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Patterns of Kingella kingae Disease Outbreaks
Nawal El Houmami1, Philippe Minodier, Grégory Dubourg
1From the *Department of Pediatric Orthopedics, University La Timone Children's Hospital; †URMITE "Unité de Recherche sur les Maladies Infectieuses Tropicales Emergentes", UM63, CNRS 7278, IRD 198, Inserm 1095, Institut Hospitalo-Universitaire Méditerranée-Infection, Aix-Marseille University; ‡Department of Pediatric Emergency Medicine, University North Hospital, Marseille, France; §Laboratoire de Virologie, Centre National de Référence des Enterovirus et Parechovirus-laboratoire associé, CHU de Clermont-Ferrand, Clermont-Ferrand, France; ¶Laboratoire de Microbiologie, Hôpital Robert Debré, AP-HP, Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France; ‖Aix Marseille Université, IRD French Institute of Research for Development, EHESP French School of Public Health, EPV UMR_D 190 "Emergence des Pathologies Virales", & Institut Hospitalo-Universitaire Méditerranée-Infection, Marseille, France; and **Clinical Microbiology Laboratory, Soroka University Medical Center, Beer-Sheva, Israel.
Kingella kingae outbreaks in childcare centers cause severe infections, often missed by traditional cultures. Genomic technologies are crucial for accurate identification and understanding these pediatric disease patterns.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Epidemiology
Background:
- Kingella kingae outbreaks are sporadic in childcare settings, posing diagnostic challenges.
- Understanding outbreak patterns is essential for effective identification and management strategies.
Purpose of the Study:
- To analyze epidemiological, clinical, and laboratory data from Kingella kingae outbreaks.
- To characterize K. kingae outbreak patterns for improved identification and management.
Main Methods:
- Collected data from reported K. kingae outbreaks and two new Israeli outbreaks in 2014.
- Utilized real-time PCR and multilocus sequence typing (MLST) for diagnosis and strain analysis.
- Investigated K. kingae carriage in close contacts via oropharyngeal sampling.
Main Results:
- Nine outbreaks occurred in the USA, Israel, and France (2003-2014) affecting 27 children.
- Osteoarticular infections were predominant (88.9%), with seasonal patterns and a 3.7% case-fatality rate.
- Real-time PCR outperformed culture; ST-6 and ST-25 strains were implicated. Coviral infections were common.
Conclusions:
- Kingella kingae outbreaks lead to severe pediatric diseases often missed by standard culture methods.
- Genomic technologies, including real-time PCR and MLST, are vital for accurate diagnosis and outbreak investigation.
- Further research using genomic approaches is recommended to fully understand K. kingae outbreaks.
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