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Increasing prevalence of Kingella kingae in osteoarticular infections in young children

D W Lundy1, D K Kehl

  • 1Scottish Rite Children's Medical Center, Atlanta, Georgia, USA.

Journal of Pediatric Orthopedics
|April 8, 1998
PubMed

Insights

Routine infant immunizations have shifted pediatric bone and joint infections. Kingella kingae now replaces Haemophilus influenzae as the leading gram-negative pathogen in children under three.

Area of Science:

  • Pediatric Infectious Diseases
  • Microbiology
  • Orthopedic Infections

Background:

  • Hematogenous septic arthritis and osteomyelitis are significant pediatric bone and joint infections.
  • Historically, Haemophilus influenzae was a predominant pathogen in young children.

Purpose of the Study:

  • To identify the causative organisms in pediatric septic arthritis and osteomyelitis.
  • To assess the impact of Haemophilus influenzae immunization on bacterial patterns.

Main Methods:

  • Retrospective review of 60 children under 3 years old with culture-positive infections.
  • Analysis of bacterial cultures from cases of septic arthritis and osteomyelitis.

Main Results:

  • Gram-positive bacteria were found in 78.3% of cases, gram-negative in 21.7%.
  • Kingella kingae was identified in 16.7% of cases, primarily in infants aged 10.5-23.5 months.
  • Haemophilus influenzae was rarely identified, indicating a significant decrease.

Conclusions:

  • Infant immunization against Haemophilus influenzae has altered the epidemiology of pediatric bone and joint infections.
  • Kingella kingae has emerged as a common pathogen, replacing H. influenzae in this age group.

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