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Antistreptokinase antibodies: implications for thrombolysis in a region with endemic streptococcal infection
  1. N Blackwell1,
  2. A Hollins1,
  3. G Gilmore2,
  4. R Norton2
  1. 1Mount Isa Hospital, Mount Isa, Queensland 4825, Australia
  2. 2Clinical Microbiology, QHPS, The Townsville Hospital, Townsville, Queensland 4814, Australia
  1. Correspondence to:
 Dr R Norton
 Clinical Microbiology, The Townsville Hospital, Townsville, Queensland 4814, Australia;


Aims: To determine antistreptokinase antibody (anti-SK) titres in patients with the acute coronary syndrome from communities with endemic group A streptococcal infection because of the implications for streptokinase (SK) thrombolysis.

Methods: Anti-SK titres were determined using a standard method in 47 consecutive SK naive patients, presenting to the Mt Isa Hospital emergency department, Australia, with an acute coronary syndrome. Both indigenous and non-indigenous subjects were enrolled. Antistreptolysin O (ASOT) and anti-DNAse B (ADB) titres were also determined.

Results: Indigenous patients were more likely to have anti-SK antibodies (p < 0.001) than the non-indigenous cohort. Anti-SK antibody titres also correlated well with ASOT/ADB titres.

Conclusions: Anti-SK antibodies are highly prevalent in SK naive indigenous patients presenting with the acute coronary syndrome. Streptokinase should not be used for thrombolysis in populations with endemic group A streptococcal infection.

  • ADB, anti-DNAse B antibodies
  • ASOT, antistreptolysin O antibodies
  • IHD, ischaemic heart disease
  • OD, optical density
  • SK, streptokinase
  • antistreptokinase antibodies
  • thrombolysis

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