Person‐to‐Person Transmission ofKingella kingaeamong Day Care Center Attendees

Abstract

Fifty Kingella kingae organisms, isolated from tonsillar cultures of day care center attendees during an 11-month period, and 60 isolates derived from epidemiologically unrelated individuals, including 19 isolates from respiratory carriers and 41 isolates from patients with invasive infections, were typed by immunoblotting, pulsed-field gel electrophoresis, and ribotyping. One strain, defined by unique immunoblotting, pulsed-field gel electrophoresis, and ribotyping patterns, represented 14 day care isolates (28%) and was frequently isolated during the first half of the follow-up period; a second strain represented 23 (46%) isolates and prevailed during the last 5 months. Children frequently carried the same strain continuously or intermittently for weeks or months, when it was replaced by a new strain. Epidemiologically unrelated organisms showed greater variability, and no strain represented >5% of isolates. The present results support person-to-person transmission of K. kingae among young children in the day care setting.

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

“…The results of many studies strongly support child-to-child transmission of K. kingae among young children [21,24,35], and that 50% of children carry this microrganism for long periods (at least twice during a 12-month follow-up period) [36]. Because, on average, young children put their hands or objects in their mouth once every 3 min, commensal respiratory organisms such as K. kingae that are disseminated by large droplets are likely to spread to young children who share toys coated with saliva [23,37].…”

“…More than 450 strains of K. kingae have been isolated from healthy carriers; these differents strains were gathered in different studies on the carriage of K. kingae conducted among children living in southern and central Israel during the last 25 years [19][20][21][22][23][24]. Among them, 181 invasive K. kingae strains have been isolated between 1992 and 2012 from Israeli patients with bacteremia, skeletal system infections and endocarditis [20].…”

Outbreak of Osteomyelitis/Septic Arthritis Caused byKingella kingaeAmong Child Care Center Attendees

“…47 Subtyping demonstrated that they were colonized with 2 dominant subtypes, which clustered temporally and lasted for weeks to months. 49 Isolates from a cohort of randomly selected children were also subtyped and showed substantially more subtype variability than seen among isolates from the child care center. 49 These studies indicate person-to-person transmission occurring within the facility, with children being a reservoir for the pathogen.…”

“…49 Isolates from a cohort of randomly selected children were also subtyped and showed substantially more subtype variability than seen among isolates from the child care center. 49 These studies indicate person-to-person transmission occurring within the facility, with children being a reservoir for the pathogen. Our investigation is consistent with these previous studies.…”

“…21,24,48 The age and equal gender distribution of colonization parallels that of invasive disease. 25,47 During an 11-month study of children aged 6 to 42 months at an Israeli child care center, 47,49 the monthly prevalence of K kingae colonization ranged from 6% to 35%, with 73% of children being colonized at some point during the study period; no invasive disease was observed. 47 Subtyping demonstrated that they were colonized with 2 dominant subtypes, which clustered temporally and lasted for weeks to months.…”