Main Article Content
Abstract
RÉSUMÉ
Introduction. La pancréatite aiguë est une inflammation soudaine et sévère du pancréas. L’objectif de ce travail était d’évaluer l’intérêt de la bandelette urinaire dans le diagnostic de l’infection du liquide d’ascite à Brazzaville. Méthodologie. Il s’agissait d’une étude analytique transversale réalisée dans la période d’avril à Novembre 2022, soit une période de huit mois portant sur tous les patients adultes atteints de cirrhose retrouvés dans le service de Gastro-entérologie et médecine interne du centre hospitalier universitaire de Brazzaville. Résultats. Nous avons recensé 93 patients cirrhotiques avec un sex-ratio de 1,2. Les patients étaient fréquemment classés dans les stades B (43%) et C (50,5%) de la classification Child Pugh. L’infection du liquide d’ascite était fréquemment retrouvée chez nos patients (82,9%). Les résultats de la bandelette urinaire ont montré un taux élevé de détection au seuil de traces (97,8%) et au seuil de deux croix avec une sensibilité de 81,2%, une spécificité de 100 % et des valeurs prédictives positives et négatives de 100 % et 96,3%. Il y avait une forte concordance entre l’analyse biologique et la bandelette urinaire positive à deux croix (kappa=0,88). Conclusion. : les performances de la bandelette urinaire sont excellentes à partir d’un seuil de positivité à deux croix indiquant ainsi une alternative au diagnostic de l’infection du liquide d’ascite.
ABSTRACT
Introduction. Acute pancreatitis is a sudden and severe inflammation of the pancreas. The objective of this study was to evaluate the usefulness of urine dipstick in the diagnosis of ascitic fluid infection in Brazzaville. Methodology. This was a cross-sectional analytical study conducted from April to November 2022, a period of eight months, involving all adult patients with cirrhosis seen in the Gastroenterology and Internal Medicine department of the university hospital in Brazzaville. Results. We identified 93 cirrhotic patients with a sex ratio of 1.2. Patients were frequently classified in Child Pugh stages B (43%) and C (50.5%). Ascitic fluid infection was commonly found in our patients (82.9%). Urine dipstick results showed a high detection rate at the trace level (97.8%) and at the two crosses level with a sensitivity of 81.2%, specificity of 100%, and positive and negative predictive values of 100% and 96.3%, respectively. There was a strong agreement between laboratory analysis and positive urine dipstick at two crosses (kappa=0.88). Conclusion. The performance of urine dipstick is excellent starting from a positivity threshold of two crosses, indicating an alternative in the diagnosis of ascitic fluid infection.
Keywords
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
- Runyon B. Spontaneous bacterial peritonitis in adults: Diagnosis [Internet]. Uptodate. 2023 [cité 24 oct 2023]. Disponible sur: https://www.uptodate.com/contents/spontaneous-bacterial-peritonitis-in-adults-diagnosis.
- Tsochatzis EA, Bosch J, Burroughs AK. Liver cirrhosis. The Lancet. 2014;383(9930):1749‑61.
- Rimola A, García-Tsao G, Navasa M, Piddock LJV, Planas R, Bernard B, et al. Diagnosis, treatment and prophylaxis of spontaneous bacterial peritonitis: a consensus document. J Hepatol. 1 janv 2000;32(1):142‑53.
- Garcia–Tsao G. Current management of the complications of cirrhosis and portal hypertension: Variceal hemorrhage, ascites, and spontaneous bacterial peritonitis. Gastroenterology. 2001;120(3):726‑48.
- Kyriakou E, Nearchakos N, Bonovas S, Makri E, Pantavou K, Nikolopoulos GK, et al. Comparison between Nageotte and flow cytometric counting of residual leucocytes in freshly prepared leucocyte-reduced red blood cell components. Transfus Apher Sci. 2018;57(4):544‑8.
- Farahmand F, Eshagh M, Ghajarzadeh M, Shams S, Mohammadi B. Diagnosis of Spontaneous Bacterial Peritonitis in Children by Reagent Strips | Acta Medica Iranica. Acta Med Iran [Internet]. 2013 [cité 24 oct 2023];51(2). Disponible sur: https://acta.tums.ac.ir/index.php/acta/article/view/4478
- Patel KP, Gallagher JP, Korbitz PM, Schmidt C, Ingviya T, Sempokuya T, et al. Performance of Leukocyte Esterase Reagent Strips in the Detection of Spontaneous Bacterial Peritonitis in Cirrhotic Patients: A Systematic Review and Meta-analysis. J Clin Exp Hepatol. 2022;12(2):519‑32.
- Sapey T, Mena E, Kabissa D, Fort E, Laurin C, Tchangaï-Kao S, et al. Rapid diagnosis of spontaneous bacterial peritonitis with leukocyte esterase reagent strips (Nephur-test(R) and multistixsg(R)) in two centers. Hepatology. 2003;(38):188‑9.
- Vanbiervliet G, Rakotoarisoa C, Filippi J, Guérin O, Calle G, Hastier P, et al. Diagnostic accuracy of a rapid urine-screening test (Multistix8SG) in cirrhotic patients with spontaneous bacterial peritonitis. Eur J Gastroenterol Hepatol. 2002;14(11):1257.
- Chinnock B, Woolard RE, Hendey GW, Crawford S, Mainis L, Vo D, et al. Sensitivity of a bedside reagent strip for the detection of spontaneous bacterial peritonitis in ED patients with ascites. Am J Emerg Med. 2019;37(12):2155.
- Chugh K, Agrawal Y, Goyal V, Khatri V, Kumar P. Diagnosing bacterial peritonitis made easy by use of leukocyte esterase dipsticks. Int J Crit Illn Inj Sci. 2015;5(1):32‑7.
- Youssef B, Massoud K. Evaluation of Leukocyte Esterase Reagent Strip Test to Detect Spontaneous Bacterial Peritonitis in Cirrhotic Patients. Gastroenterol Insights. 2012; 4(1):e13.
- Gad A, El-Nemr N, Saad M. The Diagnostic Value of Leukocyte Esterase Reagent Dip-stick in Spontaneous Bacterial Peritonitis Diagnosis in Patients with Liver Cirrhosis. Suez Canal Univ Med J. 2019;22(1):56‑63.
- Nousbaum JB, Cadranel JF, Nahon P, Khac EN, Moreau R, Thévenot T, et al. Diagnostic accuracy of the Multistix 8 SG reagent strip in diagnosis of spontaneous bacterial peritonitis. Hepatology. 2007;45(5):1275‑81.
- Khairnar H, Ingle M, Pandey V, Kolhe K, Chauhan S, Sawant P, et al. Accuracy of Leukocyte Esterase Reagent Strip (LERS) test for rapid bedside screening of spontaneous bacterial peritonitis: An observational study. J Fam Med Prim Care. 2020;9(11):5542‑6.
References
Runyon B. Spontaneous bacterial peritonitis in adults: Diagnosis [Internet]. Uptodate. 2023 [cité 24 oct 2023]. Disponible sur: https://www.uptodate.com/contents/spontaneous-bacterial-peritonitis-in-adults-diagnosis.
Tsochatzis EA, Bosch J, Burroughs AK. Liver cirrhosis. The Lancet. 2014;383(9930):1749‑61.
Rimola A, García-Tsao G, Navasa M, Piddock LJV, Planas R, Bernard B, et al. Diagnosis, treatment and prophylaxis of spontaneous bacterial peritonitis: a consensus document. J Hepatol. 1 janv 2000;32(1):142‑53.
Garcia–Tsao G. Current management of the complications of cirrhosis and portal hypertension: Variceal hemorrhage, ascites, and spontaneous bacterial peritonitis. Gastroenterology. 2001;120(3):726‑48.
Kyriakou E, Nearchakos N, Bonovas S, Makri E, Pantavou K, Nikolopoulos GK, et al. Comparison between Nageotte and flow cytometric counting of residual leucocytes in freshly prepared leucocyte-reduced red blood cell components. Transfus Apher Sci. 2018;57(4):544‑8.
Farahmand F, Eshagh M, Ghajarzadeh M, Shams S, Mohammadi B. Diagnosis of Spontaneous Bacterial Peritonitis in Children by Reagent Strips | Acta Medica Iranica. Acta Med Iran [Internet]. 2013 [cité 24 oct 2023];51(2). Disponible sur: https://acta.tums.ac.ir/index.php/acta/article/view/4478
Patel KP, Gallagher JP, Korbitz PM, Schmidt C, Ingviya T, Sempokuya T, et al. Performance of Leukocyte Esterase Reagent Strips in the Detection of Spontaneous Bacterial Peritonitis in Cirrhotic Patients: A Systematic Review and Meta-analysis. J Clin Exp Hepatol. 2022;12(2):519‑32.
Sapey T, Mena E, Kabissa D, Fort E, Laurin C, Tchangaï-Kao S, et al. Rapid diagnosis of spontaneous bacterial peritonitis with leukocyte esterase reagent strips (Nephur-test(R) and multistixsg(R)) in two centers. Hepatology. 2003;(38):188‑9.
Vanbiervliet G, Rakotoarisoa C, Filippi J, Guérin O, Calle G, Hastier P, et al. Diagnostic accuracy of a rapid urine-screening test (Multistix8SG) in cirrhotic patients with spontaneous bacterial peritonitis. Eur J Gastroenterol Hepatol. 2002;14(11):1257.
Chinnock B, Woolard RE, Hendey GW, Crawford S, Mainis L, Vo D, et al. Sensitivity of a bedside reagent strip for the detection of spontaneous bacterial peritonitis in ED patients with ascites. Am J Emerg Med. 2019;37(12):2155.
Chugh K, Agrawal Y, Goyal V, Khatri V, Kumar P. Diagnosing bacterial peritonitis made easy by use of leukocyte esterase dipsticks. Int J Crit Illn Inj Sci. 2015;5(1):32‑7.
Youssef B, Massoud K. Evaluation of Leukocyte Esterase Reagent Strip Test to Detect Spontaneous Bacterial Peritonitis in Cirrhotic Patients. Gastroenterol Insights. 2012; 4(1):e13.
Gad A, El-Nemr N, Saad M. The Diagnostic Value of Leukocyte Esterase Reagent Dip-stick in Spontaneous Bacterial Peritonitis Diagnosis in Patients with Liver Cirrhosis. Suez Canal Univ Med J. 2019;22(1):56‑63.
Nousbaum JB, Cadranel JF, Nahon P, Khac EN, Moreau R, Thévenot T, et al. Diagnostic accuracy of the Multistix 8 SG reagent strip in diagnosis of spontaneous bacterial peritonitis. Hepatology. 2007;45(5):1275‑81.
Khairnar H, Ingle M, Pandey V, Kolhe K, Chauhan S, Sawant P, et al. Accuracy of Leukocyte Esterase Reagent Strip (LERS) test for rapid bedside screening of spontaneous bacterial peritonitis: An observational study. J Fam Med Prim Care. 2020;9(11):5542‑6.