Pharyngeal Colonization by Kingella kingae, Transmission, and Pathogenesis of Invasive Infections: A Narrative Review

Abstract

With the appreciation of Kingella kingae as a prime etiology of osteoarticular infections in young children, there is an increasing interest in the pathogenesis of these diseases. The medical literature on K. kingae’s colonization and carriage was thoroughly reviewed. Kingella kingae colonizes the oropharynx after the second life semester, and its prevalence reaches 10% between the ages of 12 and 24 months, declining thereafter as children reach immunological maturity. Kingella kingae colonization is characterized by the periodic substitution of carried organisms by new strains. Whereas some strains frequently colonize asymptomatic children but are rarely isolated from diseased individuals, others are responsible for most invasive infections worldwide, indicating enhanced virulence. The colonized oropharyngeal mucosa is the source of child-to-child transmission, and daycare attendance is associated with a high carriage rate and increased risk of invasive disease. Kingella kingae elaborates a potent repeat-in-toxin (RTXA) that lyses epithelial, phagocytic, and synovial cells. This toxin breaches the epithelial barrier, facilitating bloodstream invasion and survival and the colonization of deep body tissues. Kingella kingae colonization and carriage play a crucial role in the person-to-person transmission of the bacterium, its dissemination in the community, and the pathogenesis of invasive infections.

Therapeutic target mapping from the genome of Kingella negevensis and biophysical inhibition assessment through PNP synthase binding with traditional medicinal compounds

“…Kingella negevensis is a gram-negative bacterium and produces RTX toxin associated hemolysis [ 1 ]. Its colonization is known in respiratory tract and oropharynx, with carriage and colonization resembling K. kingae [ 2 , 3 ] . Its occurrence is known to increase from 6 to 24 month children and decrease thereafter [ 4 ].…”

“…Its occurrence is known to increase from 6 to 24 month children and decrease thereafter [ 4 ]. Its role in the septic arthritis of an infant [ 2 , 4 , 5 ], endocarditis, pediatric osteomyelitis and bacteremia has been implicated [ 1 ], while the bacterial spread is through person to person contact [ 4 ].…”

Kingella kingae Reveals Its Secrets

“…The review by Yagupsky discusses our current understanding of the dual role played by the asymptomatic K. kingae colonization of the oropharyngeal mucosa as the source of hematogenous dissemination of the organism and its person-to-person transmission among the susceptible young pediatric population [ 20 ].…”