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K. kingae bacteria in throat linked to bone, joint infection in children
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Of the children who experienced bone or joint infection, 71% had the identical Kingella kingae bacterium present in their throats, suggesting that children with osteoarticular infections may benefit from examination for oropharyngeal infections to expedite diagnosis.
“The pathogenesis of osteoarticular infection related to K. kingae remains unclear, but there is evidence that the bacterium initially colonizes in the oropharynx before penetrating the bloodstream and invading distant organs,” Jocelyn Gravel, MD, MSc, from the department of pediatrics at Centre hospitalier universitaire Sainte-Justine, Université de Montréal, and colleagues wrote. “This relation has never been shown in North America.”
To assess the connection between the presence of K. kingae in the oropharynx and osteoarticular infection in preschool-aged children, the researchers conducted a prospective case-control study. The study was held between 2014 and 2016 in two tertiary care pediatric hospitals in Canada and Switzerland. Children aged 6 to 48 months with a probable osteoarticular infection diagnosis were included.
Cases of osteomyelitis or septic arthritis were confirmed through positive technetium-labeled bone scans, MRI or observation of microorganisms in joint aspirate or blood. Four age-matched controls presenting to the ED with trauma were paired with each case.
Among the children who were admitted to the ED with probable osteoarticular infection (n = 77), 71% had K. kingae observed in their oropharynx. The number of children in the control group with identifiable K. kingae in the oropharynx was noted at only 6% (OR: 38.3; 95% CI, 18.5-79.1).
“Based on this study, we plan to change the way we investigate children at risk of bone or joint infection, because the identification of K. kingae in the throat of a child with suspected bone infection will point towards K. kingae as the culprit,” the researchers said in a press release. “This may decrease the number of other tests performed to identify the pathogen.” – by Katherine Bortz
Disclosure: The researchers report no relevant financial disclosures.
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