A Prospective Study of Intrafamilial Oropharyngeal Transmission of Kingella Kingae

Καμπούρογλου, Γεώργιος; Dubois-Ferrière, Victor; Llana, Rebecca Anderson de la; Renzi, Gesuèle; Manzano, Sergio; Cherkaoui, Abdessalam; Schrenzel, Jacques; Ceroni, Dimitri

doi:10.1097/inf.0000000000000104

Cited by 13 publications

(8 citation statements)

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“…The research found that 55.0% of children with a PCR-documented invasive K. kingae infection and 40.0% of asymptomatic carriers had siblings with a positive pharyngeal PCR assay, suggesting dissemination of the organism within susceptible family members (108).…”

Section: Transmissionmentioning

confidence: 99%

Kingella kingae: Carriage, Transmission, and Disease

2015

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SUMMARY Kingella kingae is a common etiology of pediatric bacteremia and the leading agent of osteomyelitis and septic arthritis in children aged 6 to 36 months. This Gram-negative bacterium is carried asymptomatically in the oropharynx and disseminates by close interpersonal contact. The colonized epithelium is the source of bloodstream invasion and dissemination to distant sites, and certain clones show significant association with bacteremia, osteoarthritis, or endocarditis. Kingella kingae produces an RTX (repeat-in-toxin) toxin with broad-spectrum cytotoxicity that probably facilitates mucosal colonization and persistence of the organism in the bloodstream and deep body tissues. With the exception of patients with endocardial involvement, children with K. kingae diseases often show only mild symptoms and signs, necessitating clinical acumen. The isolation of K. kingae on routine solid media is suboptimal, and detection of the bacterium is significantly improved by inoculating exudates into blood culture bottles and the use of PCR-based assays. The organism is generally susceptible to antibiotics that are administered to young patients with joint and bone infections. β-Lactamase production is clonal, and the local prevalence of β-lactamase-producing strains is variable. If adequately and promptly treated, invasive K. kingae infections with no endocardial involvement usually run a benign clinical course.

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Section: Transmissionmentioning

confidence: 99%

Kingella kingae: Carriage, Transmission, and Disease

2015

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“…Kingella kingae colonises the oropharynx and spreads through droplets of buccal secretions among young siblings and playmates 4,21,22 . Crowded conditions, such as those prevalent in day care centres, facilitate child‐to‐child transmission 4,23 .…”

Section: Resultsmentioning

confidence: 99%

“…Kingella kingae colonises the oropharynx and spreads through droplets of buccal secretions among young siblings and playmates. 4,21,22 Crowded conditions, such as those prevalent in day care centres, facilitate child-to-child transmission. 4,23 Colonisation commences after the age of 6 months, suggesting that maternally derived immunity, coupled with limited socialisation, prevents early acquisition of the bacterium.…”

Section: Carriage and Transmissionmentioning

confidence: 99%

“…The carriage among adults is low and short-lived and usually reflects close contact with young children. 4,21 Kingella kingae carriage is a dynamic phenomenon, which is characterised by the replacement of colonising strains after weeks or months. This suggests that carriage induces a strain-specific immune response that eradicates the harboured organism, but does not prevent colonisation by a new and antigenically different strain.…”

Section: Carriage and Transmissionmentioning

confidence: 99%

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Review highlights the latest research in Kingella kingae and stresses that molecular tests are required for diagnosis

Yagupsky

2021

Acta Paediatrica

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Paediatric osteomyelitis, septic arthritis and spondylodiscitis are medical emergencies that require prompt diagnosis and adequate antibiotic administration to avoid systemic morbidity and permanent disability. 1,2 Detecting the causative agent remains a cornerstone for the successful treatment of these infections. However, traditional culture methods frequently fail to isolate the aetiologic agent and a substantial fraction of bone, joint and intervertebral disc infections remain bacteriologically unconfirmed. 1,2 Two intertwined advances have had an impact on the microbiological diagnosis of skeletal system infections, which has led to better and more rational management. The use of sensitive nucleic acid amplification tests has shortened the time it takes to detect microorganisms from days to hours and enabled clinicians to identify bacteria that are difficult to culture. It has also revealed new pathogens and established the aetiology of the infection in patients receiving

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“…The organism is carried in the oropharynx without clinical symptoms and is transmitted from child to child by close contact among siblings and playmates (4)(5)(6)(7). The colonized mucosal surface is also the portal of entry of K. kingae to the bloodstream, from where it may invade the skeletal system and the endocardium, for which the species exhibits a particular tropism (8-10).…”

mentioning

confidence: 99%

Investigation of Kingella kingae Invasive Infection Outbreaks in Day Care Facilities: Assessment of a Rapid Genotyping Tool Targeting the DNA Uptake Sequence

et al. 2017

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Outbreaks of Kingella kingae invasive infections have recently been reported in day care centers. Pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) revealed that although the invasive strains had widespread dissemination in the day care population, less virulent strains were also circulating in the facilities. However, these typing tools are costly, time-consuming, and laborintensive and provide delayed results. A study was conducted to assess the performance of a rapid and cost-effective genotyping tool targeting the DNA uptake sequence (DUS) in the investigation of outbreaks of K. kingae disease. DUS typing (DUST) patterns of each strain from 7 different clusters were compared to distinguish genotypically linked strains from others. PFGE and, when available, MLST results were used as gold standards. DUST was assessed on 80 K. kingae isolates from Nir-Itzhak (n ϭ 14), Tel-Nof (n ϭ 14), Palmahim (n ϭ 5), Umm-al-Fahm (n ϭ 7), Eilat (n ϭ 8), Nevatim (n ϭ 15) in Israel and Paris, France (n ϭ 17). A unique DUST pattern was involved in the Nir-Itzhak, Palmahim, Umm-al-Fahm, and Paris episodes. Two DUST patterns were found in Eilat, whereas at least 3 were identified in the TelNof and Nevatim episodes. In total, 11 (13.8%) children carried a K. kingae isolate that differed from the outbreak strain. These results were concordant with those obtained with the traditional PFGE and MLST methods. DUST appears to be sensitive and specific in distinguishing the invasive outbreak strain from others in asymptomatic carriers and could be useful to limit unnecessary exposure of the entire day care population to selective antibiotic pressure.KEYWORDS Kingella kingae, DNA uptake sequence, outbreaks, bone and joint infection, genotyping A s a result of increasing use of improved detection methods, Kingella kingae is being increasingly recognized as an important pediatric pathogen and the most common etiology of skeletal system infections in children aged 6 to 48 months in countries where sensitive molecular diagnostic methods are routinely used for processing joint aspirates and bone exudates (1-3). The organism is carried in the oropharynx without clinical symptoms and is transmitted from child to child by close contact among siblings and playmates (4-7). The colonized mucosal surface is also the portal of entry of K. kingae to the bloodstream, from where it may invade the skeletal system and the endocardium, for which the species exhibits a particular tropism (8-10). The K. kingae strains carried differ in virulence. Some strains belonging to a few distinct genotypic

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A Prospective Study of Intrafamilial Oropharyngeal Transmission of Kingella Kingae

Cited by 13 publications

References 9 publications

Kingella kingae: Carriage, Transmission, and Disease

Kingella kingae: Carriage, Transmission, and Disease

Review highlights the latest research in Kingella kingae and stresses that molecular tests are required for diagnosis

Investigation of Kingella kingae Invasive Infection Outbreaks in Day Care Facilities: Assessment of a Rapid Genotyping Tool Targeting the DNA Uptake Sequence

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