Infections caused by Kingella kingae: Report of four cases and review

Verbruggen, Alfons; Hauglustaine, D; Schildermans, F; Hauwaert, L Van der; Rombouts, Jan; Wauters, Georges; Vandepitte, J.

doi:10.1016/s0163-4453(86)92841-0

Cited by 39 publications

(23 citation statements)

References 14 publications

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“…Concomitant upper respiratory tract infection and stomatitis, including varicella-induced oral ulcers, are frequently present in affected patients [38][39][40][41][42][43]. It seems that K. kingae organisms colonizing the oropharynx penetrate a mucosal layer previously damaged by a viral disease [18].…”

Section: Concomitant Viral Infectionsmentioning

confidence: 99%

30 Years of Study of Kingella Kingae : Post Tenebras , Lux

et al. 2013

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Kingella kingae is a Gram-negative bacterium that is today recognized as the major cause of joint and bone infections in young children. This microorganism is a member of the normal flora of the oropharynx, and the carriage rate among children under 4 years of age is approximately 10%. K. kingae is transmitted from child to child through close personal contact. Key virulence factors of K. kingae include expression of type IV pili, Knh-mediated adhesive activity and production of a potent RTX toxin. The clinical presentation of K. kingae invasive infection is often subtle and may be associated to mild-to-moderate biologic inflammatory responses, highlighting the importance a high index of suspicion. Molecular diagnosis of K. kingae infections by nucleic acid amplification techniques enables identification of this fastidious microorganism. Invasive infections typically respond favorably to medical treatment, with the exception of cases of endocarditis, which may require urgent valve replacement

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Section: Concomitant Viral Infectionsmentioning

confidence: 99%

30 Years of Study of Kingella Kingae : Post Tenebras , Lux

et al. 2013

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“…The interest in K. kingae was initially limited (3)(4)(5)(6)(7)(8)(9)(10), and only 55 reports on the organism were published in the medical literature until 1990. The number, however, has sharply increased in recent years, jumping to 105 in the following decade and 83 in the short period from January 2010 through August 2014 (determined by a PubMed search with "Kingella kingae" and "Moraxella kingii"), and has firmly established the status of K. kingae as a common agent of bacteremia with no focus (also called occult bacteremia) (11,12) and the predominant etiology of joint and bone infections in 6-to 36-month-old children (13)(14)(15)(16).…”

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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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“…The peculiar sex and seasonal distributions of invasive disease, however, cannot be readily explained by the epidemiology of respiratory carriage. Viral infections and other yet-to-be-defined cofactors may play a role in the causation of invasive K. kingae infections.For most of the four decades that elapsed since the first characterization of Kingella kingae, this gram-negative bacterium was considered a rare cause of human disease and therefore was mostly neglected (5,8,20). In recent years, as the result of improved isolation techniques, there has been an increasing number of reports on invasive K. kingae infections in the United States, Western Europe, and Israel, suggesting that the organism is an important cause of bacteremia and septic arthritis in pediatric patients (2,4,6,7,13,14,21,22,25).…”

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Epidemiological Features of Invasive Kingella kingae Infections and Respiratory Carriage of the Organism

2002

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The age, sex, and seasonal distributions of invasive Kingella kingae infections in southern Israel were examined and compared to the epidemiology of respiratory carriage of the organism. Medical records of all patients diagnosed between 1988 and 2002 were reviewed, and 2,044 oropharyngeal specimens were cultured on selective media during two periods (February to May and October to December) in 2001. Invasive infections significantly affected children (73 of 74 patients [98.6%] were younger than 4 years), 50 patients (67.8%) were males (P ‫؍‬ 0.045), and 55 episodes (74.3%) occurred between July and December (P ‫؍‬ 0.004). Carriage was higher in the 0-to 3-year-old group and decreased with increasing age (P for trend ‫؍‬ 0.0008). Carriage rates were similar in both sexes and did not significantly differ between the February-to-May and October-toDecember periods. The highest rate of carriage of K. kingae coincided with the age (less than 4 years) at which invasive infections were especially frequent. The peculiar sex and seasonal distributions of invasive disease, however, cannot be readily explained by the epidemiology of respiratory carriage. Viral infections and other yet-to-be-defined cofactors may play a role in the causation of invasive K. kingae infections.For most of the four decades that elapsed since the first characterization of Kingella kingae, this gram-negative bacterium was considered a rare cause of human disease and therefore was mostly neglected (5,8,20). In recent years, as the result of improved isolation techniques, there has been an increasing number of reports on invasive K. kingae infections in the United States, Western Europe, and Israel, suggesting that the organism is an important cause of bacteremia and septic arthritis in pediatric patients (2,4,6,7,13,14,21,22,25). Moreover, studies conducted to elucidate the natural niche of K. kingae have shown that the organism is a frequent component of the oropharyngeal flora of young children and is readily transmitted from person to person among day care center (DCC) attendees (19,24).Despite the enlarging body of information on the clinical and diagnostic aspects of K. kingae infections, the epidemiology of the organism remains largely unknown. A study was performed to investigate the sex, age, and seasonal distributions of invasive K. kingae infections and to correlate these data with the respiratory carriage of the organism. MATERIALS AND METHODSSoroka University Medical Center (SUMC) is a 950-bed university hospital located in the city of Beer-Sheva and is the only medical facility providing inpatient medical services to the entire population of southern Israel (450,000 inhabitants). The Clinical Microbiology Laboratory (CML) of SUMC provides diagnostic microbiology services to hospitalized patients and to the outpatient population of 139 community clinics in the area.Bacteriological methods. Patients referred to the emergency department or hospitalized at SUMC with a febrile illness undergo routine blood cultures with the BACTEC system (B...

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Infections caused by Kingella kingae: Report of four cases and review

Cited by 39 publications

References 14 publications

30 Years of Study of Kingella Kingae : Post Tenebras , Lux

30 Years of Study of Kingella Kingae : Post Tenebras , Lux

Kingella kingae: Carriage, Transmission, and Disease

Epidemiological Features of Invasive Kingella kingae Infections and Respiratory Carriage of the Organism

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