<i>Kingella kingae</i> infections in children

Dodman, T.; Robson, Jennifer; Pincus, David

doi:10.1046/j.1440-1754.2000.00447.x

Cited by 44 publications

(47 citation statements)

References 43 publications

(104 reference statements)

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“…WBC counts are variable, with most presenting with counts of 10 000 to 15 000 cells per mm 3 . Almost all present with elevated inflammatory markers (ESR and CRP), 5,8,9,[11][12][13]15,[20][21][22] although these were only modestly elevated in our case patients. This contrasts markedly with those who present with skeletal infections caused by more common pathogens such as S aureus or S pyogenes, who usually present acutely with high fever, more notable clinical findings, and much higher inflammatory markers.…”

Section: Discussioncontrasting

confidence: 48%

“…[8][9][10][11]13 Approximately 90% of patients with invasive K kingae disease are Յ4 years of age, with most cases occurring between 6 months and 2 years of age. 5,[3][4][5][6][7][8][9][10][11][12][13][14][15][16][21][22][23][24][25] Those with K kingae skeletal infection present with low-grade fever and seem mildly toxic, as was the case with the 3 children reported here. WBC counts are variable, with most presenting with counts of 10 000 to 15 000 cells per mm 3 .…”

Section: Discussionmentioning

confidence: 90%

“…This contrasts markedly with those who present with skeletal infections caused by more common pathogens such as S aureus or S pyogenes, who usually present acutely with high fever, more notable clinical findings, and much higher inflammatory markers. K kingae invasive disease is frequently associated with concomitant or antecedent upper respiratory illness (present in all 3 case patients here) 5,[8][9][10][11][12][13]15,22,24,25 or stomatitis (singular aphthous ulcers were noted in 2 of the 3 case patients); 19,20 disrupted respiratory or buccal mucosa is hypothesized to facilitate bacterial invasion and hematogenous dissemination.…”

Section: Discussionmentioning

confidence: 99%

“…5,[8][9][10]15,16,18,22,24,32,33 Our K kingae isolates were found to have low MICs for penicillin as well as rifampin and azithromycin. The length of antimicrobial treatment for skeletal infections caused by K kingae has not been standardized.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8][9][10][11][12][13][14][15][16] K kingae is a fastidious Gram-negative coccobacillus that was first described in the 1960s as a species of Moraxella. It was later reclassified into its own genus, Kingella.…”

mentioning

confidence: 99%

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Outbreak of Osteomyelitis/Septic Arthritis Caused byKingella kingaeAmong Child Care Center Attendees

et al. 2005

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ABSTRACT. Objective. Kingella kingae often colonizes the oropharyngeal and respiratory tracts of children but infrequently causes invasive disease. In mid-October 2003, 2 confirmed and 1 probable case of K kingae osteomyelitis/septic arthritis occurred among children in the same 16-to 24-month-old toddler classroom of a child care center. The objective of this study was to investigate the epidemiology of K kingae colonization and invasive disease among child care attendees.Methods. Staff at the center were interviewed, and a site visit was performed. Oropharyngeal cultures were obtained from the staff and children aged 0 to 5 years to assess the prevalence of Kingella colonization. Bacterial isolates were subtyped by pulsed-field gel electrophoresis (PFGE), and DNA sequencing of the 16S rRNA gene was performed. A telephone survey inquiring about potential risk factors and the general health of each child was also conducted. All children and staff in the affected toddler classroom were given rifampin prophylaxis and recultured 10 to 14 days later. For epidemiologic and microbiologic comparison, oropharyngeal cultures were obtained from a cohort of children at a control child care center with similar demographics and were analyzed using the same laboratory methods. The main outcome measures were prevalence and risk factors for colonization and invasive disease and comparison of bacterial isolates by molecular subtyping and DNA sequencing.Results. The 2 confirmed case patients required hospitalization, surgical debridement, and intravenous antibiotic therapy. The probable case patient was initially misdiagnosed; MRI 16 days later revealed evidence of ankle osteomyelitis. The site visit revealed no obvious outbreak source. Of 122 children in the center, 115 (94%) were cultured. Fifteen (13%) were colonized with K kingae, with the highest prevalence in the affected toddler classroom (9 [45%] of 20 children; all case patients tested negative but had received antibiotics). Six colonized children were distributed among the older classrooms; 2 were siblings of colonized toddlers. No staff (n ‫؍‬ 28) or children aged <16 months were colonized. Isolates from the 2 confirmed case patients and from the colonized children had an indistinguishable PFGE pattern. No risk factors for invasive disease or colonization were identified from the telephone survey. Of the 9 colonized toddlers who took rifampin, 3 (33%) remained positive on reculture; an additional toddler, initially negative, was positive on reculture. The children of the control child care center demonstrated a similar degree and distribution of K kingae colonization; of 118 potential subjects, 45 (38%) underwent oropharyngeal culture, and 7 (16%) were colonized with K kingae. The highest prevalence again occurred in the toddler classrooms. All 7 isolates from the control facility had an indistinguishable PFGE pattern; this pattern differed from the PFGE pattern observed from the outbreak center isolates. 16S rRNA gene sequencing demonstrated that the outbreak K kingae...

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