BACKGROUND: Spontaneous bacterial peritonitis (SBP) is one of the potentially lifethreatening
complications in ascetic cirrhotic patients. The improved survival might be explained by a
more rapid and accurate diagnosis and treatment. Our aim is to evaluate the combined use of a
leucocyte esterase strip together with ascetic fluid lactoferrin antibodies for rapid and accurate
diagnosis of spontaneous bacterial peritonitis when compared with standard manual laboratory
polymorphonuclear leucocyte counting. METHODS: Non-selected cirrhotic 84 patients undergoing
diagnostic paracentesis had an ascitic sample sent for a conventional polymorphonuclear leucocyte
count. In addition, a sample was tested with a bedside leucocyte esterase reagent strips, and another
sample was tested by Human Lactoferrin, LTF/LF kits detected by Enzyme linked immunosorbent assay
(ELISA). RESULTS: Sensitivity of both leucocyte esterase reagent test & lactoferrin antibody test was
0.71 with confidence interval (0.53-0.85). Specificity of both leucocyte esterase reagent test &
lactoferrin antibody test was 1.00 with confidence interval (0.93-1.00). Positive predictive value of
both leucocyte esterase reagent test & lactoferrin antibody test was 1.00 with confidence interval
(0.86-1.00). Negative predictive value of both leucocyte esterase reagent test & lactoferrin antibody
test was 0.83 with confidence interval (0.71-0.92). Diagnostic accuracy of combined leucocyte esterase
reagent test & lactoferrin antibody test was 0.88 with confidence interval (0.79-0.94)