ANTISTREPTOLYSIN O/ASO

MEDICAL LABORATORY SCIENCE – 3C|IMMUNO-SERO

 ANTISTREPTOLYSIN O/ASO
INTRODUCTION
• Antistreptolysin O (ASO) is an antibody targeted against streptolysin
O, a toxic enzyme produced by group A Streptococcus bacteria
• This test measures the amount of ASO in the blood
• Group A Streptococcus (Streptococcus pyogenes) causing strep throat
(throat infection), skin infections (pyoderma, impetigo, cellulitis)
• Rheumatic fever and glomerulonephritis - damage the heart, acute
kidney dysfunction, tissue swelling (edema), and high blood pressure
(hypertension).
 ANTISTREPTOLYSIN O/ASO
PRINCIPLE
• The ASO SLIDE is a slide
agglutination test for the
quantitative and semi-quantitative
detection of anti-streptolysin O
antibodies.
• Latext particles coated with
streptolysin O are agglutinate when
ixed with samples containing ASO.
 ANTISTREPTOLYSIN O/ASO
SAMPLE
• Fresh Serum – stable for 7 days @ 2 to 8C
or 3 months @ -20C
• Sample with presence of fibrin should be
centrifuged
• Do not use highly hemolysed or lypemic
sample
ANTISTREPTOLYSIN O/ASO
 ANTISTREPTOLYSIN O/ASO
PROCEDURE: Qualitative Method
• Allow the reagents and samples to reach room temperature.
• The sensitivity of the test may be reduced at low
temperatures.
• Gently mix the latex.
• Dispense 50uL of serum upon a selected spot of the reaction
slide, add one drop of latex and accurately mix with a stirrer
paying attention to uniformly distribute the liquid on the
selected spot.
 ANTISTREPTOLYSIN O/ASO
PROCEDURE :
Qualitative Method
• Rotate the slide and observe
within two minutes possible
agglutination.
• False positive red later than 2
minutes
 ANTISTREPTOLYSIN O/ASO
PROCEDURE: Semi-quantitative Method
• Make serial two fold dilutions of
the sample in saline solution.
• Proceed for each dilution as in the
quantitative method
 ANTISTREPTOLYSIN O/ASO
READING & INTERPRETATION
• Presence or absence of visible agglutination. (+) It indicates
ASO concentration Is equal or greater than 200u/mL
• The titer is defined as the highest dilution showing a positive
result
 ANTISTREPTOLYSIN O/ASO
CALCULATION

200 * ASO Titer = u/mL

 ANTISTREPTOLYSIN O/ASO
EXPECTED VALUES

Adult: <200u/mL
Children <5y/o: <100u/mL
 ANTISTREPTOLYSIN O/ASO
PERFORMANCE
• Sensitivity: 200 u/mL (+-50) u/mL
• Prozone Effect: No prozone effect up to 1500 u/mL
• Diagnostic Sensitivity: 98%
• Diagnostic Specificitity: 97%
• Interferences: bilirubin when >20mg/dL. Lipemia and
hemoglobin when 10g/L. Rheumatoid Factor when
>300u/mL
 ANTISTREPTOLYSIN O/ASO
LIMITATIONS OF THE PROCEDURE
• False (+): Rheumatoid Arthritis, Scarlet Fever, Tonsilitis,
Several Streptococcal Infections.
• False (-): Early infections and children from 6 months to 2
years old
• A single ASO determination does not produce much
information during 4 or 6 weeks are advisable to follow the
disease evolution