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Kingella kingae seen more frequently in Jewish children than Bedouins
Further data are needed to help understand the differences in prevalence of Kingella kingae infection between Jewish children and Bedouin children, according to recently published study results.
Pablo Yagupsky, MD, of the Ben-Gurion University of the Negev, Beer-Sheva, Israel, and colleagues published data on 1,277 Jewish and 1,664 Bedouin children, who were enrolled over a 2-year period that began in November 2009. Eighty-two children were colonized with K. kingae; 52 of whom were Jewish.
The researchers said although the “carriage rate of K. kingae among Jewish and Bedouin children living in southern Israel paralleled the age-related incidence of invasive infections,” living in a shanty town actually seemed protective against infection in the Bedouin children.
Those attending day care and aged 6 to 29 months were at risk for colonization with K. kingae. The researchers attributed these risk factors to fading immunity after 6 months and increased socialization that predisposed the children to transmission.
“Because the medical literature on invasive K. kingae disease is mostly limited to case series from Western countries, scarcity of reports from developing world regions suggests that the organism mainly affects affluent populations,” the researchers wrote.
However, they added, it is possible that this diagnosis is missed in developing countries because the specific lab tests in these areas are unavailable, which limits accurate comparative data.
Disclosure: Yagupsky reports no relevant financial disclosures.
Perspective
Back to TopAmit et al investigated the prevalence of pharyngeal carriage of Kingella kingae among Jewish and Bedouin children living in southern Israel and risk factors for colonization. K. kingae is a frequent component of the oropharyngeal flora of young children and is the most common etiology of skeletal infections in children younger than 48 months. Indeed, asymptomatic colonization of pharynx by K. kingae is a crucial step in the child-to-child transmission, as well as the portal of entry of the bacterium to the bloodstream.
The results of the present study demonstrate that the pharyngeal K. kingae carriage rate is strongly dependent on the child’s age and shows a striking parallel with the age-related incidence of invasive infections.
Age 6 to 29 months was a significant risk factor for K. kingae colonization in both ethnic groups; day care attendance was a risk factor in Jewish children, whereas living in a shanty town was negatively associated with carriage in Bedouins. Indeed, day care attendance was found to be significantly associated with K. kingae colonization in Jewish children.
Because of age stratification, day care center classes usually comprise children of approximately the same age and, therefore, similar degrees of immunologic immaturity and vulnerability to infectious agents. In contrast, larges families of Bedouins comprise children of different ages, and therefore, at any given time, only a small subset of siblings belong to the age group with increased susceptibility to K. kingae colonization, limiting the chance to acquire or transmit the organism. This study of high quality with high relevance to the clinical setting for pediatricians adds to the current body of knowledge.
