Journal
PEDIATRICS
Volume 127, Issue 3, Pages 557-565Publisher
AMER ACAD PEDIATRICS
DOI: 10.1542/peds.2010-1867
Keywords
Kingella kingae; children; pathogenesis; carriage; invasive disease; daycare centers
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Kingella kingae is being recognized increasingly as a common etiology of pediatric osteoarticular infections, bacteremia, and endocarditis, which reflects improved culture methods and use of nucleic acidamplification techniques in clinical microbiology laboratories. K kingae colonizes the posterior pharynx of young children and is transmitted from child to child through close personal contact. Day care attendance increases the risk for colonization and transmission, and clusters of K kingae infections among day care center attendees have been reported. Key virulence factors in K kingae include type IV pili and a potent RTX toxin. In previously healthy children, > 95% of K kingae infections are diagnosed between the ages of 6 and 48 months. Among children with underlying medical conditions, K kingae disease may occur at older ages as well. The clinical presentation of K kingae disease is often subtle and may be associated with normal levels of acute-phase reactants, which underscores the importance of a high index of suspicion. K kingae is usually susceptible to beta-lactam antibiotics, and infections typically respond well to medical treatment, with the exception of cases of endocarditis. Pediatrics 2011;127:557-565
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