title: Detection of Kingella kingae osteoarticular infections in children by oropharyngeal swab PCR.
abstract: OBJECTIVE
  The purpose of this study was to investigate if oropharyngeal swab polymerase chain reaction (PCR) could predict osteoarticular infection (OAI) due to Kingella kingae in young children.
  
  
  METHODS
  One hundred twenty-three consecutive children aged 6 to 48 months presenting with atraumatic osteoarticular complaints were prospectively studied. All had a clinical evaluation, imaging, and blood samples. Blood and oropharyngeal specimens were tested with a PCR assay specific for K kingae. OAI was defined as bone, joint, or blood detection of pathogenic bacteria, or MRI consistent with infection in the absence of positive microbiology. K kingae OAI was defined by blood, bone, or synovial fluid positivity for the organism by culture or PCR.
  
  
  RESULTS
  Forty children met the OAI case definition; 30 had K kingae OAI, 1 had another organism, and 9 had no microbiologic diagnosis. All 30 oropharyngeal swabs from the K kingae case patients and 8 swabs from the 84 patients without OAI or with OAI caused by another organism were positive. The sensitivity and specificity of the oropharyngeal swab PCR assay for K kingae were 100% and 90.5%, respectively.
  
  
  CONCLUSIONS
  Detection of K kingae DNA in oropharyngeal swabs of children with clinical findings of OAI is predictive of K kingae OAI. If these findings are replicated in other settings, detection of K kingae by oropharyngeal swab PCR could improve the recognition of OAI.
authors.affiliation: Service of Pediatric Orthopedics, University Hospitals of Geneva, Geneva, Switzerland. dimitri.ceroni@hcuge.ch
authors.forename: Dimitri
authors.initials: D
authors.lastname: Ceroni
authors.forename: Victor
authors.initials: V
authors.lastname: Dubois-Ferriere
authors.forename: Abdessalam
authors.initials: A
authors.lastname: Cherkaoui
authors.forename: Renzi
authors.initials: R
authors.lastname: Gesuele
authors.forename: Christophe
authors.initials: C
authors.lastname: Combescure
authors.forename: Léopold
authors.initials: L
authors.lastname: Lamah
authors.forename: Sergio
authors.initials: S
authors.lastname: Manzano
authors.forename: Jonathan
authors.initials: J
authors.lastname: Hibbs
authors.forename: Jacques
authors.initials: J
authors.lastname: Schrenzel
mesh_terms: D002358:Cartilage, Articular / Q000382:microbiology* / Q000473:pathology; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D017882:Kingella kingae / Q000302:isolation & purification* / Q000472:pathogenicity; D008297:Male; D016870:Neisseriaceae Infections / Q000175:diagnosis* / Q000382:microbiology; D009960:Oropharynx / Q000382:microbiology*; D010019:Osteomyelitis / Q000175:diagnosis / Q000235:genetics / Q000382:microbiology; D016133:Polymerase Chain Reaction / Q000379:methods*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013048:Specimen Handling / Q000379:methods