Advances in Understanding Kingella kingae by Joseph W. St. Geme III

By Joseph W. St. Geme III

This booklet describes the becoming physique of knowledge at the epidemiology, scientific manifestations, transmission, pathogenesis, prognosis, and therapy of Kingella kingae infectionsin children. additionally, it covers experimental tools which were built to review the microbiology, genetics, and virulence components of K. kingae, details that gives the basis for brand spanking new techniques to remedy and prevention of K. kingae disease. With this content material in brain, excerpts from the booklet could be of relevance for clinicians who deal with pediatric sufferers, for scientific microbiologists who're focused on detecting organisms in medical specimens, and for scientists who're learning K. kingae in an attempt to boost novel ambitions for antimicrobial treatment and new ways to prevention.

First remoted within the Nineteen Sixties via Elizabeth O. King, a bacteriologist on the CDC, Kingella kingae used to be mostly neglected over the following 20 years as a human pathogen due to its unusual restoration from sufferers with sickness. besides the fact that, lately K. kingae has been more and more well-known as a clinically very important pathogen in childrens, and is at present famous because the prime reason for osteoarticular infections in childrens in more and more international locations. learn into this organism has grown vastly during the last 15 years, leading to a greater appreciation of the significance of K. kingae in pediatric sufferers and of the molecular mechanisms of affliction.

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30] found that approximately 50 % of children with invasive K. kingae disease displayed symptoms of upper respiratory tract infection, 15 to 20 % had stomatitis, and 15 to 20 % had diarrhea. In agreement with these findings, a study in France found that 19/21 patients with proven K. kingae osteoarticular infection and only 3/8 patients with non-K. kingae osteoarticular infection had at least one respiratory virus present in the oropharynx, including human rhinovirus (12/21), coronavirus OC43 (4/21), parainfluenza virus 1, 2, 3, or 4 (3/21), enterovirus (2/21), or adenovirus (2/21) [31].

Other Clinical Manifestations Case reports have described K. kingae as the cause a number of other invasive infections, including soft tissue abscesses [18], meningitis [64], peritonitis [49], urinary tract infection [65], and pericarditis [66]. Ocular infections such as endophthalmitis [67] and keratitis [68] have also been reported. The routine use of molecular diagnostic techniques on various clinical specimens will likely lead to additional reports in the future and a better understanding of the role of K.

Kingae pili are regulated by a transcription factor called r54 and by the PilS/PilR two-component sensor/regulator system [53]. Mutations in the PilS sensor result in a reduced density of pili, similar to the relative reduction in density of pili observed in isolates recovered from the bloodstream compared to isolates from the posterior pharynx. Mutations in the PilR response regulator completely eliminate piliation, similar to the absence of pili observed in isolates from joints and bones [53].

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