Thierry Thévenot1, Charline Briot1, Vincent Macé2, Hortensia Lison3, Laure Elkrief4, Alexandra Heurgué-Berlot5, Christophe Bureau6, Caroline Jézéquel7, Ghassan Riachi8, Alexandre Louvet9, Arnaud Pauwels10, Isabelle Ollivier-Hourmand11, Rodolphe Anty12, Nicolas Carbonell13, Hélène Labadie14, Karim Aziz15, Denis Grasset16, Eric Nguyen-Khac17, Mehdi Kaassis18, Sofia Hermann19, Florence Tanné20, Thomas Mouillot21, Olivier Roux4, Aurélie Le Thuaut22, Jean-Paul Cervoni1, Jean-François Cadranel3, Matthieu Schnee2. 1. Service d'Hépatologie et de Soins Intensifs Digestifs, hôpital Jean Minjoz, Besançon, France. 2. Service d'Hépato-Gastroentérologie, CHD-Vendée, La Roche sur Yon, France. 3. Service d'Hépato-Gastroentérologie, de Nutrition et d'Alcoologie, GHPSO, Hôpital Laennec, Creil, France. 4. DHU UNITY, Service d'Hépatologie, Hôpital Beaujon, APHP, and Inserm U1149, Centre de Recherche sur l'Inflammation (CRI), Clichy cédex, France. 5. Service d'Hépato-Gastroentérologie, hôpital Robert Debré, Reims cedex, France. 6. Service d'Hépato-Gastroentérologie, hôpital Purpan, clinique Dieulafoy, Toulouse, France. 7. Service des Maladies du Foie, CHU Pontchaillou, Rennes, France. 8. Service d'Hépato-Gastroentérologie, hôpital de Rouen, Rouen, France. 9. Service des Maladies de l'Appareil Digestif, CHRU de Lille, rue M. Polonovski, Lille cedex, France. 10. Service d'Hépato-Gastroentérologie, Centre Hospitalier, Gonesse Cedex, France. 11. Service d'Hépato-Gastroentérologie et de nutrition, CHU Côte de Nacre, Caen, France. 12. INSERM U1065, hôpital universitaire de Nice, pôle digestif; Université de Nice-Sophia-Antipolis, Nice, France. 13. Service d'Hépato-Gastroentérologie, hôpital Saint-Antoine, Paris cedex 12, France. 14. Service d'Hépato-Gastroentérologie, CH de Saint-Denis, Saint-Denis, France. 15. Service d'Hépato-Gastroentérologie, CH de Saint-Brieuc, St Brieuc, France. 16. Service d'Hépato-Gastroentérologie, CH Bretagne-Atlantique, Vannes, France. 17. Service d'Hépato-Gastroentérologie, hôpital d'Amiens, Amiens, France. 18. Service d'Hépato-Gastroentérologie, Hôpital de Cholet, Cholet, France. 19. Service d'Hépato-Gastroentérologie, hôpital de la Source, Orléans cedex 12, France. 20. Service d'Hépato-Gastroentérologie, CHU La-Cavale-Blanche, Brest, France. 21. Service d'Hépato-Gastroentérologie, hôpital du Bocage, Dijon cedex, France. 22. Unité de Recherche Clinique, CHD-Vendée, La Roche sur Yon, France.
Abstract
OBJECTIVES: We aimed to assess the performance of a new strip (Periscreen) for the rapid diagnosis of spontaneous bacterial peritonitis (SBP). METHODS: Ascitic fluid (AF) of cirrhotic patients hospitalized between March 2014 and August 2015 was independently tested by two readers using the new strip, which has four colorimetric graduations (negative, trace, small, and large). SBP was diagnosed on neutrophils in ascites>250/mm3. Ascites not related to portal hypertension were excluded. RESULTS: Overall, 649 patients from 21 French centers were included and 1,402 AF (803 AF samples from 315 outpatients and 599 samples from 334 inpatients) were assessed. Eighty-four AF samples (17 AF in 9 outpatients and 67 AF in 31 inpatients) were diagnosed as SBP. The prevalence of SBP was 6% (2.1% in outpatients vs. 11.2% in inpatients; P<0.001) and 7.2% in patients with symptoms suggestive of SBP (3% in outpatients vs. 11.3% in inpatients; P<0.001). The κ value for inter-reader agreement was 0.81 (95% confidence interval: 0.77-0.84) when using the "trace" threshold. Considering discordant results (n=131) as positive to interpret the diagnostic performance of the strip at the "trace" threshold, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 91.7, 57.1, 12.0, and 99.1%, respectively. At this "trace" threshold, sensitivity and NPV were both 100% in outpatients, and 89.5 and 97.9% in inpatients, respectively. At the "small" threshold, sensitivity, specificity, PPV and NPV were 81.0, 85.9, 25.9 and 98.7%, respectively. CONCLUSIONS: The Periscreen strip is a rapid and highly efficient tool for excluding SBP in the outpatient setting.
OBJECTIVES: We aimed to assess the performance of a new strip (Periscreen) for the rapid diagnosis of spontaneous bacterial peritonitis (SBP). METHODS: Ascitic fluid (AF) of cirrhotic patients hospitalized between March 2014 and August 2015 was independently tested by two readers using the new strip, which has four colorimetric graduations (negative, trace, small, and large). SBP was diagnosed on neutrophils in ascites>250/mm3. Ascites not related to portal hypertension were excluded. RESULTS: Overall, 649 patients from 21 French centers were included and 1,402 AF (803 AF samples from 315 outpatients and 599 samples from 334 inpatients) were assessed. Eighty-four AF samples (17 AF in 9 outpatients and 67 AF in 31 inpatients) were diagnosed as SBP. The prevalence of SBP was 6% (2.1% in outpatients vs. 11.2% in inpatients; P<0.001) and 7.2% in patients with symptoms suggestive of SBP (3% in outpatients vs. 11.3% in inpatients; P<0.001). The κ value for inter-reader agreement was 0.81 (95% confidence interval: 0.77-0.84) when using the "trace" threshold. Considering discordant results (n=131) as positive to interpret the diagnostic performance of the strip at the "trace" threshold, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 91.7, 57.1, 12.0, and 99.1%, respectively. At this "trace" threshold, sensitivity and NPV were both 100% in outpatients, and 89.5 and 97.9% in inpatients, respectively. At the "small" threshold, sensitivity, specificity, PPV and NPV were 81.0, 85.9, 25.9 and 98.7%, respectively. CONCLUSIONS: The Periscreen strip is a rapid and highly efficient tool for excluding SBP in the outpatient setting.
Authors: John J Kim; Michelle M Tsukamoto; Arvind K Mathur; Yashar M Ghomri; Linda A Hou; Sarah Sheibani; Bruce A Runyon Journal: Am J Gastroenterol Date: 2014-08-05 Impact factor: 10.864
Authors: Raj C Butani; Richard T Shaffer; Ronald D Szyjkowski; Barbara E Weeks; Linda G Speights; Shailesh C Kadakia Journal: Am J Gastroenterol Date: 2004-03 Impact factor: 10.864
Authors: Marco Fiore; Alberto Enrico Maraolo; Ivan Gentile; Guglielmo Borgia; Sebastiano Leone; Pasquale Sansone; Maria Beatrice Passavanti; Caterina Aurilio; Maria Caterina Pace Journal: World J Hepatol Date: 2017-10-28