Prevalence of Kingella kingae oropharyngeal carriage and predominance of type a and type b polysaccharide capsules among French young children

Basmaci, Romain; Deschamps, K.; Lévy, Corinne; Mathy, Vincent; Corrard, F.; Thollot, Franck; Béchet, Stéphane; Sobral, Elsa; Bidet, Philippe; Cohen, Robert; Bonacorsi, Stéphane

doi:10.1016/j.cmi.2018.07.033

Cited by 9 publications

(6 citation statements)

References 12 publications

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“…In a large collection of K. kingae-positive osteoarticular samples in France, we demonstrated that our capsular PCR is able to identify the capsular serotypes of invasive K. kingae in skeletal system specimens. Knowing that rtxA, rtxB, and cpn60 PCRs cannot discriminate K. kingae from Kingella negevensis and Simonsiella muelleri, respectively, it may be suggested that adding the capsular PCR to the molecular diagnosis may increase its specificity (4). We observed that 99% of K. kingae OAI involved a strain harboring a capsule type a or b, which is similar to that observed in the Israeli and international collections of invasive isolates (2, 3).…”

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confidence: 79%

Distribution of Kingella kingae Capsular Serotypes in France Assessed by a Multiplex PCR Assay on Osteoarticular Samples

et al. 2018

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K ingella kingae is the leading pathogen of osteoarticular infection (OAI) in Ͻ4-yearold children in different countries where improved culture methods and nucleic acid amplification assays are routinely employed (1). The oropharynx is recognized as the portal of entry for K. kingae, which can penetrate the bloodstream and invade distant organs, facilitated by several virulence factors, such as a recently described polysaccharide capsule (2). From an international collection of 150 invasive and carriage isolates from 10 countries, Porsch et al. (2) have described four capsule types using a multiplex PCR approach. Over 95% of invasive isolates in the collection were types a or b, while capsule types c and d were more commonly observed among carriage isolates (2, 3). This distribution was described based on K. kingae isolates; however, K. kingae is a fastidious bacterium, and whether strains harboring capsule types a or b can be more easily cultivated from clinical samples is unknown. Such differences may lead to biased epidemiological results. Moreover, among this collection, 30 invasive isolates were from France, mainly isolated from 2010 to 2013 (n ϭ 24/30, date range 1972 to 2013). To our knowledge, no more recent data are available yet, and whether the epidemiology has changed remains to be determined. We aimed to describe the K. kingae capsule serotypes using a multiplex PCR protocol, as recently described (4), on a fraction of our collection of osteoarticular samples, which were positive with the K. kingae specific real-time PCR used as routine in our laboratory (5). From July 2013 to April 2018, we found 115 K. kingae-positive osteoarticular samples from 105 patients (1 to 3 samples per patient). Sample origins were joint fluid (95/105; 90.5%), synovial biopsy specimen (8/105; 7.6%), bone abscess (1/105; 0.9%), and subcutaneous collection (1/105; 0.9%). Capsular PCR allowed unambiguously identification of a capsule type in all of these 115 samples (Fig. 1). Among the 105 patients, the PCR results showed 71 (67.6%) type a capsules, 33 (31.4%) type b capsules, 1 (0.9%) type c capsule, and no type d capsules. When multiple samples were available for one patient, the results were identical for each sample. There were no significant variations between distribution of type a and b

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confidence: 79%

Distribution of Kingella kingae Capsular Serotypes in France Assessed by a Multiplex PCR Assay on Osteoarticular Samples

et al. 2018

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“…Studies have shown a pediatric carriage rate of 23% in Christchurch, New Zealand [ 55 ], 13% in Western Norway [ 47 ], 10% in Southern Israel [ 6 , 19 ], 9% in Geneva, Switzerland [ 52 ], and 5% in the Paris region [ 56 ], but nil in Vancouver, Canada [ 31 ] and in Sidney, Australia [ 57 ]. Although the wide range of colonization rates found in these studies may indicate actual disparities, factors such as the age of the studied populations, daycare attendance patterns, recent antibiotic exposure, the specimen collection technique, or the sensitivity of the detection method (culture-based or NAATs) may explain some of these discrepancies.…”

Section: Resultsmentioning

confidence: 99%

“…While the Israeli and Australian studies were based on pharyngeal cultures, all others employed NAATs. Remarkably, the use NAATs detected K. kingae in 11 out of 217 (5.1%) children in the French study, whereas the parallel cultures failed to isolate the organism in all cases [ 56 ]. Employing a vancomycin-containing agar plate, Olijve et al recovered K. kingae in only 4 out of 176 (2.3%) New Zealand children aged 6–48 months [ 55 ].…”

Section: Resultsmentioning

confidence: 99%

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

Yagupsky

2022

Microorganisms

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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.

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“…The peak of incidence of many respiratory viral infections coincides with the age of K. kingae carriage and invasive infections [1]. Knowing that the reservoir of K. kingae is the oropharynx of young children [1,34], and that K. kingae possesses some virulence factors such as type IV pili (allowing adhesion to respiratory epithelium) [6,35,36], and RTX toxin (having a cytotoxic activity able to breach the respiratory epithelium) [7,37,38], it seems plausible that damage to the mucosal layer caused by a viral disease facilitates the entry of K. kingae organisms in the bloodstream [1].…”

Section: Discussionmentioning

confidence: 99%

Kingella kingae and Viral Infections

2022

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Kingella kingae (K. kingae) is an oropharyngeal commensal agent of toddlers and the primary cause of osteoarticular infections in 6–23-month-old children. Knowing that the oropharynx of young children is the reservoir and the portal of entry of K. kingae, these results suggested that a viral infection may promote K. kingae infection. In this narrative review, we report the current knowledge of the concomitance between K. kingae and viral infections. This hypothesis was first suggested because some authors described that symptoms of viral infections were frequently concomitant with K. kingae infection. Second, specific viral syndromes, such as hand, foot and mouth disease or stomatitis, have been described in children experiencing a K. kingae infection. Moreover, some clusters of K. kingae infection occurring in daycare centers were preceded by viral outbreaks. Third, the major viruses identified in patients during K. kingae infection were human rhinovirus or coxsackievirus, which both belong to the Picornaviridae family and are known to facilitate bacterial infections. Finally, a temporal association was observed between human rhinovirus circulation and K. kingae infection. Although highly probable, the role of viral infection in the K. kingae pathophysiology remains unclear and is based on case description or temporal association. Molecular studies are needed.

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Prevalence of Kingella kingae oropharyngeal carriage and predominance of type a and type b polysaccharide capsules among French young children

Cited by 9 publications

References 12 publications

Distribution of Kingella kingae Capsular Serotypes in France Assessed by a Multiplex PCR Assay on Osteoarticular Samples

Distribution of Kingella kingae Capsular Serotypes in France Assessed by a Multiplex PCR Assay on Osteoarticular Samples

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

Kingella kingae and Viral Infections

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