Association between oropharyngeal carriage of Kingella kingae and osteoarticular infection in young children: a case–control study

Gravel, Jocelyn; Ceroni, Dimitri; Lacroix, Laurence; Renaud, Christian; Grimard, Guy; Samara, Eleftheria; Cherkaoui, Abdessalam; Renzi, Gesuèle; Schrenzel, Jacques; Manzano, Sergio

doi:10.1503/cmaj.170127

Cited by 38 publications

(40 citation statements)

References 25 publications

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“…31 Twenty-nine articles were considered relevant with respect to identifying the number of confirmed infections with K. kingae in bacteriologically proven musculoskeletal infections in children (Table 1). 2,22,28,29,[32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][66][67][68][69][70] This was further studied to summarize the frequency of K. kingae infections among children under 48 months old ( Table 2). Additional epidemiological data extracted and collated included musculoskeletal infection sites, gender, age and seasonality.…”

Section: Search Findingsmentioning

confidence: 99%

Systematic Review of Kingella kingae Musculoskeletal Infection in Children: Epidemiology, Impact and Management Strategies

Wong¹,

Williams²,

Cooper³

2020

PHMT

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Kingella kingae, a pathogen often responsible for musculoskeletal infections in children is the most common cause of septic arthritis and osteomyelitis in children 6 to 36 months of age. The aim of this study was to perform a systematic review of previous studies to determine the proportion of K. kingae in bacteriologically proven musculoskeletal infections among the pediatric population. A secondary objective was to describe the diagnostic strategies and outcome of patients with musculoskeletal infections caused by K. kingae. A systematic review was conducted to identify publications that report on musculoskeletal infections caused by K. kingae in the pediatric population (patients 0 to <18 years old with microbiologic culture and/or polymerase chain reaction (PCR) confirmation of K. kingae and a description of the musculoskeletal infection involved). Of 144 studies included in this review, we sought to determine the proportion of K. kingae pediatric musculoskeletal infections. A total of 711 (30.8%) out of 2308 pediatric cases with culture and/or PCR proven musculoskeletal infections had K. kingae successfully identified from twenty-nine studies. Of the 1070 patients who were aged less than 48 months, K. kingae was the organism identified in 47.6% of infections. We found the average age from the collated studies to be 17.73 months. Of 520 pediatric musculoskeletal patients in which K. kingae infections were identified and where the studies reported the sites of infection, a large proportion of cases (65%) were joint infections. This was followed by 18.4% osteoarticular infection (concomitant bone and joint involvement), with isolated bone and spine at 11.9% and 3.5%, respectively. Twenty-one papers reported clinical and laboratory findings in children with confirmed K. kingae infection. The median temperature reported at admission was 37.9°C and mean was 38.2°C. Fourteen studies reported on impact and treatment, with the majority of children experiencing good clinical outcome and function following antibiotic treatment with no serious orthopaedic sequelae.

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Section: Search Findingsmentioning

confidence: 99%

Systematic Review of Kingella kingae Musculoskeletal Infection in Children: Epidemiology, Impact and Management Strategies

Wong¹,

Williams²,

Cooper³

2020

PHMT

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“…Kingella kingae continues to dominate the literature regarding microbial etiology in pediatric orthopaedics. In 1 case-control study, 65 children aged 6 to 48 months with osteoarticular infection were 38 times more likely to have oropharyngeal carriage of K. kingae DNA on specific PCR assay compared with 286 age-matched controls, providing additional support for the use of this test in diagnostic algorithms 99 . In 1 hospital, the proportion of admissions for osteoarticular infection due to Pneumococcus decreased by 35% since the introduction of pneumococcal conjugate vaccination, and decreased by 87% for osteoarticular disease caused by vaccine serotypes 100 .…”

Section: Pediatric Orthopaedicsmentioning

confidence: 95%

What’s New in Musculoskeletal Infection: Update on Biofilms

Nana

Nelson

McLaren

et al. 2016

The Journal of Bone and Joint Surgery

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“…Oropharyngeal carriage of K. kingae has previously been shown to have a strong association with osteoarticular infections in children [3]. The cytotoxin RTX (repeat-in-toxin) facilitates spread of the pathogen to the bloodstream and other surrounding tissues [1].…”

Section: Introductionmentioning

confidence: 99%

Pediatric Infectious Prepatellar Bursitis with Kingella kingae

Pitts

Smith

Conklin

2020

Case Reports in Orthopedics

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We present the first reported case of septic prepatellar bursitis with Kingella kingae in a 2-year-old female. Although it is a well-established cause of osteoarticular infections in the pediatric population, K. kingae has never been reported as the etiology for septic bursitis. A high index of suspicion is required for the diagnosis given that this organism is difficult to culture and isolate using standard laboratory methods. Our diagnosis was established through bursal fluid analysis, though oropharyngeal polymerase chain reaction (PCR) may be also be considered. Our case also builds upon prior literature suggesting that the pathophysiology of septic bursitis in children differs from that of the adult and may be more comparable to that of pediatric osteomyelitis. As an organism of increasing prevalence, K. kingae should remain high on the differential for osteoarticular or periarticular infections when cultures fail to isolate a distinct pathogen. Early diagnosis and a formal irrigation and debridement, if warranted, are crucial in preventing devastating complications of untreated septic bursitis.

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Association between oropharyngeal carriage of Kingella kingae and osteoarticular infection in young children: a case–control study

Cited by 38 publications

References 25 publications

<p>Systematic Review of <em>Kingella kingae</em> Musculoskeletal Infection in Children: Epidemiology, Impact and Management Strategies</p>

<p>Systematic Review of <em>Kingella kingae</em> Musculoskeletal Infection in Children: Epidemiology, Impact and Management Strategies</p>

What’s New in Musculoskeletal Infection: Update on Biofilms

Pediatric Infectious Prepatellar Bursitis with Kingella kingae

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