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Accuracy of blood and peritoneal glucose difference for septic peritonitis identification in horses

Grant number: 18/16013-8
Support type:Scholarships in Brazil - Scientific Initiation
Effective date (Start): November 01, 2018
Effective date (End): July 11, 2019
Field of knowledge:Agronomical Sciences - Veterinary Medicine - Animal Clinics and Surgery
Principal researcher:Juliana de Moura Alonso
Grantee:Carolina Soares Esper
Home Institution: Faculdade de Medicina Veterinária e Zootecnia (FMVZ). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil


Septic peritonitis' diagnosis is established through clinical signs, laboratorial and ultrasonographic exams. However, there is often a difficulty to distinguish between an exclusive inflammatory case and a septic one. This challenge becomes tougher due to the time needed to get the results from peritoneal fluid's culture and to the possibility of false negatives. In equines, it is described that differences e 50 mg/dL between sanguineous and peritoneal glucose are indicative of septic peritonitis, although there aren't studies to evaluate the accuracy of this test to diagnose the disease. In this regard, the present study aims to evaluate the accuracy of the difference between sanguineous and peritoneal glucose to identify septic peritonitis in horses. Animals with suspicion of having the disease will be submitted to aseptic blood and peritoneal fluid samples harvest. The blood will be destined to evaluation of glycaemia and peritoneal fluid to nucleated cells' total count, direct microscopic exam, microbiologic exam and evaluation of glucose concentration. The blood-to-fluid glucose difference will be measured, and the animals will be divided in two groups: difference e 50 mg/dL (positive test) and difference < 50 mg/dL (negative test). As the gold standard to detect septic peritonitis it will be used nucleated cells's count e 10.000/µL, or positivity of microbiologic exam, and/or bacterial presence in direct microscopic exam. Accuracy parameters analyzed will be sensitivity and specificity. Also, will be determined the proportion of false positive and false negative results and predictive values, positive and negative. In case the test using a 50 mg/dL blood-to-fluid glucose difference has a low accuracy, it will be built a ROC curve in which others cut-off points in each 5 mg/dL in 20 mg/dL to 50 mg/dL interval will be evaluated. Therefore, the value of blood-to-fluid glucose difference corresponding to the best diagnosis test's accuracy will be determined.

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
ALONSO, JULIANA DE MOURA; ESPER, CAROLINA SOARES; FIGUEIREDO PANTOJA, JOSE CARLOS; ROSA, GUSTAVO DOS SANTOS; GIAMPIETRO, RODRIGO ROSA; DOS SANTOS, BRUNA; GUERRA, SIMONY TREVIZAN; RIBEIRO, MARCIO GARCIA; TAKAHIRA, REGINA KIOMI; WATANABE, MARCOS JUN; et al. Accuracy of differences in blood and peritoneal glucose to differentiate between septic and non-septic peritonitis in horses. Research in Veterinary Science, v. 132, p. 237-242, . (16/08712-8, 18/16013-8)

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