Clinical features and epidemiology of invasive Kingella kingae infections in southern Israel.
OBJECTIVE
To characterize the clinical spectrum and epidemiology of invasive Kingella kingae infections in children living in southern Israel.


METHODS
Five-year observational, descriptive study.


METHODS
Children in whom K. kingae was isolated from blood or other normally sterile body fluid.


RESULTS
Twenty-five patients with invasive K. kingae infection (13 male and 12 female) were identified. Twenty-four of these children were younger than 2 years. The annual incidence was 14.3, 27.4, and 31.9 cases per 100,000 children < or = 4 years, < or = 24 months, and < or = 12 months, respectively. Seventeen (68%) of 25 patients sought treatment between July and December. Concomitant upper respiratory tract infection or stomatitis was observed in 14 (56%) of the patients, suggesting a respiratory or buccal source for the infection. Four children were bacteremic: 2 of them suffered from a lower respiratory tract infection, and the remaining 2 had bacteremia with no evident focal infection. Twenty-one children had skeletal infections and none of them was bacteremic; 16 had septic arthritis, 3 had osteomyelitis, 1 had both osteomyelitis and septic arthritis of the adjacent joint, and 1 had dactylitis of the hand. Involvement of the ankle was unusually frequent among children with septic arthritis, whereas the calcaneus was involved in 3 of the 4 children with osteomyelitis. Antibiotic treatment resulted in full recovery in all cases, and only 2 patients with septic arthritis required surgical drainage.


CONCLUSIONS
Kingella kingae is a much more common cause of invasive infection in young children than has been previously recognized. The disease has a clear seasonal pattern, usually affects the skeletal system, frequently involves unusual bones and joints, and follows a benign course.
Yagupsky
P
P
Clinical Microbiology Laboratory, Soroka Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Dagan
R
R
Howard
C B
CB
Einhorn
M
M
Kassis
I
I
Simu
A
A
D001170:Arthritis, Infectious / Q000453:epidemiology / Q000382:microbiology; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007557:Israel / Q000453:epidemiology; D017882:Kingella kingae / Q000302:isolation & purification; D008297:Male; D016870:Neisseriaceae Infections / Q000453:epidemiology*; D010019:Osteomyelitis / Q000453:epidemiology / Q000382:microbiology; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000382:microbiology; D013280:Stomatitis / Q000453:epidemiology / Q000382:microbiology