title: Increasing prevalence of Kingella kingae in osteoarticular infections in young children.
abstract: Sixty children younger than 3 years with culture-positive hematogenous septic arthritis and acute/subacute osteomyelitis treated between 1990 and 1995 were reviewed to identify the infecting organism. Gram-positive bacteria were identified in 47 (78.3%) patients, and gram-negative organisms were identified in 13 (21.7%) patients. Haemophilus influenzae was cultured in none of the cases of septic arthritis and in only one (1.6%) case of acute osteomyelitis. Kingella kingae was cultured in 10 (16.7%) cases, with all of these patients between the ages of 10.5 and 23.5 months. Routine immunization of infants against H. influenzae has caused a change in the historically reported bacteria of bone and joint infections in children younger than 3 years. Haemophilus influenzae has lost its predominance as the most commonly identified gram-negative pathogen, and in this study, has been replaced by K. kingae.
authors.affiliation: Scottish Rite Children's Medical Center, Atlanta, Georgia, USA.
authors.forename: D W
authors.initials: DW
authors.lastname: Lundy
authors.forename: D K
authors.initials: DK
authors.lastname: Kehl
mesh_terms: D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D002675:Child, Preschool; D004927:Escherichia coli Infections / Q000453:epidemiology; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006192:Haemophilus Infections / Q000453:epidemiology; D006193:Haemophilus influenzae / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D017882:Kingella kingae / Q000302:isolation & purification*; D008297:Male; D016870:Neisseriaceae Infections / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D011859:Radiography; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents