{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T15:09:25Z","timestamp":1789744165987,"version":"4.0.1"},"reference-count":29,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["shmpublications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Hospital Medicine"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Bacterial peritonitis in patients with malignant ascites (BP\u2010MA) is an understudied, high\u2010mortality condition. While ascitic polymorphonuclear (PMN) cell count \u2265 250\u2009cells\/mm\n                      <jats:sup>3<\/jats:sup>\n                      defines the diagnosis of spontaneous bacterial peritonitis (SBP) in patients with cirrhosis, an ascitic fluid parameter for the diagnosis of BP\u2010MA has not been established.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>We performed a retrospective observational study at a single academic medical center evaluating patients with malignant ascites who underwent paracentesis with a complete laboratory evaluation between 2020 and 2025. We used uni\u2010 and multivariable logistic regression to identify patient and fluid characteristics associated with positive ascitic fluid cultures. Receiver operating characteristic (ROC) curve analysis identified hypothetical diagnostic thresholds for BP\u2010MA and examined performance characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 337 paracenteses in 261 patients were evaluated, with 318 samples (244 patients) having negative ascitic fluid cultures and 19 samples (17 patients) having positive ascitic fluid cultures. The best performing diagnostic thresholds for BP\u2010MA were ascitic PMN percentage \u2265 63% (sensitivity 68.4%, specificity 90.8%) and ascitic PMN cell count\u2009&gt;\u20091318\u2009cells\/mm\n                      <jats:sup>3<\/jats:sup>\n                      (sensitivity 68.4%, specificity 93.0%). A PMN cell count\u2009\u2265\u2009250\u2009cells\/mm\n                      <jats:sup>3<\/jats:sup>\n                      was associated with a sensitivity of 73.7% and specificity of 72.4%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The diagnostic threshold of PMN count \u2265 250\u2009cells\/mm\n                      <jats:sup>3<\/jats:sup>\n                      used to diagnose SBP in cirrhosis may be inappropriate for diagnosing BP\u2010MA. We identified hypothetical diagnostic thresholds for BP\u2010MA, although performance characteristics were suboptimal, and validation from larger studies would be required prior to clinical utilization.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jhm.70485","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T14:46:42Z","timestamp":1789742802000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Characteristics of ascitic fluid and diagnosis of bacterial peritonitis in malignant ascites: An observational study"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4381-2234","authenticated-orcid":false,"given":"Mark M.","family":"Kelly","sequence":"first","affiliation":[{"name":"Division of General Internal Medicine, Department of Internal Medicine University of Utah Health Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Johnston","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Internal Medicine University of Utah Health Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2291-6039","authenticated-orcid":false,"given":"Joanne","family":"Kuznicki","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University of Utah\u2014Huntsman Cancer Institute Salt Lake CIty Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3059-8026","authenticated-orcid":false,"given":"Stacy A.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Internal Medicine University of Utah Health Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3429-4655","authenticated-orcid":false,"given":"Hannah","family":"Imlay","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine University of Utah Health Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"issue":"5","key":"e_1_2_8_2_1","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1093\/annonc\/mdl499","article-title":"Pattern and prognostic factors in patients with malignant ascites: a retrospective study","volume":"18","author":"Ayantunde AA","year":"2007","journal-title":"Ann Oncol"},{"issue":"3","key":"e_1_2_8_3_1","first-page":"146","article-title":"Does spontaneous bacterial peritonitis occur in malignant ascites?","volume":"77","author":"Kurtz RC","year":"1982","journal-title":"Am J 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