
Reactive Protein

scholarly journals Evaluation of diagnostic accuracy of C-Reactive protein as a biomarker of spontaneous bacterial peritonitis in patients having decompensated chronic liver disease.

2021 ◽  
Vol 28 (10) ◽  
pp. 1438-1442
Author(s):  
Kapeel Raja ◽  
Rizwan Saeed Kiyani ◽  
Sadia Rehman ◽  
Abdul Rashid ◽  
Sanjay Kumar ◽  
...  
Keyword(s):  
Liver Disease ◽  
Diagnostic Accuracy ◽  
Chronic Liver Disease ◽  
Ascitic Fluid ◽  
Predictive Value ◽  
Spontaneous Bacterial Peritonitis ◽  
Chronic Liver ◽  
C Reactive Protein ◽  
Bacterial Peritonitis ◽  
Reactive Protein

Objective: The objective of this study was to evaluate the diagnostic accuracy of C Reactive Protein (CRP) in diagnosing spontaneous bacterial peritonitis (SBP) in patients with decompensated chronic liver disease. Study Design: Cross Sectional study. Setting: Department of Medicine Sheikh Khalifa Bin Zayed Hospital Rawalakot Azad Kashmir. Period:  Feb 2018 to Dec 2018. Material & Methods: One hundred subjects with decompensated liver disease were recruited in this study after fulfilling inclusion criteria. The patients’ medical record number, age and gender was recorded upon admission. Baseline investigations including complete blood count, urine examination and chest X ray were done. Abdominal ultrasound was performed for detecting the presence of ascitic fluid. SBP was diagnosed if > 250 mm3 neutrophils are detected in the ascitic fluid. Serum CRP was detected and reported in mg/L. Results: SBP was detected in 32.8% of the patients having decompensated chronic liver disease. CRP levels were > 29.5mg/L in 36% of the patients while in 64% patients the CRP levels were < 29.5mg/L. The sensitivity of CRP for the diagnosis of SBP was calculated as 83.61% while the specificity was calculated as 87.2%. A positive predictive value was estimated as 76.12% and a negative predictive value was 91.59% while the diagnostic accuracy was calculated as 86.02% from the given data. Conclusion: CRP is a reliable diagnostic biomarker for spontaneous bacterial peritonitis in subjects having complications of chronic liver disease.

scholarly journals Amyloid A in Serum and Ascitic Fluid as a Novel Diagnostic Marker of Spontaneous Bacterial Peritonitis

2020 ◽  
Vol 19 (2) ◽  
pp. 140-148 ◽  
Author(s):  
Rehab Badawi ◽  
Muhammad N. Asghar ◽  
Sherief Abd-Elsalam ◽  
Samah A. Elshweikh ◽  
Tamer Haydara ◽  
...  
Keyword(s):  
Ascitic Fluid ◽  
Sensitivity And Specificity ◽  
Spontaneous Bacterial Peritonitis ◽  
Neutrophil To Lymphocyte Ratio ◽  
C Reactive Protein ◽  
Lymphocyte Ratio ◽  
Bacterial Peritonitis ◽  
Reactive Protein ◽  
Amyloid A ◽  
Ascetic Fluid

Background: Diagnosis of Spontaneous Bacterial Peritonitis (SBP) depends mainly on ascetic fluid culture which may be negative in spite of the clinical suggestion of SBP and high ascetic fluid neutrophilic count. Aim: This study aimed to evaluate the biological importance of amyloid A biomarker in both serum and ascetic fluid to diagnose SBP as early as possible and to compare it to other markers (C-reactive protein (CRP), and the neutrophil-to-lymphocyte ratio (NLR)). Methods: This study included 37 patients with hepatic ascites; twenty-two of them had SBP, and 15 patients did not have SBP. Serum and ascetic fluid amyloid A, ascetic fluid neutrophil, C-reactive protein, and neutrophil-to-lymphocyte ratio were measured in all subjects before the start of antimicrobial chemotherapy to the infected ones. Results: Both the serum and ascetic fluid amyloid and also, CRP were significantly higher in patients infected with ascetic fluid than others. The cut-off point of serum amyloid A for early detection of SBP was 9.25ug/ml with the high sensitivity and specificity. For ascetic amyloid A, the sensitivity and specificity were 90.09% and 60% at cut-off point 2.85ug/ml, respectively. Conclusion: Amyloid A in serum and ascitic fluid can be considered as a good biomarker for early diagnosis of SBP.

scholarly journals Blood Neutrophil / Lymphocyte Ratio and C –Reactive Protein / Albumin Ratio as Markers of Response for Treatment of Spontaneous Bacterial Peritonitis

2021 ◽  
pp. 52-62
Author(s):  
Marwa Awad Mustafa ◽  
Maaly Mohamad Mabrouk ◽  
Sabry Abd Ellatif Abou Saif ◽  
Nadia Muhammad Elwan
Keyword(s):  
Spontaneous Bacterial Peritonitis ◽  
Acute Infection ◽  
Blood Neutrophil ◽  
C Reactive Protein ◽  
Gold Standard Method ◽  
Albumin Ratio ◽  
Bacterial Peritonitis ◽  
Reactive Protein ◽  
Group I

Background: Spontaneous bacterial peritonitis (SBP) is an acute infection of ascites with the absence of surgically treatable cause and the gold standard method in its diagnosis is the presence of 250 polymorphonuclear neutrophils (PMN) /mm3 or more by diagnostic paracentesis. Blood neutrophil/lymphocytic ratio (NLR) is an applicable, inexpensive, and simple test for inflammation. C-reactive protein/albumin ratio (CAR) is an inflammatory marker used for the diagnosis and follow-up of many diseases and morbidities. We aimed to evaluate the clinical utility of both blood NLR and CAR as applicable, simple and non-invasive tests for SBP follow-up. Patients and Methods: This study was done on 80 cirrhotic ascitic patients attending the Tropical Medicine Department of Tanta University Hospital. They were subjected to full history taking, clinical examination, laboratory investigations, and ascitic fluid analysis. The patients were divided into two groups according to the results of diagnostic paracentesis into group I: 40 cirrhotic ascitic patients without spontaneous bacterial peritonitis and group II: 40 cirrhotic ascitic patients with spontaneous bacterial peritonitis, and then SBP group were tested after treatment by third-generation cephalosporin for five days for ascitic sample, NLR and CAR. Results: Both blood NLR and CAR were significantly higher in SBP patients. Also, a significant decrease in both ratios was observed post-treatment with significant positive correlations between both NLR and CAR with ascitic neutrophil count after SBP treatment. Conclusion: NLR and CAR can be used as quick, cheap, and applicable markers of the response of treatment in SBP patients.

scholarly journals Ascitic Fluid Calprotectin and Serum Procalcitonin as Accurate Diagnostic Markers for Spontaneous Bacterial Peritonitis

Gut and Liver ◽  
2016 ◽  
Vol 10 (4) ◽  
pp. 624-631 ◽  
Author(s):  
Ahmed Abdel-Razik ◽  
Nasser Mousa ◽  
Dina Elhammady ◽  
Rania Elhelaly ◽  
Rasha Elzehery ◽  
...  
Keyword(s):  
Ascitic Fluid ◽  
Spontaneous Bacterial Peritonitis ◽  
Diagnostic Markers ◽  
Bacterial Peritonitis

Elevated C-Reactive Protein and Spontaneous Bacterial Peritonitis in Children With Chronic Liver Disease and Ascites

2014 ◽  
Vol 58 (1) ◽  
pp. 96-98 ◽  
Author(s):  
Marcela Preto-Zamperlini ◽  
Sylvia Costa Lima Farhat ◽  
Maria Beatriz Moliterno Perondi ◽  
Adriana Pozzi Pestana ◽  
Patricia Salles Cunha ◽  
...  
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Spontaneous Bacterial Peritonitis ◽  
Chronic Liver ◽  
C Reactive Protein ◽  
Bacterial Peritonitis ◽  
Reactive Protein

scholarly journals Update Review Article: Spontaneous Bacterial Peritonitis

2018 ◽  
Vol 8 (6-s) ◽  
pp. 384-393
Author(s):  
Priyanka Chouhan ◽  
Rupal Dubey ◽  
Neeraj Upmanyu ◽  
Anoop Shrivastava
Keyword(s):  
Early Diagnosis ◽  
Ascitic Fluid ◽  
Spontaneous Bacterial Peritonitis ◽  
Signs And Symptoms ◽  
Diagnostic Markers ◽  
Regional Lymph Nodes ◽  
Bacterial Peritonitis ◽  
Treatment And Prevention ◽  
Criteria For Diagnosis ◽  
End Stage

Spontaneous bacterial peritonitis (SBP) is a frequent and severe complication in cirrhotic patients with ascites. To describe spontaneous bacterial peritonitis (SBP) in the context of currently accepted criteria for diagnosis, treatment and prevention. A review of SBP and its associated etiopathogenic factors is presented. Numerous studies on mechanisms of disease, bacteriology, epidemiology, diagnostic markers, and current guidelines for its diagnosis, treatment and prevention are discussed. Peritonitis in patients with ascites in the absence of secondary causes, such as perforation of a viscus, occurs primarily in patients with end-stage liver disease. Enteric organisms, mainly gram-negative bacilli, probably translocate to regional lymph nodes to produce bacteremia and seeding of ascitic fluid. Signs and symptoms of peritonitis are usually subtle. The ascitic fluid polymorphonuclear leukocyte count is the best determinant for early diagnosis and treatment of SBP. Third-generation cephalosporins such as cefotaxime are considered the drugs of choice for treatment, whereas quinolones such as norfloxacin are used to decrease recurrence. Despite increased awareness, early diagnosis, and prompt and effective antimicrobial therapy, SBP recurs frequently and is associated with a high mortality rate. Patients with SBP should be assessed for candidacy for liver transplantation. Keyword: Spontaneous bacterial peritonitis, Bacteriology, Epidemiology, Diagnostic markers, Cephalosporins

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