Facultade de Fisioterapia

MUL plus DO: a multicomponent index for the quick diagnosis of peritonitis in peritoneal dialysis patients

Miguel, Núñez Moral; Martínez Camblor, Pablo; Alejandra, Méndez González; Carmen, Rodríguez Suárez; E., Sánchez Álvarez José
Abstract:
Peritoneal infection is a common problem that has a negative impact on the survival of patients and the technique. The early administration of peritoneal infection treatment reduces complications. The goal of this study is to propose a multicomponent index (MUL+DO) for the quick and efficient diagnosis of peritoneal infection. We selected a training cohort of peritoneal effluent samples which were analysed by Multistix (R) 10 SG Siemens test strips for leukocyte detection. Then, each sample was examined according to the gold standard: number of leukocytes, polymorphonuclear percentage and microbiological culture. We constructed the MUL+DO index by adding one point to the MULTISTIX [0-1-2-3] modified chromatic scale if the patient reported pain. The MUL+DO index ranged from 0 to 4. A model validation cohort was then created. MUL+DO was applied to each sample and leukocytes and polymorphonuclear percentage were also assessed. The training cohort ultimately included 134 samples, 34 of which with infection (25.4% [17.6-33.1]). Samples with a MUL+DO value greater than 1 presented a sensitivity and specificity of 100%. The validation cohort included 100 samples with 16 infections (16% [8.3-23.7]). Assuming a sample with a MUL+DO value greater than 1 to be positive, we obtained a sensitivity of 100% and a specificity of 95.2%. The MUL+DO index applied to the training cohort showed a perfect separation of the positive and negative populations. All positive patients presented a score >= 2. In the validation cohort, the MUL+DO reported a sensitivity of 100% and a specificity of 95.2%. (C) 2017 Sociedad Espanola de Nefrologia. Published by Elsevier Espana, S.L.U.
Year:
2018
Type of Publication:
Article
Keywords:
Peritoneal dialysis; Peritonitis; Urine test strip; Diagnosis; SPONTANEOUS BACTERIAL PERITONITIS; STAPHYLOCOCCUS-AUREUS; CIRRHOTIC-PATIENTS; REAGENT STRIPS; UTILITY; UPDATE
Journal:
NEFROLOGÍA
Volume:
38
Number:
3
Pages:
273-278
Month:
May-June
Note:
Q4 65/76 h-index 1,167 (JCR2017)
DOI:
10.1016/j.nefro.2017.09.012
Hits: 1526