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At least 19 recordsLinked to original sources
PubMed1983

Septic arthritis caused by Kingella kingae.

Kingella kingae is a slow-growing, fastidious gram-negative coccobacillus that is a normal inhabitant of the oropharynx of man, but it has rarely been implicated as a human pathogen. Two cases of septic arthritis caused by this organism are reported along with a review of seven previously reported cases of infections caused by this organism. Bone and joint infections predominate. Gram's-stained smears of pus from bone or joint fluid aspirate have been negative for organisms, and a delay of growth in cultures with initial difficulty in classification of the isolate is characteristic. Kingella kingae organisms have been uniformly sensitive to the penicillins and all other commonly used antibiotics that were tested. Response to treatment was good in all nine patients found to have infections caused by this organism.

Anti-Bacterial Agents↗
PubMed2006

Identification and characterization of an RTX toxin in the emerging pathogen Kingella kingae.

Kingella kingae is an emerging bacterial pathogen that is increasingly recognized as the causative agent of a variety of pediatric diseases, including septic arthritis and osteomyelitis. The pathogenesis of K. kingae disease is believed to begin with colonization of the upper respiratory tract. In the present study, we examined interactions between K. kingae and cultured respiratory epithelial cells and observed potent cytotoxicity, detected by both microscopy and lactic acid dehydrogenase (LDH) release assays. Experiments with synovial and macrophage cell lines revealed cytotoxicity for these cell types as well. Using mariner mutagenesis and a screen for loss of cytotoxicity, a genetic locus encoding an RTX toxin system was identified. Disruption of the K. kingae RTX locus resulted in a loss of cytotoxicity for respiratory epithelial, synovial, and macrophage cell lines. DNA sequence analysis demonstrated that the RTX locus is flanked by insertion elements and has a reduced G+C content compared to that of the whole genome. Two relatively less invasive Kingella species, K. oralis and K. denitrificans, were found to be noncytotoxic and to lack the RTX region, as determined by LDH release assays and Southern blotting. We concluded that K. kingae expresses an RTX toxin that has wide cellular specificity and was likely acquired horizontally. The possible roles for this toxin in the pathogenesis of K. kingae disease include breaching of the epithelial barrier and destruction of target tissues, such as synovium (joint lining).

Animals↗
PubMed1981

Identification and characterization of Kingella kingae.

Kingella kingae is a rarely isolated opportunistic pathogen in the family Neisseriaceae. Thirteen strains of this organism, including six strains isolated in Denmark, were characterized. They formed a homogeneous group of small, non-motile, fastidious Gram-negative rods which were beta-haemolytic, oxidase positive, catalase negative and saccharolytic. Acid was produced for glucose and maltose. Growth was most pronounced aerobically but corroding colonies increased considerably in size during anaerobic incubation.

Anti-Bacterial Agents↗
PubMed2000

A rare manifestation of Kingella kingae infection.

Kingella kingae is an aerobic gram-negative coccobacillus that has been associated predominantly with bone and joint infection but also with septicemia and endocarditis. Until now, only four cases of proven K. kingae meningitis have been reported. We describe a case of a K. kingae meningitis in a male adolescent who presented with a history of fever of unclear origin.

Journal Article↗
PubMed1984

Septicemia caused by Kingella kingae.

A case of Kingella kingae septicemia following acute gastroenteritis is described. Intravenous antibiotic treatment with mezlocillin and tobramycin led to rapid and sustained recovery. The infection with Kingella kingae may have been food-borne.

Acute Disease↗
PubMed1986

[Sensitivity of Kingella kingae to antibiotics].

Kingella kingae is a small Gram negative rod of the Neisseriaceae family, formerly called Moraxella kingae. This microorganism is found occasionally in the oral cavity and is capable of causing infections. We report three cases of septic arthritis in children due to K. kingae. In vitro susceptibility of the recovered strains was tested using determination of MICs in agar. The strains were susceptible to penicillin, ampicillin, ticarcillin, cephalothin, cefotaxime, gentamicin, chloramphenicol, tetracycline, trimethoprim-sulfamethoxazole, and pefloxacin, less susceptible to erythromycin and resistant to lincomycin (MIC 32 mg/l).

Anti-Bacterial Agents↗
PubMed2001

[Kingella kingae osteomyelitis].

A case of Kingella kingae osteomyelitis in a 1-year-old child is described. Kingella kingae osteoarticular infections in children and the difficulties of isolating this slow growing, fastidious bacterium are discussed.

Diagnosis, Differential↗
PubMed1984

Endocarditis due to Kingella kingae.

Four cases of endocarditis due to Kingella kingae are described in compromised patients. All had primary heart disease, and two had systemic lupus erythematosis and congenital heart defect respectively, in addition. Confirmation of Kingella kingae was made in one case at autopsy. The literature on 11 cases of endocarditis, 2 bacteremia, 4 osteomyelitis, 5 septic arthritis and 1 intervertebral disc infection, all caused by Kingella kingae, is reviewed. Our findings confirm that the organism is of low pathogenicity. Children may be predisposed to infection with Kingella kingae.

Adolescent↗
PubMed2002

[Kingella kingae: a rare cause of meningitis].

UNLABELLED: Kingella kingae is the second most frequent germ involved in arthritis affecting young children. This germ isolation on ordinary environment is difficult, which may explain why it is seldom known. It is now widely accepted that a direct inoculate of articular and osseous samples on liquid substrate improves the culture sensitivity. Other septic localizations have been described such as endocarditis or, less commonly, meningitis. CASE REPORT: We report the observation of a five-year-old child, treated for meningitis, with CSF culture showing evidence of scarce colonies of Kingella kingae. CONCLUSION: By analogy with arthritis, Kingella kingae may regularly be undetected, not being isolated, in some cases of non-documented meningitis with a cerebrospinal fluid (CSF) cytology recalling a bacterial origin. It would be of interest to verify if the seeding of CSF in liquid substrate would increase the sensitiveness of the cultures.

Ceftriaxone↗
PubMed2006

Kingella kingae infections in children.

Kingella kingae is a beta-hemolytic gram-negative bacillus. It was first described in the 1960's by EO King and has been reported as a cause of osteo-articular pediatric infections since the early 1980's. We performed a retrospective review of all pediatric cases of invasive K. kingae infection between 1997 and 2002, in order to define the incidence, clinical presentation and outcome of invasive K. kingae infections in a pediatric population. During the study period, a total of 24 pediatric patients with K. kingae infection were identified. There were 15 blood culture isolates of K. kingae, out of a total of 1151 (1.3%) positive blood cultures, and 9 synovial fluid culture isolates out of a total of 76 (11.8%) positive synovial fluids. Fifteen patients had osteo-articular infections and 9 had primary bacteremia without osteo-articular infection. Outcome was favorable in all cases and only in 2 patients with knee joint infection was surgical intervention performed, by means of formal knee arthrotomy. All patients recovered uneventfully, in 7 cases without any intervention and in the others with intravenous or oral antibiotic. In conclusion, invasive K. kingae infection is not uncommon in Israel. It usually has a mild course and thus is not always detected and treated. As K. kingae grows best in blood culture broth, blood and joint fluid should always be inoculated into blood culture bottles in suspected cases. This bacterium is highly sensitive to betalactame antibiotics and infection resolves quickly with antibiotic treatment. Surgical intervention for osteo-articular infection is seldom indicated.

Adolescent↗
PubMedDate not supplied

[Kingella kingae osteomyelitis].

A case of Kingella kingae osteomyelitis characterized by an early onset of cellulitis, positive blood culture and negative bone scintigraphy is reported. Exclusive of vertebral involvement, eleven cases have been described in the pediatric literature. The bacterial nature of this disorder may prove hard to demonstrate since fever, leucocytosis, and increased CRP levels are inconstant. The difficulties of isolation and growth of Kingella kingae as well as its likely resistance to antistaphylococcal agents constitute the main features of this type of infection.

Bacterial Infections↗
PubMed2000

[Kingella kingae osteoarticular infections in children. A report of a series of eight new cases].

UNLABELLED: Kingella kingae is a Gram-negative bacillus which belongs to the Neisseriaceae family. Its involvement in osteoarticular infections is relatively recent. METHODS AND RESULTS: We report eight cases of Kingella kingae osteoarticular infections that have been diagnosed at the paediatric surgical centre of Rouen University Hospital since October 1995. Six boys and two girls (mean age: 30.6 months) presented with osteomyelitis in six cases and arthritis in two. Only 75% of patients had a fever at time of diagnosis. The biological findings were slightly modified. All samples were obtained from blood, bone or joint fluid. These samples were systematically inoculated into a blood culture tube. Positive Kingella kingae culture was achieved in seven local samples and in one blood culture. All children received two antibiotics via intravenous injection while waiting for the bacteriologic results. Later, the antibiotic treatment (amoxycillin) was given per os. The mean duration of treatment was 33 days. Patients were given intravenous treatment for a period of only ten days. Six patients were followed up for a period of more than 18 months and outcome was always uneventful. DISCUSSION: Kingella kingae is usually present in the nasopharyngeal mucosa and spreads in the blood due to various infections. Different types of Kingella kingae infection have been reported with a large frequency of osteoarticular infection. CONCLUSION: This type of infection does not present any unusual characteristics as compared to other osteoarticular infections. Because of its antibiotic sensitivity treatment duration could be reduced. Kingella kingae is a fragile microbe and its culture is often difficult; therefore, it is important to use blood culture tubes to inoculate joint fluid and bone samples.

Anti-Bacterial Agents↗
PubMed2000

Isolation of Kingella kingae from synovial fluids using four commercial blood culture bottles.

According to the literature, Kingella kingae may be an underdiagnosed cause of joint and bone infections in children. The use of the Bactec blood culture system for culture of joint fluids has dramatically improved the isolation of this fastidious bacterium. The aim of this study was to test the recovery rate and detection time of four commercial blood culture systems: three different BacT/Alert (Organon Teknika, USA) bottles and one Bactec (Becton Dickinson Microbiology Systems, USA) bottle, all inoculated with Kingella kingae strains mixed with pooled synovial fluids. For each strain the same inoculum and volume of synovial fluid was distributed into each of the four bottles. All 24 strains tested grew in the BacT/Alert Aerobic (100%) and the BacT/Alert Pedi-BacT (100%) bottles. Twenty-one strains grew in the BacT/Alert FAN aerobic (88%) bottle, and 15 strains grew in the Bactec Plus Aerobic F (63%) bottle, in both systems within 12 days (P<0.01). The Kingella kingae strains were first detected in the BacT/Alert Pedi-BacT bottles (P<0.001). The results were reproducible. The BacT/Alert blood culture bottles were superior to previously described blood culture systems in isolating Kingella kingae from synovial fluid, even with small inoculums and small volumes of synovial fluid.

Blood↗
PubMed2005

Characterization and immunogenicity of Kingella kingae outer-membrane proteins.

In recent years, Kingella kingae has emerged as an important pediatric pathogen but the antigenicity of the organism and the host immune response have not been studied. Outer membrane proteins (OMPs) of 57 K. kingae isolates were characterized and the immune response of 19 children with invasive infections was studied by immunoblotting. Kingella kingae OMPs were remarkably similar disregarding place and time of isolation and associated clinical condition (asymptomatic carriage, bacteremia, endocarditis, septic arthritis or osteomyelitis). Most OMPs were immunogenic but the specific bands that reacted in each strain and the intensity of the reactions varied substantially. When convalescent sera were reacted with heterologous strains, bands that either were not recognized by the homologous serum or were not present in the homologous strain were visualized. These results demonstrate that OMPs of K. kingae are highly conserved but suggest that some epitopes are polymorphic, resulting in a variable pattern of immune response.

Adult↗
PubMed1986

Manifestations of Kingella kingae infections in adults: resemblance to neisserial infections.

Kingella kingae is a rare human pathogen. Most reported infections are in children and involve endocardium, vascular space, and skeletal tissues. We report herein two cases of K. kingae infection recently seen in adults. Kingella kingae caused acute meningitis in a patient with sickle cell anemia and in the second patient with alcoholic liver disease, sepsis with a petechial rash. The clinical presentation due to K. kingae closely resembled that caused by related Neisseria genus.

Adult↗
PubMed2000

Kingella kingae infections in children.

OBJECTIVE: To increase awareness of Kingella kingae infections in children by presenting four cases seen at the Gold Coast Hospital, Southport, Queensland, and reviewing the literature. METHODOLOGY: Records of the four cases were reviewed and relevant information described. A MEDLINE search of the English literature from 1983 to 1998 was conducted. RESULTS: Osteoarticular infections are the commonest type of invasive paediatric infection but bacteraemia and endocarditis also occur. Isolation of the organism is difficult but inoculation of the specimen into enriched blood culture systems improves the recovery rate. The majority of isolates are sensitive to beta-lactam antibiotics but resistance has been described. CONCLUSIONS: Kingella kingae infections in children are more common than previously recognized. The organism should be actively sought in any child with suspected osteoarticular infections. Recommended empiric therapy is a third generation cephalosporin until susceptibility to penicillin is confirmed.

Arthritis, Infectious↗
PubMed1998

Five cases of Kingella kingae skeletal infection in a French hospital.

Five cases of Kingella kingae skeletal infections were diagnosed in children admitted to La Timone Hospital between 1992 and 1997. Patients were between 6 and 31 months old and presented with septic spondylodiskitis, calcaneus osteomyelitis, and hip-joint arthritis. All displayed either an upper respiratory tract infection or eczema during the month prior to their admission. Laboratory findings included an elevated leukocyte count and an elevated erythrocyte sedimentation rate. Standard radiography was unrevealing, but 99mTc bone scans and magnetic resonance imaging showed significant abnormalities. Isolation of Kingella kingae was achieved in all cases by culture of fluid aspirates using the Bactec blood culture system. This bacterium was sensitive to the most common antibiotics tested, and the outcome was favourable in all cases.

Arthritis↗
PubMed1984

Kingella kingae osteomyelitis of the clavicle.

Kingella kingae is the most recent addition to the list of etiologic agents causing osteomyelitis and septic arthritis in previously well children. A case is presented of a child with K. kingae osteomyelitis of the clavicle--an uncommon site of infection due to any organism. In the hope of facilitating the detection and treatment of this increasingly recognized pathogen, a brief discussion of its microbiologic characteristics and a summary of the patients reported to date with bone and joint infections due to this organism are included. To our knowledge, this is the first discussion of K. kingae in the orthopedic literature.

Bacterial Infections↗