Journal
EXPERT REVIEW OF ANTI-INFECTIVE THERAPY
Volume 15, Issue 10, Pages 925-934Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/14787210.2017.1381557
Keywords
Kingella kingae; infections; children; detection; culture; nucleic acid amplification assays
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Introduction: Kingella kingae is currently recognized as the prime etiology of skeletal system infections in children aged 6-48months. The organism is notoriously fastidious, its growth is inhibited by synovial fluid and bone exudates, and its presence in clinical specimens is commonly missed by traditional culture methods.Areas covered: The present review discusses the use of improved laboratory methods to detect the organism in normally sterile body fluids, exudates, and upper respiratory tract specimens.Expert commentary: While inoculation of joint and bone exudates into blood culture vials dilutes the concentration of detrimental factors and significantly improves the isolation of the organism, novel PCR-based assays have enhanced sensitivity, shortened the time-to-detection of K. kingae from 3-4days to <24h, and enabled the bacteriological diagnosis in patients being administered antibiotic therapy. PCR-based assays that amplify the 16S rRNA gene results in a 200% improvement in the diagnosis of the organism compared to culture, whereas the use of real-time PCR tests that target K. kingae-specific DNA sequences increases the detection rate by a five-fold factor and reduces the fraction of culture-negative septic arthritis and osteomyelitis in infants and young children.
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