An Evaluation of Novel Inflammatory Biomarkers in Children with Kingella kingae Osteoarticular Infections
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Published on: December 3, 2017
Matteo Fortunato1,2, Anne Tabard-Fougère2, Giacomo De Marco2
1Faculty of Medicine, University of Geneva, 1206 Geneva, Switzerland.
Insights
Immune-inflammatory biomarkers (IIBs) derived from complete blood counts show limited utility in screening for Kingella kingae osteoarticular infections (OAIs) in children. Most IIBs remained within normal ranges, indicating they are not reliable standalone diagnostic tools.
Area of Science:
- Pediatrics
- Infectious Diseases
- Hematology
Background:
- Kingella kingae is a leading cause of pediatric osteoarticular infections (OAIs).
- Early diagnosis of K. kingae OAIs is challenging due to mild symptoms and weak inflammatory responses.
- Complete blood count-derived immune-inflammatory biomarkers (IIBs) are low-cost indicators of systemic inflammation with potential diagnostic value.
Purpose of the Study:
- To evaluate the utility of IIBs in screening for K. kingae OAIs in children.
- To assess if IIBs can aid in the early detection of K. kingae osteoarticular infections.
Main Methods:
- Retrospective review of medical records of 209 children with confirmed or suspected K. kingae OAIs.
- Analysis of complete blood counts, including leukocyte subtypes.
- Calculation and interpretation of IIBs (NLR, MLR, PLR, SII, SIRI, PIV) using age-adjusted reference values.
Main Results:
- Most patients were under 48 months old, with septic arthritis being the most common presentation.
- Conventional inflammatory markers (WBC, CRP, ESR) were often normal or mildly elevated.
- Most IIBs were within or near reference ranges; only the platelet-to-lymphocyte ratio exceeded thresholds in 59.3% of patients.
Conclusions:
- Complete blood count-derived IIBs have limited standalone screening utility for Kingella kingae osteoarticular infections.
- Further research is needed to determine if systemic IIBs can differentiate K. kingae OAIs from those caused by pyogenic bacteria.
Abstract:
Kingella kingae is now recognised as the leading cause of osteoarticular infections (OAIs) in young children. Because these infections typically produce mild symptoms and a weak inflammatory response, early diagnosis remains challenging. Complete blood count-derived immune-inflammatory biomarkers (IIBs) have recently gained interest as accessible, low-cost indicators of systemic inflammation, with potential diagnostic value in several fields, including oncology, rheumatology, cardiology, and infectious diseases. This study therefore aimed to assess whether IIBs could support the screening of K. kingae OAIs. We retrospectively reviewed the medical records of 209 children admitted to our hospital between 2007 and 2025 with confirmed or highly suspected K. kingae OAIs. Complete blood counts were analysed for each patient, including leukocyte subtypes such as neutrophils, lymphocytes, monocytes, eosinophils, and basophils. We then calculated biomarkers (NLR, MLR, PLR, SII, SIRI, and PIV) and interpreted them using age-adjusted reference values. As expected, most children were younger than 48 months, and septic arthritis was the predominant clinical presentation. Classical acute-phase reactants (WBC, CRP, and ESR) were frequently normal or only mildly elevated. Likewise, most IIBs remained within or near reference ranges; the platelet-to-lymphocyte ratio was the most commonly abnormal marker, exceeding the threshold in only 59.3% of patients. These results indicate that, like conventional inflammatory markers, CBC-derived IIBs have limited standalone screening utility for K. kingae OAIs. Further studies are needed to determine whether systemic IIBs can help distinguish OAIs caused by K. kingae from those caused by pyogenic bacteria.