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Kingella kingae
a Potentially Emerging Pathogen: a Comprehensive Review
5
Studies have demonstrated that
Kingella kingae
is
susceptible to various groups of antibiotics including
the aminoglycosides, fluoroquinolones, cephalosporins,
macrolides and others. Resistance was observed
against trimethoprim-sulphamethoxazole, glycopeptides
and clindamycin (Yagupsky et al., 2001).
Future Implications
In view of increasing reports of invasive infections
with
Kingella kingae
both in paediatrics age and in
adults, it becomes necessary for, paediatricians,
orthopaeditians and clinical microbiologists to
consider this organism as a potential pathogen. More
than fifty years since its first description,
Kingellae
have evolved from being a normal commensal in
children and adults to an established pathogen in
paediatrics age group and a potential pathogen in
adults. In most of the cases it is clearly imperative that
a precise clinical suspicion is necessary and that
recovery of these bacteria depends on appropriate
laboratory methods/culture techniques used by clinical
microbiologists (Dubnov-Raz et al., 2008; Gen’e et al.,
2004; Yagupsky et al., 1992). Bacteriological
identification is only possible when laboratory
personnel are aware of the unusual cultural,
morphological and biochemical characters of
Kingella
kingae
group. Further, as these bacteria are reported
worldwide, studies on the carriage rates among
children of different ages and in adults, possible
predisposing factors in different geographical regions
is an area of much interest that should be explored
(Yagupsky and Dagan, 2000; Yagupsky et al., 2002;).
Molecular epidemiology of colonizing and invasive
Kingell kingae
infections is the need of the hour as
indicated by recent studies that have revealed a
remarkable genetic variability among various clinical
isolates of
Kingella kingae
. Studies have confirmed
that strains isolated from colonized individuals were
genetically significantly different from those isolated
from strains responsible for invasive infections
(Basmaci et al., 2012; Amit et al., 2012).
Conclusion
Existing literature about the
Kingella kingae
bacterium suggests that this bacterium though is
present as a normal flora, has the potential to cause
serious invasive infections. Use of automated blood
culture systems for primary isolations will improve
bacteriological diagnosis which otherwise are culture
negative by conventional methods and novel PCR
based nucleic acid amplification assays aid in
confirmation and study on virulence characters.
Studies further should be concentrated on the
antibiotic susceptibility profile of the clinical isolates
of
Kingella kingae
. Finally prompt clinical suspicion
and rapid laboratory confirmation would certainly
help in reducing the morbidity and mortality due to
invasive infections caused by
Kingella kingae
especially in children and debilitated adults.
References
Amit U., Porat N., Basmaci R., Bidet P., Bonacorsi S., Dagan
R., and Yaqupsky P., 2012, Genotyping of invasive
Kingella kingae
isolates reveals predominant clones and
association with specific clinical syndromes, Clin. Infect
Dis., 55(8): 1074-1079
http://dx.doi.org/10.1093/cid/cis622 PMid:22806593
Basmaci R., Ilharreborde B., Bidet P., Doit C., Lorrot M.,
Mazda K., Bingen E., and Bonacorsi S., 2012, Isolation of
Kingella kingae
in the oropharynx during K. kingae
arthritis on children, Clin. Microbiol. Infect., 18(5):
e134-6
http://dx.doi.org/10.1111/j.1469-0691.2012.03799.x
PMid:22390653
Basmaci R., Yagupsky P., Ilharreborde B., Guyot K., Porat N.,
Chomton M., Thiberqe J.M., Mazda K., Bingen E.,
Bonacorsi S., and Bidet P., 2012, Molitilocus sequence
typing and rtxA toxin gene sequencing analysis of
Kingella kingae
isolates demonstrates genetic diversity
and international clones, PLoS One, 7(5): e38078
http://dx.doi.org/10.1371/journal.pone.0038078
PMid:22693588 PMCid:PMC3365011
Baticle E., Courtivron B., Baty G., Holstein A., Morange V.,
Mereghetti L., Goudeau A., and Lanotte P., 2008, Pediatric
osteoarticular infections caused by
Kingella kingae
from
1995 to 2006 at CHRU de Tours, Ann. Biol. Clin. (Paris),
66(4): 454-458
Bendaoud M., Vinogradov E., Balashova N.V., Kadouri D.E.,
Kachlany S.C., and Kaplan J.B., 2011, Broad-spectrum
biofilm inhibition by
Kingella kingae
exopolysaccharide, J.
Bacteriol., 193(15): 3879-3886
http://dx.doi.org/10.1128/JB.00311-11
PMid:21602333 PMCid:PMC3147541
Ceroni D., Dubois-Ferrière V., Anderson R., Combescur e
C. , Lamah L. , Che rkaou i A. , and Schr enze l J . ,
2012 , Small risk of osteoarticular infections in children
Molecular Pathogens