<i>Kingella kingae</i> spondylodiscitis in young children: toward a new approach for bacteriological investigations? A preliminary report

Ceroni, Dimitri; Cherkaoui, Abdessalam; Kaelin, André; Schrenzel, Jacques

doi:10.1007/s11832-009-0233-2

Cited by 35 publications

(31 citation statements)

References 25 publications

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“…We used qPCR analysis to confirm the presence of bacteria in the blood. The rtxA and rtxB toxin genes are used as a specific target to diagnose K. kingae infection in clinical samples (61). We adopted this molecular diagnostic tool for our study.…”

Section: Figmentioning

confidence: 99%

RTX Toxin Plays a Key Role in Kingella kingae Virulence in an Infant Rat Model

et al. 2014

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b Kingella kingae is a human oral bacterium that can cause diseases of the skeletal system in children and infective endocarditis in children and adults. K. kingae produces a toxin of the RTX group, RtxA. To investigate the role of RtxA in disease pathogenesis in vivo, K. kingae strain PYKK081 and its isogenic RtxA-deficient strain KKNB100 were tested for their virulence and pathological consequences upon intraperitoneal injections in 7-day-postnatal (PN 7) rats. At the doses above 8.0 ؋ 10 6 cells/animal, PYKK081 was able to cause a fatal illness, resulting in rapid weight loss, bacteremia, and abdominal necrotic lesion formation. Significant histopathology was observed in thymus, spleen, and bone marrow. Strain KKNB100 was less toxic to animals. Neither weight loss, bacteremia, nor histopathological changes were evident. Animals injected with KKNB100 exhibited a significantly elevated circulating white blood cell (WBC) count, whereas animals injected with PYKK081 had a WBC count that resembled that of the uninfected control. This observation parallels the subtleties associated with clinical presentation of K. kingae disease in humans and suggests that the toxin contributes to WBC depletion. Thus, our results demonstrate that RtxA is a key K. kingae virulence factor. Furthermore, our findings suggest that the PN 7 rat can serve as a useful model for understanding disease caused by K. kingae and for elucidating diagnostic parameters in human patients.

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Section: Figmentioning

confidence: 99%

RTX Toxin Plays a Key Role in Kingella kingae Virulence in an Infant Rat Model

et al. 2014

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“…It is also interesting to highlight that the epiphysis or apophysis, which are almost never invaded by other organisms, may be commonly involved in K. kingae osteomyelitis [51,77,85,88,89]. Today, K. kingae is probably responsible for many cases of hematogenous spondylodiscitis in children younger than 4 years of age [90][91][92][93]. Patients usually present with limping, back pain, refusal to sit or walk, abdominal pain or, in rare instances, neurologic symptoms.…”

Section: Osteoarticular 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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“…Dependiendo de la complejidad del estudio microbiológi-co, en aproximadamente un tercio de los casos no se logra establecer la causa etiológica. Tras avances en biología molecular y aparición de mejores métodos de aislamiento microbiológicos, K. kingae ha surgido como una de las principales etiologías en niños bajo 3 años de edad 13 . La vía hematógena es la principal fuente de infección; sin embargo, los hemocultivos suelen ser negativos 14 .…”

Section: Discussionunclassified

“…La mayoría de los pacientes presentan síntomas durante varias semanas [2][3][4][5][6][7][8][9][10][11][12][13][14][15] . El cuadro clínico inicial se manifi esta con irritabilidad, rechazo alimentario, compromiso del estado general, llanto a la bipedestación, deambulación y a la sedestación, alteraciones de la marcha que van desde cojera progresiva hasta la imposibilidad de caminar, hiperlordosis o rectifi cación lumbar y dolor lumbar de predominio nocturno 1-2-3-11- 16 .…”

Section: Discussionunclassified

Espondilodiscitis causada por Kingella kingae en pediatría: reporte de un caso

Budnik

Porte²,

Arce

et al. 2011

Rev. chil. infectol.

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During the last years, spondilodiskitis due to Kingella kingae has been a new target of interest, since it is the second agent that causes non tuberculous espondilodiskitis in children, after Staphylococcus aureus. Its clinical presentation is very inespecifi c, sometimes with fever, abdominal or lumbar disconfort, nocturnal pain, altered walking and sedestation. Images, culture methods and PCR (polymerase chain reaction) can be helpful for diagnosis, although in an important percent of the cases, etiology cannot be determined. Although there are no established guidelines for treatment, before the suspicion, empiric antibiotic treatment should be started for good prognosis. We describe a case of a 3 year old boy, who had this disease and then a review about spondilodiskitis in childhood and microbiological aspects of Kingella kingae.Key words: Diskitis, Kingella kingae, infectious spondylitis, bone and joint infection, vertebral osteomyelitis. Palabras clave: Discitis, Kingella kingae, espondilitis infecciosa, infecciones osteoarticulares, osteomielitis vertebral.Universidad de Los Andes, Santiago, Chile. Facultad de Medicina (IBO).Clínica Santa María, Santiago, Chile. Servicio de Radiología (JDAV).Servicio de Traumatología (SVS). Servicio de Pediatría (JZR).Establecimiento(s) donde se realizó el trabajo: Clínica Santa María.Este trabajo no tiene conflictos de interés. IntroducciónL a espondilodiscitis es una patología muy infrecuente en pediatría, que requiere de un alto índice de sospecha diagnóstica, ya que un adecuado manejo determinará en parte el buen pronóstico. Aunque su etiología es controvertida, en la mayoría de los casos corresponde a infección de la columna vertebral que compromete el disco y los cuerpos vertebrales adyacentes. Avances en biología molecular han permitido identifi car nuevos agentes, particularmente Kingella kingae, cambiando el conocimiento de la etiología y así el enfoque terapéutico. En la actualidad, los agentes causantes descritos con mayor frecuencia son Staphylococcus aureus, Kingella kingae y Mycobacterium tuberculosis. La aproximación clínica de estos pacientes requiere del uso de imágenes y la obtención de muestra de tejidos para cultivo, estudio histológico y molecular. El tratamiento es con antimicrobianos, inicialmente endovenosos y luego orales, aunque no hay estudios que establezcan con certeza la terapia específi ca, su vía de administración y duración.Se describe a continuación el caso de un prescolar, que presentó una espondilodiscitis por K. kingae y posteriormente se realiza una revisión sobre esta localización de infección ostearticular en niños, fi nalizando con una actualización en K. kingae, patógeno que ha adquirido importancia en los últimos años en el desarrollo de infecciones osteo-articulares en niños.

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Kingella kingae spondylodiscitis in young children: toward a new approach for bacteriological investigations? A preliminary report

Cited by 35 publications

References 25 publications

RTX Toxin Plays a Key Role in Kingella kingae Virulence in an Infant Rat Model

RTX Toxin Plays a Key Role in Kingella kingae Virulence in an Infant Rat Model

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

Espondilodiscitis causada por Kingella kingae en pediatría: reporte de un caso

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