PubMed · 8055749
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H J Schmitt. 1994-08-05. [Persistent antistreptolysin titer].. https://pubmed.ncbi.nlm.nih.gov/8055749/
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Single serologic tests may occasionally influence clinicians in making diagnoses. The antistreptolysin O (ASO) test is a frequently used tool for detecting recent Streptococcus pyogenes infection and is helpful in the diagnosis of diseases like rheumatic fever. Using data from a 1989 prospective study of 600 healthy male military recruits, in which 43% experienced S. pyogenes upper respiratory tract infection (2-dilution rise in ASO), this report compared two methods of interpreting a single ASO titer. Using the "upper limit of normal" (80 percentile) method, recruits with an ASO titer of greater than 400 showed evidence of recent S. pyogenes infection. This method had a sensitivity and specificity of only 65.9 and 81.9% respectively. In contrast to the "yes-no" dichotomy of the "upper limit of normal" method, the likelihood ratio method statistics were ASO value specific, more consistent with clinical judgment, and better emphasized the caution clinicians must use in interpreting a single ASO test.
OBJECTIVE: To determine whether group A streptococcal infection and poststreptococcal sequelae are still a significant health issue for Aboriginal communities. DESIGN: A cross-sectional survey of streptococcal carriage, infection and antibody levels. SETTING: A north Queensland Aboriginal community. PARTICIPANTS: One hundred and twenty preschool and school-aged children (2 to 12 years of age) living in the Lockhart River Community on Cape York Peninsula. RESULTS: Pyoderma was present in 43% of the children and in 76% of these culture of skin lesions grew group A streptococci. Group A streptococci also grew from 13% of throat swabs, making a total of 36% of children culture positive. Anti-streptolysin O and anti-DNAase B levels were remarkably high and increased with age. CONCLUSIONS: The evidence presented confirms a high level of group A streptococcal carriage and infection in children of the Lockhart River Community. Further investigation of this problem is warranted in other Aboriginal communities with a view to instituting appropriate control programs.
During the 1980's, quantifications of immunoserological testings, especially C reactive protein, rheumatoid factor and antistreptolysin O, progressed rapidly. However, marked interlaboratory differences in these quantifications have been observed. In this brief review, difficulties to satisfy requirements for good quantitative performance in immunochemical assays are discussed.