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Review highlights the latest research in Kingella kingae and stresses that molecular tests are required for diagnosis
1Clinical Microbiology Laboratory, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Insights
Kingella kingae is a common cause of skeletal infections in young children, often spread through daycare. Molecular tests are crucial for diagnosing this difficult-to-culture bacterium.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Clinical Diagnostics
Background:
- Kingella kingae is an emerging pathogen causing significant infections in children.
- Understanding its transmission and clinical presentation is vital for timely diagnosis and management.
Purpose of the Study:
- To provide an updated review of pediatric Kingella kingae infections.
- To highlight key aspects of its epidemiology, clinical features, diagnosis, and treatment.
Main Methods:
- Systematic literature search of PubMed database.
- Inclusion of studies published in English, French, and Spanish up to November 15, 2020.
Main Results:
- Kingella kingae colonizes the oropharynx and spreads child-to-child, with day care centers facilitating transmission.
- Skeletal infections present with mild symptoms, but diagnosis is challenging due to culture difficulties; molecular tests improve detection.
- While generally susceptible to beta-lactams, endocarditis cases can be severe with high fatality rates.
Conclusions:
- Kingella kingae is the primary cause of skeletal infections in children aged 6-48 months.
- Pediatricians must recognize the unique characteristics of Kingella kingae infections and utilize molecular diagnostic methods.
Aim:
The aim of this study was to provide an update on paediatric Kingella kingae infections.
Methods:
We used the PubMed database to identify studies published in English, French and Spanish up to 15 November 2020.
Results:
Kingella kingae colonised the oropharynx after the age of 6 months, and the mucosal surface was the portal of entry of the organism to the bloodstream and the source of child-to-child spread. Attending day care centres was associated with increased carriage rate and transmission and disease outbreaks were detected in day care facilities. Skeletal system infections were usually characterised by mild symptoms and moderately elevated inflammation markers, requiring a high clinical suspicion index. The organism was difficult to recover in cultures and molecular tests significantly improve its detection. Kingella kingae was generally susceptible to beta-lactam antibiotics, and skeletal diseases and bacteraemia responded to antimicrobial, leaving no long-term sequelae. However, patients with endocarditis frequently experienced life-threatening complications and the case fatality rate exceeded 10%.
Conclusion:
Kingella kingae was the prime aetiology of skeletal system infections in children aged 6-48 months. Paediatricians should be aware of the peculiar features of this infection and the need to use molecular tests for diagnosis.
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