title: [Pediatric osteo-articular infections with negative culture results: what about Kingella kingae?].
abstract: Kingella kingae is an emerging pathogen that is recognized as a causative agent of septic arthritis and osteomyelitis, primarily in infants and children. The bacterium is best detected by rapid inoculation in blood culture systems or by real-time PCR assays. Pathogenesis of the agent was linked recently to the production of a potent cytotoxin, known as RTX, which is toxic to a variety of human cell types. The locus encoding the RTX toxin is thought to be a putative virulence factor, and is, apparently, essential for inducing cytotoxic effects on respiratory epithelial, synovial and macrophage-like cells. Herein, we describe a novel real-time PCR assay that targets the RTX toxin gene. The assay exhibited a sensitivity of 30 c.f.u., which is 10-fold more sensitive than a previously published semi-nested broad-range 16S rRNA gene PCR, and showed no crossreactivity with several related species and common osteoarticular pathogens. Its clinical impact is illustrated by three pediatric cases.
authors.affiliation: Laboratoire de bactériologie, Service des maladies infectieuses, HUG, 1211 Genève 14. abdessalam.cherkaoui@hcuge.ch
authors.forename: A
authors.initials: A
authors.lastname: Cherkaoui
authors.forename: D
authors.initials: D
authors.lastname: Ceroni
authors.forename: S
authors.initials: S
authors.lastname: Ferey
authors.forename: S
authors.initials: S
authors.lastname: Emonet
authors.forename: J
authors.initials: J
authors.lastname: Schrenzel
mesh_terms: D001850:Bone Diseases, Infectious / Q000175:diagnosis*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D017882:Kingella kingae; D008297:Male; D016870:Neisseriaceae Infections / Q000175:diagnosis*