Review highlights the latest research in Kingella kingae and stresses that molecular tests are required for diagnosis

Abstract

Paediatric osteomyelitis, septic arthritis and spondylodiscitis are medical emergencies that require prompt diagnosis and adequate antibiotic administration to avoid systemic morbidity and permanent disability. 1,2 Detecting the causative agent remains a cornerstone for the successful treatment of these infections. However, traditional culture methods frequently fail to isolate the aetiologic agent and a substantial fraction of bone, joint and intervertebral disc infections remain bacteriologically unconfirmed. 1,2 Two intertwined advances have had an impact on the microbiological diagnosis of skeletal system infections, which has led to better and more rational management. The use of sensitive nucleic acid amplification tests has shortened the time it takes to detect microorganisms from days to hours and enabled clinicians to identify bacteria that are difficult to culture. It has also revealed new pathogens and established the aetiology of the infection in patients receiving

Osteomyelitis in a General Pediatric Ward

“…Other chosen antibiotics were ceftriaxone (n=2), cefuroxime (n=2), clindamycin (n=3) and gentamicin (n=1). Parenteral treatment was performed for 14.7 ± 6.2 days [8][9][10][11][12][13][14][15][16][17][18][19][20]. Patients were discharged 17.1 ± 8.2 days after admission.…”

“…17,18 K. kingae is generally susceptible to beta-lactams alone, but the minimal inhibitory concentrations of these antibiotics are elevated. 19 Treatment of neonatal AO should have a broader antibiotic spectrum due to the increased probability of gram-negative bacillary infection. 5 In our study, flucloxacillin was the main choice.…”

Infective Endocarditis Due to Kingella kingae

“…While K. kingae asymptomatic carriage and osteoarticular infections are well known, data on IE epidemiology remain scarce. Colonization of an infant’s oropharynx typically begins around 6 months, which probably corresponds to the decline in maternal antibodies and the onset of daycare attendance [ 2 , 45 , 46 ]. The colonization rate peaks in children aged 12–24 months, with a reported prevalence ranging from 9 to 23% depending on study populations, and decreases afterwards [ 7 , 47 , 48 , 49 ].…”

“…Kingella kingae (K. kingae) is a facultative anaerobic, β-hemolytic, encapsulated organism belonging to the Neisseriaceae family of Gram-negative bacteria that yields positive oxidase and negative catalase reactions [ 1 , 2 , 3 ]. Since the early 1990s, advances in culture and molecular diagnostic methods have significantly improved K. kingae detection, leading to its recognition as an important cause of invasive infection in children [ 4 , 5 , 6 ].…”

Staphylococcus aureus infection in children: diagnosis and treatment in the context of antibiotic resistance spread

“…Частота виявлення цього патогену при гематогенному остеомієліті в дітей коливається від 65 до 85 % [40]. Навіть з огляду на те, що останнім часом з'являється все більше даних про зростання ролі інших грампозитивних мікроорганізмів, зокрема Kingella kingae, у розвитку остеомієліту, принаймні в дітей раннього віку (що пов'язано з покращенням можливостей щодо виявлення даного патогену) [49], сумарна частка стафілококів та стрептококів в етіологічній структурі остеомієліту залишається на рівні 80-90 %. Остеомієліт, спричинений CA-MRSA, характеризується більш тяжким перебігом, із частішим розвитком поліосальної хвороби, міозиту, піоміозиту, внутрішньокісткових та субперіостальних абсцесів, патологічних переломів та септичного тромбофлебіту [50].…”