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1Department of Paediatric Rheumatology, Bristol Royal Hospital for Children, Bristol, UK.
Archives of Disease in Childhood. Education and Practice Edition
|February 1, 2014
Summary
Diagnosing Group A Streptococcus infections is challenging with single antibody tests. Sequential antistreptolysin O titre (ASOT) and anti-DNase B measurements improve diagnostic accuracy for past GAS infections.
Area of Science:
- Microbiology
- Immunology
- Infectious Diseases
Background:
- Group A Streptococcus (GAS) causes acute and non-suppurative diseases like rheumatic fever.
- Diagnosing post-streptococcal conditions requires evidence of prior GAS infection.
- GAS produces extracellular antigens, including streptolysin O, triggering antibody responses.
Purpose of the Study:
- To address challenges in diagnosing preceding GAS infections.
- To improve the interpretation of antistreptolysin O titre (ASOT) results.
- To recommend an optimized diagnostic strategy for GAS infections.
Main Methods:
- Analysis of antibody responses to GAS extracellular antigens.
- Evaluation of single versus sequential ASOT measurements.
- Inclusion of anti-DNase B antibody assays in diagnostic protocols.
Main Results:
- Single ASOT measurements are often insufficient and prone to misdiagnosis.
- The timing of a single ASOT test relative to infection is frequently unknown.
- Sequential ASOT testing combined with anti-DNase B offers enhanced diagnostic utility.
Conclusions:
- Optimizing GAS infection diagnosis requires more than one antibody test.
- Sequential ASOT measurements are recommended for accurate diagnosis.
- Simultaneous anti-DNase B assay provides a valuable second marker for GAS infection.
