Background and study aim: A manual count of polymorphonuclear cells (PMNs) in ascitic fluid is the basis for diagnosis of spontaneous bacterial peritonitis (SBP). The process is operator-dependent and false negative results may occur from PMN lysis during laboratory transportation. Ascitic fluid culture is also insensitive and causes delays in diagnosis. The authors aimed in this study to evaluate the diagnostic performance of ascitic fluid lactoferrin in the early detection of SBP and follow-up of its antimicrobial treatment.
Patients and Methods: This case-control study involved fifty patients with liver cirrhosis complicated by ascites. Patients were classified into two groups: group (1) included 25 ascitic patients with moderate or tense ascites with evidence of SBP diagnosed by ascitic fluid neurolytic count > 250 cell/mm3 and group (2) \
Included 25 ascitic patients with moderate or tense ascites without evidence of SBP diagnosed by ascitic fluid neutrocytic count < 250 cell/mm3. Lactoferrin levels in ascitic fluid were measured in patients of both groups and group I patients 2 days after starting antibiotic treatment.
Results: There was a statistically highly significant difference in ascitic fluid lactoferrin between patients with SBP and patients without SBP and in ascitic fluid lactoferrin of patients with SBP before and after successful antibiotic treatment.
Conclusion: Measuring ascitic fluid lactoferrin may serve as a rapid and reliable marker for diagnosis and follow-up of treatment of SBP in ascitic patients with liver cirrhosis.