TY - JOUR
T1 - Performance of Leukocyte Esterase Reagent Strips in the Detection of Spontaneous Bacterial Peritonitis in Cirrhotic Patients
T2 - A Systematic Review and Meta-analysis
AU - Patel, Kishan P.
AU - Gallagher, John P.
AU - Korbitz, Parker M.
AU - Schmidt, Cynthia
AU - Ingviya, Thammasin
AU - Sempokuya, Tomoki
AU - Manatsathit, Wuttiporn
N1 - Funding Information:
This study was not supported by funding or grants. All authors report no financial disclosures.
Publisher Copyright:
© 2021 Indian National Association for Study of the Liver
PY - 2022/3/1
Y1 - 2022/3/1
N2 - Background: Spontaneous bacterial peritonitis (SBP) is a bacterial infection associated with a high mortality rate in cirrhotic patients. The gold standard for the detection of SBP is a manual cell count from ascitic fluid; however, alternative screening methods are under investigation. In particular, leukocyte esterase reagent strips (LERS) has been studied as an alternative method to detect SBP with a low cost and instant turnaround time. Therefore, this study aims to evaluate the performance of LERS in the detection of SBP. Methods: A literature search was performed for studies evaluating LERS for the detection of SBP on PubMed, Embase, Scopus, Cochrane, and clinical trial registries. Summary sensitivity, specificity, log diagnostic odds ratio (LDOR), and the area under the summary receiver operating curve (AUC) were calculated according to the respective manufacturer. Results: In total, 31 studies were evaluated. The summary sensitivity of Aution Sticks, Combur, Multistix, Periscreen reagent strips was 0.962 (95% confidence interval [CI] 0.926, 0.998), 0.892 (95% CI 0.846, 0.938), 0.806 (95% CI 0.738, 0.874), and 0.939 (95% CI 0.900, 0.979), respectively. The summary specificity of Aution Sticks, Combur, Multistix, and Periscreen reagent strips was 0.940 (95% CI 0.904, 0.976), 0.922 (95% CI 0.874, 0.970), 0.974 (95% CI 0.962, 0.985), and 0.672 (95% CI 0.381, 0.963), respectively. Conclusion: LERS appears to have a notable overall performance for the detection of SBP. LERS appeared to be an acceptable alternative to diagnose SBP in facilities without ability to perform cell count. However, there were significant differences in performance between each manufacturer.
AB - Background: Spontaneous bacterial peritonitis (SBP) is a bacterial infection associated with a high mortality rate in cirrhotic patients. The gold standard for the detection of SBP is a manual cell count from ascitic fluid; however, alternative screening methods are under investigation. In particular, leukocyte esterase reagent strips (LERS) has been studied as an alternative method to detect SBP with a low cost and instant turnaround time. Therefore, this study aims to evaluate the performance of LERS in the detection of SBP. Methods: A literature search was performed for studies evaluating LERS for the detection of SBP on PubMed, Embase, Scopus, Cochrane, and clinical trial registries. Summary sensitivity, specificity, log diagnostic odds ratio (LDOR), and the area under the summary receiver operating curve (AUC) were calculated according to the respective manufacturer. Results: In total, 31 studies were evaluated. The summary sensitivity of Aution Sticks, Combur, Multistix, Periscreen reagent strips was 0.962 (95% confidence interval [CI] 0.926, 0.998), 0.892 (95% CI 0.846, 0.938), 0.806 (95% CI 0.738, 0.874), and 0.939 (95% CI 0.900, 0.979), respectively. The summary specificity of Aution Sticks, Combur, Multistix, and Periscreen reagent strips was 0.940 (95% CI 0.904, 0.976), 0.922 (95% CI 0.874, 0.970), 0.974 (95% CI 0.962, 0.985), and 0.672 (95% CI 0.381, 0.963), respectively. Conclusion: LERS appears to have a notable overall performance for the detection of SBP. LERS appeared to be an acceptable alternative to diagnose SBP in facilities without ability to perform cell count. However, there were significant differences in performance between each manufacturer.
KW - ascites
KW - cirrhosis
KW - leukocyte esterase
KW - reagent strips
KW - spontaneous bacterial peritonitis
UR - http://www.scopus.com/inward/record.url?scp=85107977889&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85107977889&partnerID=8YFLogxK
U2 - 10.1016/j.jceh.2021.05.002
DO - 10.1016/j.jceh.2021.05.002
M3 - Article
C2 - 35535110
AN - SCOPUS:85107977889
SN - 0973-6883
VL - 12
SP - 519
EP - 532
JO - Journal of Clinical and Experimental Hepatology
JF - Journal of Clinical and Experimental Hepatology
IS - 2
ER -