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Kingella kingae, Molecular Detection

Molecular testing of Kingella kingae can be used to confirm the presence of the microbe in clinical samples, such as joint fluid, blood, or other specimens collected from a patient suspected of having a Kingella kingae infection.

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Kingella kingae is a small, Gram-negative bacterium that is primarily associated with various infections, particularly in children, although it can affect individuals of all ages. Kingella kingae infections can manifest as osteoarticular infections (infections of the bones and joints), bacteremia (presence of bacteria in the bloodstream), and other localized infections. First isolated in 1960 by Elizabeth King.

Kingella kingae infections are more commonly found in young children, typically affecting those aged 6 months to 4 years. However, they can occur in individuals of all ages. The bacterium is recognized as a significant pathogen in pediatric medicine. The exact mode of transmission of Kingella kingae is not well understood, but it is believed to spread through respiratory secretions and close person-to-person contact. It can also be found in the normal flora of the respiratory and upper gastrointestinal tracts.

Kingella kingae is associated with several clinical presentations, including:

  • Osteoarticular Infections: These are the most common manifestations in children. Kingella kingae is a leading cause of septic arthritis and osteomyelitis in young children.
  • Bacteremia: The bacterium can cause bacteremia, where the bacteria enter the bloodstream. This can lead to systemic symptoms and complications.
  • Endocarditis: In some cases, Kingella kingae can lead to infective endocarditis. Kingella kingae is a significant cause of endocarditis in pediatric patients. It is one of the HACEK organisms (Haemophilus species, Aggregatibacter species, Cardiobacterium hominis, Elkenella corrodens, and Kingella species). Kingella endocarditis typically affects adults and older children, unlike the skeletal system infections, which are predominantly in younger children. Antecedent dental health or procedures are the risk factors for HACEK endocarditis. Other predisposing factors are cardiac anomalies and rheumatic fever. 
  • Respiratory Infections: It can also cause respiratory tract infections, although this is less common.

Diagnosis of Kingella kingae infections can be challenging, particularly with osteoarticular infections. It often requires specialized laboratory techniques, such as PCR (polymerase chain reaction) testing to detect the genetic material of the bacterium. Traditional cultural methods may not always be successful in isolating Kingella kingae.

Kingella kingae infections are typically treated with antibiotics. The choice of antibiotics depends on the type and severity of the infection and the susceptibility of the bacteria to specific drugs.

Given the unique clinical manifestations and the age group commonly affected, Kingella kingae is of particular interest in pediatric medicine. Timely and accurate diagnosis, using molecular diagnostic techniques like PCR, is crucial for the effective management and treatment of infections caused by this bacterium, especially in cases of septic arthritis and osteomyelitis in young children.

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