New Real-Time PCR-Based Method for
            <i>Kingella kingae</i>
            DNA Detection: Application to Samples Collected from 89 Children with Acute Arthritis

Ilharreborde, Brice; Bidet, Ph.; Lorrot, Mathie; Even, Julien; Mariani‐Kurkdjian, Patricia; Liguori, Sandrine; Vitoux, C.; Lefevre, Yann; Doit, Catherine; Fitoussi, Franck; Penneçot, Georges-François; Bingen, Édouard; Mazda, Keyvan; Bonacorsi, Stéphane

doi:10.1128/jcm.01289-09

Cited by 41 publications

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“…kingae has recently emerged as an important cause of OAI in young children (1)(2)(3)13). This organism belongs to the normal commensal flora of the posterior pharynx (14,15), but rarely penetrates the bloodstreams and invades distant organs (6,16).…”

Section: Discussionmentioning

confidence: 99%

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Oropharyngeal Kingella kingae carriage in children: characteristics and correlation with osteoarticular infections

et al. 2015

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Section: Discussionmentioning

confidence: 99%

“…K ingella kingae is considered the major bacterial cause of osteoarticular infections (OAI) in children less than 48 mo (1)(2)(3). This organism is a frequent component of the oropharyngeal flora of young children (4).…”

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confidence: 99%

Oropharyngeal Kingella kingae carriage in children: characteristics and correlation with osteoarticular infections

et al. 2015

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“…Subacute haematogenous osteomyelitis is most likely due to an atypical host-pathogen relationship that may comprise any combination of: increased host resistance; decreased virulence of the causative organism; and/or prior antibiotic exposure [13,14,20,27,28]. Since the 1980s, the number of K. kingae osteoarticular infections (OAI) has markedly increased [22,23,[29][30][31][32][33] and several current studies indicate that K. kingae is becoming a leading cause of bacterial osteoarticular infections in children aged from 6-48 months [23,30,31]. K. kingae has a naturally low virulence and OAIs caused by this pathogen are characterized by a mild-to-moderate clinical and biological inflammatory response [22,23,29,30,33,34].…”

Section: Discussionmentioning

confidence: 99%

Patellar Subacute Hematogenous Osteomyelitis in Children Due To K. Kingae: A Report of Two Cases

Samara¹,

Steiger²,

Valaikaitė³

et al. 2017

J Infect Dis Preve

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Isolated osteomyelitis of the patella is a rare condition mainly occurring in the pediatric population. Diagnosis is often delayed as clinical presentation manifests with vague anterior knee pain, sometimes with mild local signs of inflammation but frequently without any local signs at all. While falls on the knee can explain mild knee pain, erythema, swelling and persistent peripatellar pain should raise a high index of suspicion for local infection. We present two cases of subacute osteomyelitis of the patella in young children. In both cases bone lesions presented as an osteolytic lesion of the patella. After open biopsy of the lesion, bacteriological analysis confirmed infection with Kingella kingae.Keywords: Osteomyelitis; Kingella kingae; Trauma; Bone edema; Intravenous antibiotics; Radiographic; PCR Level of EvidenceCase reports, level IV. Case Report 1A 14-month-old Caucasian girl was admitted to the emergency department (ED) of our hospital due to persistent limping for more than 2 weeks. There was no history of trauma. A febrile episode (38.7°C) had occurred approximately 2 weeks before presentation at the ED, but as symptoms had decreased progressively no investigations into the cause of infection and no treatment had been undertaken. On admittance to our hospital, the child was afebrile and walked with a stiff knee. Clinical examination revealed right-sided knee pain, slight prepatellar edema, and a mild knee joint effusion. Laboratory results showed a white blood cell count of 17,000 cells/mm 3 , normal Creactive protein (2 mg/dL) and erythrocyte sedimentation rate (11 mm/h), but a high platelet count (520.000cells/mm 3 ). Conventional radiograph showed no significant abnormality. MRI demonstrated prepatellar soft tissue swelling, joint effusion, synovial enhancement and bone edema, all signs compatible with septic arthritis (Figure 1). Moreover, MRI revealed an osteolytic lesion located in the upper part of the right patella with anterior erosion of the cortical bone. The child underwent joint aspiration where a small quantity of mildly opaque liquid was extracted; the joint cavity was then thoroughly irrigated and the patient was immediately started on intravenous antibiotics (cefuroxime). A switch to oral antibiotics was undertaken after 3 days and treatment was continued for another 20 days. No pathogen was cultivated from the joint fluid, but K. kingae specific rtPCR gave a positive result. At the final clinical control, 12 months after surgery, the child did not complain about any pain and gait was normal. The clinical exam did not reveal any tenderness, swelling or erythema around the knee and the range of motion of the right knee joint was normal. Radiographs showed a normal patella without pathological findings.

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“…Su limitación es no proveer información sobre la sensibilidad antimicrobiana. 11,12 Dado que K. kingae es altamente sensible a antibióticos betalactámi-cos, permite comenzar un tratamiento precoz con amoxicilina. 13,14 La experiencia es limitada, pero en casos de brotes se han utilizado pautas cortas de profilaxis antibiótica con rifampicina o rifampicina con amoxicilina, para erradicar el estado de portador en contactos de entre seis meses y cuatro años de edad.…”

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Artritis séptica pediátrica causada por Kingella kingae

et al. 2012

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Presentación de casos clínicos RESUMENKingella kingae es un microorganismo que coloniza el tracto respiratorio superior. A pesar de su baja patogenicidad en esta localización, los procesos patológicos respiratorios previos pueden favorecer su diseminación sistémica y producir infecciones osteoarticulares, principalmente en menores de cinco años. En pacientes pediátricos, se considera un patógeno emergente en la infección osteoarticular. Presentamos el caso de una niña de dos años de edad con cuadro clínico de dolor de caderas, limitación de la abducción y extensión, y fiebre. La radiografía y la ecografía eran compatibles con sinovitis transitoria y la gammagrafía con patología osteoarticular inflamatoria de la cadera derecha. Se realizó punción articular y los parámetros bioquímicos arrojaron resultados alterados. Se procesó microbiológicamente y se aisló K. kingae sensible a antibióticos betalactámicos, azitromicina y trimetoprima-sulfametoxazol. Los hemocultivos fueron negativos. Se trató empíricamente con cloxacilina y cefotaxima IV y se continuó oralmente con amoxicilina-clavulánico, con mejoría osteoarticular. Palabras clave: Kingella kingae, artritis, infancia. SUMMARYKingella kingae is a bacterium that colonizes the upper respiratory tract. Despite its low pathogenicity in this location, previous respiratory pathological processes may favor its systemic spread causing bone and joint infections, mainly in children under five years. It can be considered an emerging pathogen in osteoarticular infection in pediatric patients. We report the case of a two-year-old girl with hips pain and limitation of both abduction and extension, and fever. Radiography and ultrasonography were compatible with transitory synovitis; showed scintigraphy inflammatory pathology of the right hip. Articular puncture was performed. The material showed altered biochemical parameters. Microbiological culture yielded isolation of a strain of K. kingae susceptible to beta-lactam antibiotics, azithromycin and trimethoprim-sulfamethoxazole. Blood cultures were negative. The patient was treated empirically with cloxacillin and cefotaxime iv. and continued with amoxicillinclavulanate orally with osteoarticular improvement. INTRODUCCIÓNLa artritis séptica de la cadera infantil es un proceso poco frecuente, caracterizado por la invasión del espacio articular por diversos microorganismos. Su relevancia radica en la asociación de un manejo difícil, desde el punto de vista mé-dico-quirúrgico, con numerosas complicaciones. Por esta razón se plantean importantes retos diagnósticos que deben ser abordados de forma multidisciplinar. La tinción de Gram y el cultivo son los métodos convencionales más frecuentemente empleados para detectar el agente etiológico de una forma rápida y precisa, de modo de abordar un correcto tratamiento en forma precoz.Kingella kingae pertenece a la familia Neisseriaceae. Coloniza el tracto respiratorio superior a nivel amigdalino, condición que favorece su transmisión persona-persona, especialmente entre niños de corta ed...

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New Real-Time PCR-Based Method for Kingella kingae DNA Detection: Application to Samples Collected from 89 Children with Acute Arthritis

Cited by 41 publications

References 0 publications

Oropharyngeal Kingella kingae carriage in children: characteristics and correlation with osteoarticular infections

Oropharyngeal Kingella kingae carriage in children: characteristics and correlation with osteoarticular infections

Patellar Subacute Hematogenous Osteomyelitis in Children Due To K. Kingae: A Report of Two Cases

Artritis séptica pediátrica causada por Kingella kingae

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