Specific real-time polymerase chain reaction places Kingella kingae as the most common cause of osteoarticular infections in young children.
BACKGROUND
The use of universal 16S rDNA polymerase chain reaction (PCR) has recently shown that the place of Kingella kingae in osteoarticular infections (OAI) in young children has been underestimated, but this technique is not the most sensitive or the most rapid method for molecular diagnosis. We developed a specific real-time PCR method to detect K. kingae DNA and applied it to the etiologic diagnosis of OAI.


METHODS
All children admitted to a pediatric unit for OAI between January 2004 and December 2005 were enrolled in this prospective study. Culture-negative osteoarticular specimens were tested by 16S rDNA PCR and by K. kingae-specific real-time PCR when sufficient sample remained.


RESULTS
By culture alone, a pathogen was identified in 45% of the 131 specimens tested (Staphylococcus aureus, n = 25; K. kingae, n = 17; others, n = 18). 16S rDNA PCR and K. kingae-specific PCR were both applied to 61 of the culture-negative samples. The combination of culture and 16S rDNA PCR identified a pathogen in 61% of cases (K. kingae DNA, n = 16; DNA of other microorganisms, n = 5). Specific real-time PCR identified a further 6 cases caused by K. kingae and confirmed all 16 universal PCR-positive cases, bringing the overall documentation rate to 66%. K. kingae was the leading cause of OAI in this pediatric series (n = 39, 45%), followed by S. aureus (n = 25, 29%)


CONCLUSIONS
The K. kingae-specific real-time PCR places K. kingae as the leading cause of OAI in children at our hospital.
Chometon
Sylvia
S
Laboratoire de Bactériologie, Hôpital Cardiologique Louis Pradel, Lyon, France.
Benito
Yvonne
Y
Chaker
Mourad
M
Boisset
Sandrine
S
Ploton
Christine
C
Bérard
Jérôme
J
Vandenesch
François
F
Freydiere
Anne Marie
AM
D001170:Arthritis, Infectious / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D017882:Kingella kingae / Q000302:isolation & purification*; D008297:Male; D016870:Neisseriaceae Infections / Q000382:microbiology*; D010019:Osteomyelitis / Q000382:microbiology*; D016133:Polymerase Chain Reaction / Q000379:methods*; D012336:RNA, Ribosomal, 16S / Q000235:genetics
D012336:RNA, Ribosomal, 16S