Skip to main content
NCBI home page
Journal of Clinical Microbiology logoLink to Journal of Clinical Microbiology
. 1992 May;30(5):1278–1281. doi: 10.1128/jcm.30.5.1278-1281.1992

High prevalence of Kingella kingae in joint fluid from children with septic arthritis revealed by the BACTEC blood culture system.

P Yagupsky 1, R Dagan 1, C W Howard 1, M Einhorn 1, I Kassis 1, A Simu 1
PMCID: PMC265264  PMID: 1583131

Abstract

In an effort to improve detection of fastidious organisms, joint fluid aspirates of pediatric patients were inoculated into BACTEC 460 aerobic blood culture bottles, in addition to cultures on solid media. Culture records for the 1988 to 1991 period were reviewed to compare the performance of both methods for the recovery of pathogens. Overall, 216 children underwent a diagnostic joint tap, and 63 specimens grew significant organisms, including Kingella kingae in 14. While both methods were comparable for recovery of usual pathogens, with a single exception, K. kingae isolates were detected by the BACTEC system only. K. kingae appears to be a more common cause of septic arthritis in children than has been previously recognized. The BACTEC blood culture system enhances the recovery of K. kingae from joint fluid and improves bacteriologic diagnosis of pediatric septic arthritis.

Full text

PDF
1278

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Almquist E. E. The changing epidemiology of septic arthritis in children. Clin Orthop Relat Res. 1970 Jan-Feb;68:96–99. [PubMed] [Google Scholar]
  2. Aronoff S. C., Scoles P. V. Treatment of childhood skeletal infections. Pediatr Clin North Am. 1983 Apr;30(2):271–280. doi: 10.1016/s0031-3955(16)34357-7. [DOI] [PubMed] [Google Scholar]
  3. BORELLA L., GOOBAR J. E., SUMMITT R. L., CLARK G. M. Septic arthritis in childhood. J Pediatr. 1963 May;62:742–747. doi: 10.1016/s0022-3476(63)80044-x. [DOI] [PubMed] [Google Scholar]
  4. Barton L. L., Dunkle L. M., Habib F. H. Septic arthritis in childhood. A 13-year review. Am J Dis Child. 1987 Aug;141(8):898–900. doi: 10.1001/archpedi.1987.04460080084034. [DOI] [PubMed] [Google Scholar]
  5. Bosworth D. E. Kingella (Moraxella) kingae infections in children. Am J Dis Child. 1983 Jul;137(7):650–653. doi: 10.1001/archpedi.1983.02140330034009. [DOI] [PubMed] [Google Scholar]
  6. Claesson B., Falsen E., Kjellman B. Kingella kingae infections: a review and a presentation of data from 10 Swedish cases. Scand J Infect Dis. 1985;17(3):233–243. doi: 10.3109/inf.1985.17.issue-3.01. [DOI] [PubMed] [Google Scholar]
  7. Clément J. L., Berard J., Cahuzac J. P., Gaubert J. Kingella kingae osteoarthritis and osteomyelitis in children. J Pediatr Orthop. 1988 Jan-Feb;8(1):59–61. doi: 10.1097/01241398-198801000-00013. [DOI] [PubMed] [Google Scholar]
  8. Davis J. M., Peel M. M. Osteomyelitis and septic arthritis caused by Kingella kingae. J Clin Pathol. 1982 Feb;35(2):219–222. doi: 10.1136/jcp.35.2.219. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Fink C. W., Nelson J. D. Septic arthritis and osteomyelitis in children. Clin Rheum Dis. 1986 Aug;12(2):423–435. [PubMed] [Google Scholar]
  10. Gamble J. G., Rinsky L. A. Kingella kingae infection in healthy children. J Pediatr Orthop. 1988 Jul-Aug;8(4):445–449. doi: 10.1097/01241398-198807000-00012. [DOI] [PubMed] [Google Scholar]
  11. Gay R. M., Lane T. W., Keller D. C. Septic arthritis caused by Kingella kingae. J Clin Microbiol. 1983 Jan;17(1):168–169. doi: 10.1128/jcm.17.1.168-169.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Gillespie R. Septic arthritis of childhood. Clin Orthop Relat Res. 1973 Oct;(96):152–159. [PubMed] [Google Scholar]
  13. Goldenberg D. L., Cohen A. S. Acute infectious arthritis. A review of patients with nongonococcal joint infections (with emphasis on therapy and prognosis). Am J Med. 1976 Mar;60(3):369–377. doi: 10.1016/0002-9343(76)90753-1. [DOI] [PubMed] [Google Scholar]
  14. Goldenberg D. L., Reed J. I. Bacterial arthritis. N Engl J Med. 1985 Mar 21;312(12):764–771. doi: 10.1056/NEJM198503213121206. [DOI] [PubMed] [Google Scholar]
  15. Graham D. R., Band J. D., Thornsberry C., Hollis D. G., Weaver R. E. Infections caused by Moraxella, Moraxella urethralis, Moraxella-like groups M-5 and M-6, and Kingella kingae in the United States, 1953-1980. Rev Infect Dis. 1990 May-Jun;12(3):423–431. doi: 10.1093/clinids/12.3.423. [DOI] [PubMed] [Google Scholar]
  16. Green N. E., Edwards K. Bone and joint infections in children. Orthop Clin North Am. 1987 Oct;18(4):555–576. [PubMed] [Google Scholar]
  17. Haapasaari J., Essen R. V., Kahanpä A., Kostiala A. A., Holmberg K., Ahlqvist J. Fungal arthritis simulating juvenile rheumatoid arthritis. Br Med J (Clin Res Ed) 1982 Oct 2;285(6346):923–924. doi: 10.1136/bmj.285.6346.923. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Henriksen S. D. Corroding bacteria from the respiratory tract. 1. Moraxella kingii. Acta Pathol Microbiol Scand. 1969;75(1):85–90. [PubMed] [Google Scholar]
  19. Jackson M. A., Nelson J. D. Etiology and medical management of acute suppurative bone and joint infections in pediatric patients. J Pediatr Orthop. 1982 Aug;2(3):313–323. [PubMed] [Google Scholar]
  20. Jacobs N. M. Pneumococcal osteomyelitis and arthritis in children. A hospital series and literature review. Am J Dis Child. 1991 Jan;145(1):70–74. doi: 10.1001/archpedi.1991.02160010076019. [DOI] [PubMed] [Google Scholar]
  21. Lewis D. A., Settas L. Kingella kingae causing septic arthritis in Felty's syndrome. Postgrad Med J. 1983 Aug;59(694):525–526. doi: 10.1136/pgmj.59.694.525. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Mitchell M., Howard B., Haller J., Sartoris D. J., Resnick D. Septic arthritis. Radiol Clin North Am. 1988 Nov;26(6):1295–1313. [PubMed] [Google Scholar]
  23. Molteni R. A. The differential diagnosis of benign and septic joint disease in children. Clinical, radiologic, laboratory, and joint fluid analysis, based on 37 children with septic arthritis and 97 with benign aseptic arthritis. Clin Pediatr (Phila) 1978 Jan;17(1):19–23. doi: 10.1177/000992287801700104. [DOI] [PubMed] [Google Scholar]
  24. Morrey B. F., Bianco A. J., Jr, Rhodes K. H. Septic arthritis in children. Orthop Clin North Am. 1975 Oct;6(4):923–934. [PubMed] [Google Scholar]
  25. Morrison V. A., Wagner K. F. Clinical manifestations of Kingella kingae infections: case report and review. Rev Infect Dis. 1989 Sep-Oct;11(5):776–782. doi: 10.1093/clinids/11.5.776. [DOI] [PubMed] [Google Scholar]
  26. Nade S. Choice of antibiotics in management of acute osteomyelitis and acute septic arthritis in children. Arch Dis Child. 1977 Sep;52(9):679–682. doi: 10.1136/adc.52.9.679. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Nelson J. D., Koontz W. C. Septic arthritis in infants and children: a review of 117 cases. Pediatrics. 1966 Dec;38(6):966–971. [PubMed] [Google Scholar]
  28. Nelson J. D. The bacterial etiology and antibiotic management of septic arthritis in infants and children. Pediatrics. 1972 Sep;50(3):437–440. [PubMed] [Google Scholar]
  29. Patel N. J., Moore T. L., Weiss T. D., Zuckner J. Kingella kingae infectious arthritis: case report and review of literature of Kingella and Moraxella infections. Arthritis Rheum. 1983 Apr;26(4):557–559. doi: 10.1002/art.1780260417. [DOI] [PubMed] [Google Scholar]
  30. Peltola H., Vahvanen V. A comparative study of osteomyelitis and purulent arthritis with special reference to aetiology and recovery. Infection. 1984 Mar-Apr;12(2):75–79. doi: 10.1007/BF01641675. [DOI] [PubMed] [Google Scholar]
  31. Peltola H., Vahvanen V. Acute purulent arthritis in children. Scand J Infect Dis. 1983;15(1):75–80. doi: 10.3109/inf.1983.15.issue-1.12. [DOI] [PubMed] [Google Scholar]
  32. Powell J. M., Bass J. W. Septic arthritis caused by Kingella kingae. Am J Dis Child. 1983 Oct;137(10):974–976. doi: 10.1001/archpedi.1983.02140360038013. [DOI] [PubMed] [Google Scholar]
  33. Raymond J., Bergeret M., Bargy F., Missenard G. Isolation of two strains of Kingella kingae associated with septic arthritis. J Clin Microbiol. 1986 Dec;24(6):1100–1101. doi: 10.1128/jcm.24.6.1100-1101.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Redfield D. C., Overturf G. D., Ewing N., Powars D. Bacteria, arthritis, and skin lesions due to Kingella kingae. Arch Dis Child. 1980 May;55(5):411–411. doi: 10.1136/adc.55.5.411. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Salminen I., von Essen R., Koota K., Nissinen A. A pitfall in purulent arthritis brought out in Kingella kingae infection of the knee. Ann Rheum Dis. 1984 Aug;43(4):656–657. doi: 10.1136/ard.43.4.656. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Shuler T. E., Riddle C. D., Jr, Potts D. W. Polymicrobic septic arthritis caused by Kingella kingae and enterococcus. Orthopedics. 1990 Feb;13(2):254–256. doi: 10.3928/0147-7447-19900201-19. [DOI] [PubMed] [Google Scholar]
  37. Speiser J. C., Moore T. L., Osborn T. G., Weiss T. D., Zuckner J. Changing trends in pediatric septic arthritis. Semin Arthritis Rheum. 1985 Nov;15(2):132–138. doi: 10.1016/0049-0172(85)90031-9. [DOI] [PubMed] [Google Scholar]
  38. Syrogiannopoulos G. A., Nelson J. D. Duration of antimicrobial therapy for acute suppurative osteoarticular infections. Lancet. 1988 Jan 2;1(8575-6):37–40. doi: 10.1016/s0140-6736(88)91013-6. [DOI] [PubMed] [Google Scholar]
  39. Toshniwal R., Draghi T. C., Kocka F. E., Kallick C. A. Manifestations of Kingella kingae infections in adults: resemblance to neisserial infections. Diagn Microbiol Infect Dis. 1986 May;5(1):81–85. doi: 10.1016/0732-8893(86)90095-7. [DOI] [PubMed] [Google Scholar]
  40. Verbruggen A. M., Hauglustaine D., Schildermans F., van der Hauwaert L., Rombouts J. J., Wauters G., Vandepitte J. Infections caused by Kingella kingae: report of four cases and review. J Infect. 1986 Sep;13(2):133–142. doi: 10.1016/s0163-4453(86)92841-0. [DOI] [PubMed] [Google Scholar]
  41. Vincent J., Podewell C., Franklin G. W., Korn J. H. Septic arthritis due to Kingella (Moraxella) kingii: case report and review of the literature. J Rheumatol. 1981 May-Jun;8(3):501–503. [PubMed] [Google Scholar]
  42. Washington J. A., 2nd, Ilstrup D. M. Blood cultures: issues and controversies. Rev Infect Dis. 1986 Sep-Oct;8(5):792–802. doi: 10.1093/clinids/8.5.792. [DOI] [PubMed] [Google Scholar]
  43. Washington J. A., 2nd The microbiology of musculoskeletal infection. Orthop Clin North Am. 1975 Oct;6(4):1115–1128. [PubMed] [Google Scholar]
  44. Welkon C. J., Long S. S., Fisher M. C., Alburger P. D. Pyogenic arthritis in infants and children: a review of 95 cases. Pediatr Infect Dis. 1986 Nov-Dec;5(6):669–676. doi: 10.1097/00006454-198611000-00014. [DOI] [PubMed] [Google Scholar]
  45. von Essen R., Hölttä A. Improved method of isolating bacteria from joint fluids by the use of blood culture bottles. Ann Rheum Dis. 1986 Jun;45(6):454–457. doi: 10.1136/ard.45.6.454. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of Clinical Microbiology are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES