a comparative study on ascetic fluid biochemical markers in cirrhotic children with and without spontaneous bacterial peritonitis: a cross-sectional observation

Background: cirrhotic ascites is frequently complicated with spontaneous bacterial peritonitis (sbp). objectives: here, we assessed the diagnostic validity of some inflammatory markers in children with sbp. methods: this cross-sectional study was performed in the pediatric gastroenterology ward of namazi hospital of shiraz. sbp was considered as≥ 250 polymorphonuclear cell (pmn) /l ascetic fluid (af). results: out of 150 liver cirrhotic patients with ascites, 41 (27.3%) were diagnosed with sbp. mean wbc count and pmn per l of af were significantly higher in sbp patients than non-sbp (p < 0.0001). the highest specificity for the diagnosis of sbp was recorded for af smear test (100%). positive af smear and culture tests rendered the highest positive predictive values (ppv, 100% and 88.2% respectively). the highest negative predictive value (npv) was related to af leukocyte esterase test (94.2%). the highest area under the curve (auc) for diagnosis of sbp belonged to wbc count (0.956), total cell count (0.817), and ldh concentration (0.814) of af. a cut off value of 290wbcperl af resulted in respective 95.1% and 88.1% sensitivity and specificity. trespass of wbccount and lactate dehydrogenase (ldh) level of af higher than cutoff values (290 cells/µl, and 175 (u/l), respectively) resulted in 82.9%, 92.7%, 81%, and 93.5% sensitivity, specificity, ppv and npv, respectively. conclusions: total cell and wbc counts of af strongly correlated with ascetic pmn count. ascetic ldh, alone or in combination with wbc count of af can be used as a potential surrogate for pmn counts in diagnosis of sbp.