{"id":386,"date":"2023-09-16T22:09:58","date_gmt":"2023-09-16T21:09:58","guid":{"rendered":"https:\/\/microregistrar.com\/?p=386"},"modified":"2023-09-16T22:09:58","modified_gmt":"2023-09-16T21:09:58","slug":"kingella-spp","status":"publish","type":"post","link":"https:\/\/microregistrar.com\/?p=386","title":{"rendered":"Kingella spp."},"content":{"rendered":"\n<h4 class=\"wp-block-heading\"><strong>Bacteria:<\/strong><\/h4>\n\n\n\n<p>Fastidious gram-negative coccobacilli that appear in pairs or short chains.<br>Commensal of the mouth and upper respiratory tract.<br>The genus Kingela have species like&nbsp; \u2013&nbsp;<em>K. kingae<\/em>,&nbsp;<em>K. denitrificans<\/em>,&nbsp;<em>Kingella negevensis<\/em>,&nbsp;<em>K. oralis etc.<\/em><\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Identification:<\/strong><\/h4>\n\n\n\n<p>It appears as pairs\/short chains of plump bacilli (or coccobacilli) with tapered ends.<br>Capnophilic and facultatively anaerobic, nonmotile, non-spore-forming.<br>Beta-haemolytic colonies on blood agar often produce&nbsp;marked pitting of the agar surface.<br>It is catalase, urease, and indole tests negative. It is oxidase positive.<\/p>\n\n\n\n<p><em>Kingella kingae produces 4 different types of colonies-<\/em><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>A<em>&nbsp;spreading-corroding type \u2013 a small central colony encircled by a wide fringe,<\/em><\/li>\n\n\n\n<li><em>A non-spreading\/noncorroding type \u2013 a flat colony surrounded by a narrow fringe,<\/em><\/li>\n\n\n\n<li><em>A dome-shaped colony with no noticeable fringe<\/em><\/li>\n\n\n\n<li><em>Small-colony variants \u2013 pinpoint colonies on blood agar plates and no growth on Thayer-Martin medium<\/em><\/li>\n<\/ul>\n\n\n\n<p>Identification could be made using \u2013&nbsp;API NH, Vitek 2,&nbsp;MALDI-TOF,&nbsp;16S rRNA gene sequencing. Remel RapID NH kit is not reliable.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Pathogenicity:<\/strong><\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Pilli \u2013 adherence and colonisation.<\/li>\n\n\n\n<li>Capsule \u2013&nbsp;protection from phagocytosis and complement-mediated killing.<\/li>\n\n\n\n<li>Biofilm formation.<\/li>\n\n\n\n<li>RTX (repeat-in-toxin) toxin \u2013 broad-spectrum cytotoxicity, adherence to mucosa and persistence in the body.<\/li>\n\n\n\n<li>Outer Membrane Vesicles.<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Predisposing factors\/association:<\/strong><\/h4>\n\n\n\n<p><strong>Varicella infection, stomatitis<\/strong>, failure to thrive, congenital heart disease, prolonged corticosteroid therapy, primary immunodeficiency, haematological malignancies, liver cirrhosis, end-stage renal disease, sickle cell anaemia, diabetes mellitus, cardiac valve pathology, systemic lupus erythematosus, rheumatoid arthritis, renal transplants, solid tumours, or AIDS.<\/p>\n\n\n\n<p>[<a href=\"https:\/\/cmr.asm.org\/content\/28\/1\/54\">Yagupsky 2015<\/a>]<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Clinical Condition:<\/strong><\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Kingella infection is mild unless associated with a deep infection \u2013 Fever,&nbsp;rhinorrhea, pharyngitis, stomatitis, diarrhoea, transient bacteraemia.<\/li>\n\n\n\n<li><strong>Deep infections:<\/strong><br><strong>Endocarditis<\/strong>&nbsp;\u2013 it is a part of the HACEK group of organisms. It could be associated with the embolic phenomenon.<br>Septic arthritis and osteomyelitis&nbsp;\u2013 the commonest cause of septic arthritis in 6m to 3 years olds, usually involves large weight-bearing joints: association \u2013 varicella, stomatitis.<br><strong>Spondylodiscitis<\/strong>.<br><strong>Lower respiratory tract pleural empyema<\/strong>.<br><strong>Pediatric vaginitis<\/strong>.<br><strong>Chorioamnionitis, and<\/strong><br><strong>Granulomatous disease in AIDS patients<\/strong><\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Treatment:&nbsp;<\/strong><\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Penicillin or cephalosporin group of drugs are usually used for treatment \u2013&nbsp;<strong>The drug of choice<\/strong>&nbsp;is usually a third-generation cephalosporin- cefotaxime or ceftriaxone.<\/li>\n\n\n\n<li><strong>Other antibiotics to which Kingella is susceptible in vitro:<\/strong>&nbsp;aminoglycosides, trimethoprim-sulfamethoxazole, tetracycline, erythromycin, and fluoroquinolones.<\/li>\n\n\n\n<li><strong>Duration of treatment:<\/strong>&nbsp;The deep infection needs 4-12 weeks of treatment, depending on the condition.<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Questions:<\/strong><\/h4>\n\n\n\n<p>Short answer question \u2013<br>Kingella kingae,<br>Septic arthritis in children,<br>Kingella arthritis,<br>HACEK endocarditis.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Bacteria: Fastidious gram-negative coccobacilli that appear in pairs or short chains.Commensal of the mouth and upper respiratory tract.The genus Kingela [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center 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