Basic HTML Version
Molecular Pathogens
2
Children usually show symptoms including fever,
viral upper respiratory tract infections, stomatitis and
swollen joints, show decreased mobility and their
blood cultures remain negative (Dodman et al., 2000).
Predisposing factors for invasive
Kingella kingae
infection include acute lymphocytic leukaemia, sickle
cell anaemia, presence of prosthetic devices and
congenital heart disease. Other predisposing factors
for
K. kingae
infection include poor oral hygiene,
pharyngitis, or mucosal ulceration due to cancer
chemotherapy.
Kingella kingae
has also been
associated with cardiovascular complications in
children with mitral valve perforation resulting in
infective endocarditis in children (Holmes et al., 2011).
Predisposing factors in adults include history of major
cardiac surgery, old age, chronic kidney diseases,
diabetes mellitus, cancer patients and presence of
orthopaedic and other prosthetic devices (Henrikssen
et al., 1976). Acquired immunodeficiency due to
infection with HIV or immunocompromised due to
immunosuppressive therapies (solid organ transplants),
autoimmune conditions like systemic lupus
erythematosus
(SLE)
and haematological
malignancies may also predispose to invasive
Kingella kingae
infections (Wolak et al., 2000) (Table
1). A recent study has reported the genome sequence
of
Kingella kingae
(strain-PYKK081) that has been
isolated from joint fluid of an 8-month old child who
was suffering from septic arthritis in 1991. The study
revealed that the genome sequence was unique and not
matching with other
Kingella kingae
(nasal isolate
ATCC 23330/gene bank No: AFHS0100000) and
members of
Neisseria
warranting a separate status.
The study also mapped several protein coding genes
including some genes responsible for resistance to
antibiotics and some coding for invasive activity
(Jeffrey et al., 2012). It has been revealed that 27.4 out
of every 100 000 children suffer from
Kingella kingae
invasive infection annually in Israel (Yagupsky and
Dagan, 1997).
Table 1 Spectrum of infections and possible predisposing factors caused by
Kingella kingae
in children and adults
Children
Predisposing factors
Osteomyelitis
Children between 6months-24months
Osteoarticular infections (Septic arthritis, diskitis, tenosynovitis
and dactylitis)
Congenital heart disease (Valvular pathology) or other
anomalies
Endocarditis
Sickle cell anaemia
Hematogenous spondylodiscitis
Acute lymphocytic leukaemia
Bacteremia
Presence of prosthetic devices
Lower respiratory tract infections
Poor oral hygiene
Meningitis
Chronic Pharyngitis
Peritonitis
Mucosal ulceration due to cancer/cancer chemotherapy
Cellulitis
Old age
Ocular infections
History of major cardiac surgery
Haematogenous endophthalmitis
Chronic kidney diseases
Soft tissue infections
Diabetes mellitus
Pneumonia
Cancer patients with solid tumors/ Haematological
Adult
malignancies
Infective endocarditis
Presence of orthopaedic and other prosthetic devices
Bacteremia
Autoimmune conditions like systemic lupus erythematosus (SLE)
Osteomyelitis
Solid organ transplants
Intervertebral diskitis
Liver cirrhosis
Urinary tract infection
Cardiac vascular pathology
Spondylodiscitis
HIV infection
Sacroillitis, Pericarditis
Herpetic gingivostomatitis
Post menopause abnormal bleeding
Oral Varicella blisters
Lower respiratory tract infections
Aphthous ulcers
Arthritis, Epiglottitis and Tracheobronchitis
Other viral respiratory tract infections
Molecular Pathogens