Spontaneous bacterial peritonitis (SBP) is common and dangerous infection that occurs in
8-27% of cirrhotic inpatients with ascites. In the current study we have demonstrated and
compared the diagnostic performance of ascitic fluid lactoferrin and calprotectin in the
screening and diagnosis of SBP. In addition we have evaluated ascitic fluid calprotectin to
albumin ratio as a novel marker in the diagnosis and Prognosis of SBP. In this cross
sectional analytic study, ascitic fluids were collected from 87 cirrhotic patients (49 with
SBP and 38 without SBP. Calprotectin and lactoferrin were measured in the ascitic fluids
by quantitative sandwich enzyme-linked immunosorbent assay (ELISA). Ascitic fluid
calprotectin and lactoferrin were increased significantly in SBP group when compared
with non SBP group. Moreover, they were correlated in a positive manner with white
blood cells (WBCs) count in ascitic fluid, Polymorphnuclear cells (PMN) count, and
serum C-reactive protein (CRP). Also, calprotectin to albumin ratio was increased in SBP
cases versus non SBP cases. Moreover, calprotectin to albumin ratio was significantly
higher among SBP patients who died inside the hospital than patients with SBP who
survived. Both ascitic fluid lactoferrin and calprotectin can be used as valuable markers for
diagnosis of SBP. However, ascitic fluid calprotectin is more sensitive and more specific
than lactoferrin for diagnosis of SBP. Moreover, calprotectin to albumin ratio in ascites is
useful in the diagnosis for SBP as well as it provides prognostic information about the in
hospital mortality.