Published online December 1, 2008
PEDIATRICS Vol. 122 No. 6 December 2008, pp. 1305-1309 (doi:10.1542/peds.2007-3070)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Dubnov-Raz, G.
Right arrow Articles by Garty, B.-Z.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Dubnov-Raz, G.
Right arrow Articles by Garty, B.-Z.
Related Collections
Right arrow Infectious Disease & Immunity
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

ARTICLE

Invasive Kingella kingae Infections in Children: Clinical and Laboratory Characteristics

Gal Dubnov-Raz, MD, MSca,b, Oded Scheuerman, MDb,c, Gabriel Chodick, PhDb,d, Yaron Finkelstein, MDb,e, Zmira Samra, PhDb,f and Ben-Zion Garty, MDb,c

a Department of Pediatrics, Mt Scopus, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
d Epidemiology and Preventive Medicine
b Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
c Department of Pediatrics B, Schneider Children's Medical Center of Israel, Petah Tiqwa, Israel
e Division of Clinical Pharmacology and Toxicology, Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
f Department of Clinical Microbiology, Rabin Medical Center, Beilinson Campus, Petah Tiqwa, Israel

OBJECTIVE. Kingella kingae, a Gram-negative coccobacillus, is being increasingly recognized as an invasive pathogen in children, causing mainly bacteremia and arthritis; however, there have been only a few studies on K kingae infections to date, mostly small-scale series. The aim of this study was to report our experience with invasive K kingae infections in children who were hospitalized at a major tertiary medical center in Israel.

METHODS. The medical charts of 62 children with proven invasive K kingae infections were reviewed: 42 with positive blood culture results and 20 with positive synovial fluid culture results.

RESULTS. Most infections occurred among previously healthy children aged 5 to 22 months. Eighty percent had a mild concurrent illness of the respiratory or gastrointestinal tract. A chronic underlying disease was documented in 19% of the 1- to 15-year-old children with bacteremia. Three patients had persistent bacteremia, identified by 2 positive blood cultures drawn 1 to 4 days apart. Four (10%) patients from the bacteremia group had endocarditis, and 2 required emergency cardiac surgery. Only a mild-to-moderate elevation of serum inflammatory markers was noted except for patients with endocarditis or a prolonged course of arthritis. Patients with bacteremia received a diagnosis significantly later than those with arthritis, with no other between-group differences in age, month of disease onset, and inflammatory marker levels. All K kingae isolates were resistant to vancomycin and clindamycin.

CONCLUSIONS. Our large series indicates that invasive K kingae infections occur in previously healthy children, mostly during the first 2 years of life; affected older children usually have an underlying medical condition. The infection generally elicits only a mild inflammatory response unless accompanied by endocarditis. Despite its low virulence, K kingae might cause a life-threatening heart disease that requires emergent, aggressive treatment.

Key Words: Kingella • bacteremia • arthritis • endocarditis • children

Accepted Mar 3, 2008.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 J. Clin. Microbiol.Home page
B. Ilharreborde, P. Bidet, M. Lorrot, J. Even, P. Mariani-Kurkdjian, S. Liguori, C. Vitoux, Y. Lefevre, C. Doit, F. Fitoussi, et al.
New Real-Time PCR-Based Method for Kingella kingae DNA Detection: Application to Samples Collected from 89 Children with Acute Arthritis
J. Clin. Microbiol., June 1, 2009; 47(6): 1837 - 1841.
[Abstract] [Full Text] [PDF]