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bacterial endosymbiont localization in hyalesthes obsoletus, the insect vector of bois noir in vitis vinifera.one emerging disease of grapevine in europe is bois noir (bn), a phytoplasmosis caused by "candidatus phytoplasma solani" and spread in vineyards by the planthopper hyalesthes obsoletus (hemiptera: cixiidae). here we present the first full characterization of the bacterial community of this important disease vector collected from bn-contaminated areas in piedmont, italy. length heterogeneity pcr and denaturing gradient gel electrophoresis analysis targeting the 16s rrna gene revealed the presenc ...201021183640
diagnosis of e. coli tricuspid valve endocarditis: a case report.escherichia coli is a rare cause of bacterial endocarditis. we report a case of an elderly man with cirrhosis who developed bacterial endocarditis due to e.coli. we review the literature that summarizes a total of 41 cases, with a predominance of elderly women, diabetics, and patients with urinary tract infections and prosthetic heart valves. e.coli bacteremia may be mistakenly attributed to a more benign source such as urosepsis and overlooked as an indication of endocarditis. a delay in diagno ...201021225584
kingella kingae endocarditis and a cluster investigation among daycare attendees.kingella kingae can cause invasive pediatric infections and outbreaks of osteomyelitis/septic arthritis in daycare facilities have been described. this is the first reported public health investigation prompted by a case of k. kingae endocarditis in an infant attending a daycare facility. a concurrent case of osteomyelitis was identified. screening of daycare contacts revealed a low rate of colonization before antibiotic prophylaxis.201019884874
kingella kingae spondylodiscitis in young children: toward a new approach for bacteriological investigations? a preliminary report.as the result of improved bacteriological techniques, kingella kingae is a slow-growing gram-negative coccobacillus that is emerging as an important cause of spondylodiscitis in children younger than 3 years of age. the high pharyngeal carrier rates of this slow-growing gram-negative coccobacillus combined with the low incidence of identified k. kingae infections is possibly explained by a low virulence of this bacterium. the use of specific real-time polymerase chain reaction (pcr) on blood sam ...201021455474
differentiating osteoarticular infections caused by kingella kingae from those due to typical pathogens in young children.osteoarticular infections caused by kingella kingae are characterized by mild-to-moderate clinical and biologic inflammatory signs that are different from those caused by gram-positive cocci. a combined score was built to find the best model to predict k. kingae osteoarticular infections by using the following 4 variables: body temperature <38°c, serum c-reactive protein <55 mg/l, white blood cell count <14,000/mm, and band forms <150/mm.201121494171
broad spectrum biofilm inhibition by kingella kingae exopolysaccharide.cell-free extracts prepared from kingella kingae colony biofilms were found to inhibit biofilm formation by aggregatibacter actinomycetemcomitans, klebsiella pneumoniae, staphylococcus aureus, s. epidermidis, candida albicans and k. kingae. the extracts evidently inhibited biofilm formation by modifying the physicochemical properties of the cell surface, the biofilm matrix, and the substrate. chemical and biochemical analyses indicated that the biofilm inhibition activity in the k. kingae extrac ...201121602333
the utility of matrix assisted laser desorption/ionization time-of-flight mass spectrometry (maldi-tof ms) following introduction for routine laboratory bacterial identification.maldi-tof ms was evaluated prospectively in a diagnostic laboratory. 927 organisms were tested in triplicate; 2351/2781 (85%) species and 2681/2781 (96%) genus identifications were correct. known issues such as the misidentification of α-haemolytic streptococci as streptococcus pneumonia were easily corrected. identifications cost $aud0.45 per isolate and were available in minutes. maldi-tof ms is rapid, accurate and inexpensive.201121632894
antibiotic treatment for acute haematogenous osteomyelitis of childhood: moving towards shorter courses and oral administration.acute haematogenous osteomyelitis (ahom) of childhood usually affects the long bones of the lower limbs. although almost any agent may cause ahom, staphylococcus aureus is the most common bacterium, followed by streptococcus pneumoniae and, in some countries, salmonella spp. and kingella kingae. magnetic resonance imaging (mri) has improved the diagnostic accuracy of traditional radiography and scintigraphy. except for the pre-treatment diagnostic sample from bone before the institution of antib ...201121640559
advances in the diagnosis and management of pediatric osteomyelitis.acute hematogenous osteomyelitis is a common disease that affects previously healthy children of all age groups. despite its importance, there are limited data in the current literature to guide many aspects of the diagnosis and therapy of this infection. over the last decade, our understanding of the etiology of this infection has changed, with increased recognition of kingella kingae and the dramatic increase in community-associated methicillin-resistant staphylococcus aureus (ca-mrsa) infecti ...201121789499
[antibiotic therapy of bone and joint infections in children: recent changes].management of bone and joint infections in children associates early appropriate antibiotic therapy against staphylococcus aureus and kingella kingae and, if necessary, surgical drainage of abscess or septic arthritis. in 2007, the paediatric infectious diseases group of the french society of paediatrics (gpip) proposed guidelines for antibiotherapy in acute and non-complicated cases, with an intravenous therapy during 4 to 7days followed by oral therapy during 3weeks.201121733665
Epidemiology of Invasive Kingella kingae Infections in Two Distinct Pediatric Populations Cohabiting in One Geographic Area.The annual incidence of invasive Kingella kingae younger than 4 years of age was significantly higher in westernized Jews than in indigent Bedouins living side-by-side in southern Israel (12.21/100,000 and 5.83/100,000, respectively, (P<0.05). One K. kingae clone was over-represented among isolates from Jewish children, suggesting that differences in bacterial pathogenicity may contribute to the morbidity excess detected in this population group.201122146739
Simplifying the treatment of acute bacterial bone and joint infections in children.The treatment of acute hematogenous bone and joint infections of children - osteomyelitis (OM), septic arthritis (SA) and OM-SA combination (OM+SA) - has simplified over the past years. The old approach included months-long antibiotic treatment, started intravenously for at least a week, followed by oral completion of the course. Recent prospective randomized trials show that most cases heal with a total course of 3 weeks (OM, OM+SA) or 2 weeks (SA) of an appropriate antibiotic, provided the cli ...201122114963
abiotrophia defectiva knee prosthesis infection: a case report.abstract:201121896178
can early mri distinguish between kingella kingae and gram-positive cocci in osteoarticular infections in young children?background: k. kingae is a common causative organism in acute osteoarticular infections (oais) in children under 4 years of age. differentiation between k. kingae and gram-positive cocci (gpc) is of great interest therapeutically. objective: our aim was to identify early distinguishing mri features of oais. materials and methods: thirty-one children younger than 4 years of age with oai underwent mri at presentation. of these, 21 were caused by k. kingae and ten by gpc. bone and soft tissue react ...201121909715
high frequency of tropheryma whipplei in culture-negative endocarditis."classical" whipple's disease (cwd) is caused by tropheryma whipplei and is characterized by arthropathy, weight loss, and diarrhea. t. whipplei infectious endocarditis (twie) is rarely reported, either in the context of cwd or as isolated twie without signs of systemic infection. the frequency of twie is unknown, and systematic studies are lacking. here, we performed an observational cohort study on the incidence of t. whipplei infection in explanted heart valves in two german university center ...201122135251
Kingella kingae endocarditis: A rare case of mitral valve perforation.Kingella kingae, a HACEK (Haemophilus parainfluenzae, Aggregatibacter actinomycetemcomitans, Aggregatibacter aphrophilus, Cardiobacterium hominis, Eikenella corrodens, Kingella kingae) organism, is a common resident of the upper airway in children; it has been associated with endocarditis in children with pre-existing heart conditions. This case report describes K. kingae endocarditis leading to valvular damage in a previously healthy 18-month-old child. Our patient developed a K. kingae bactere ...201121976892
Kingella kingae Infections in Children: An Update. 201122125036
Predictive score to discriminate Kingella kingae from Staphylococcus aureus arthritis in France. 201122105423
identification of hacek clinical isolates by matrix-assisted laser desorption ionization-time of flight mass spectrometry.matrix-assisted laser desorption ionization-time of flight (maldi-tof) mass spectrometry is a rapid and accurate tool for the identification of many microorganisms. we assessed this technology for the identification of 103 haemophilus parainfluenzae, aggregatibacter aphrophilus, aggregatibacter actinomycetemcomitans, cardiobacterium hominis, eikenella corrodens, and kingella kingae (hacek) clinical isolates and 20 haemophilus influenzae clinical isolates. ninety-three percent of hacek organisms ...201121227988
[pathognomonic presentation of kingella kingae infection].kingella kingae is an important and probably under-recognized pathogen in children. it has a predilection for bones, joints and vascular endothelium, but can also cause bacteraemia alone. we present a case of kingella kingae that manifested itself by presternal soft tissue infection, and suggest that infection of the lower sternum and the junction between the manubrium and the xyphoid process are typical, if not pathognomonic for the organism.201121276404
[kingella kingae endocarditis]. 201121288787
first report of performance of the versant ct/gc dna 1.0 assay (kpcr) for detection of chlamydia trachomatis and neisseria gonorrhoeae.we evaluated the analytical, work flow, and clinical performance of the versant ct/gc dna 1.0 assay (versant ct/gc assay, where "ct" represents chlamydia trachomatis and "gc" represents neisseria gonorrhoeae). the assay simultaneously detects chlamydia trachomatis and neisseria gonorrhoeae in swab and first-catch urine (fcu) specimens. the limit of detection (lod) was determined to be 342 copies/ml for c. trachomatis and 137 copies/ml for gc. the versant ct/gc assay detected 15 c. trachomatis se ...201121307209
kingella kingae: an emerging pathogen in young children.kingella kingae is being recognized increasingly as a common etiology of pediatric osteoarticular infections, bacteremia, and endocarditis, which reflects improved culture methods and use of nucleic acid-amplification techniques in clinical microbiology laboratories. k kingae colonizes the posterior pharynx of young children and is transmitted from child to child through close personal contact. day care attendance increases the risk for colonization and transmission, and clusters of k kingae inf ...201121321033
Direct Detection of Staphylococcus Osteoarticular Infections by Use of Xpert MRSA/SA SSTI Real-Time PCR.We evaluated the Xpert MRSA/SA SSTI real-time PCR assay (Cepheid, Sunnyvale, CA) directly on perioperative bone and joint samples. The sensitivity and specificity for detection of methicillin-susceptible Staphylococcus aureus (MSSA), methicillin-resistant Staphylococcus aureus (MRSA), and methicillin-resistant coagulase-negative Staphylococcus were, respectively, 100% and 98.3%, 100% and 100%, and 100% and 95.3%. The median total test turnaround time was 72 min for PCR versus 79 h for culture. U ...201121998420
septic arthritis caused by kingella kingae: a case report. 201122737437
human immunodeficiency virus & cardiovascular risk.highly active antiretroviral therapy (haart) significantly changed the prevalence of the cardiovascular manifestations of human immunodeficiency virus (hiv)/aids. in developed countries, a 30 per cent reduction in the prevalence of cardiomyopathy and pericardial effusion was observed, possibly related to a reduction of opportunistic infections and myocarditis. in developing countries, however, where the availability of haart is limited, and the pathogenic impact of nutritional factors is signifi ...201122310821
microbiological profile of haematogenous osteoarticular infections in children.introduction: staphylococcus aureus, kingella kingae and ß-hemolytic streptococcus are presently the most frequently identified bacteria in child haematogenous osteoarticular infection. objective: to determine the microbiological profile (bacteria and antibiotic susceptibility) of osteoarticular infections in a paediatric hospital, so as to adapt treatment protocols to the ecology of the bacteria isolated. patients and methods: prospective descriptive study, including children admitted for acute ...201121371961
cytotoxic effects of kingella kingae outer membrane vesicles on human cells.kingella kingae is an emerging pathogen causing osteoarticular infections in pediatric patients. electron microscopy of k. kingae clinical isolates revealed the heterogeneously-sized membranous structures blebbing from the outer membrane that were classified as outer membrane vesicles (omvs). omvs purified from the secreted fraction of a septic arthritis k. kingae isolate were characterized. among several major proteins, k. kingae omvs contained virulence factors rtxa toxin and pilc2 pilus adhes ...201121443941
pseudomonas aeruginosa pily1 binds integrin in an rgd- and calcium-dependent manner.pily1 is a type iv pilus (tfp)-associated protein from the opportunistic pathogen pseudomonas aeruginosa that shares functional similarity with related proteins in infectious neisseria and kingella species. previous data have shown that pily1 acts as a calcium-dependent pilus biogenesis factor necessary for twitching motility with a specific calcium binding site located at amino acids 850-859 in the 1,163 residue protein. in addition to motility, pily1 is also thought to play an important role i ...201122242136
comparison of clinical and biologic features of kingella kingae and staphylococcus aureus arthritis at initial evaluation.we conducted a retrospective study comparing the presenting clinical and biologic features of 64 children who had septic arthritis caused by kingella kingae with 26 children who had septic arthritis caused by staphylococcus aureus. children with k. kingae septic arthritis were significantly younger than those with s. aureus septic arthritis. otherwise, there were no significant differences between the 2 groups with respect to fever, location, white blood cell count, synovial fluid cell count, c- ...201121552181
[kingella kingae infections in the pediatric age].kingella kingae infections have aroused great interest in the last few years because of the increasing number of identified cases. although considered an emerging pathogen, the increase in diagnosis of these infections can probably be explained by better knowledge of the bacteria, improved microbiological diagnostic techniques and greater awareness among clinicians. k. kingae is an aerobic cocobacillus with high tropism for osteoarticular tissue, endocardium, and vascular space. this pathogen ma ...201121458708
the rtxa toxin gene of kingella kingae: a pertinent target for molecular diagnosis of osteoarticular infections.kingella kingae is an emerging osteoarticular pathogen in young children. its isolation by traditional culture methods remains difficult, underscoring the need to implement other diagnostic methods for its detection and identification, such as nucleic acid amplification tests. although the genome of this bacterium has not yet been sequenced, a toxin named rtx has been identified. the goal of this study was to develop sensitive, specific, and rapid molecular methods based on the rtxa toxin gene s ...201121248099
culture negative endocarditis: a diagnostic and therapeutic challenge!infective endocarditis remains a diagnostic and therapeutic challenge. the authors report an older male who presented with a lower extremities rash and signs of cardiac failure. echocardiography showed vegetations attached to the bio-prosthetic aortic valve, however, with negative blood cultures. further investigation revealed positive bartonella serologies. the patient was diagnosed with bartonella endocarditis affecting the prosthetic valve and started on appropriate antibiotics. valvular surg ...201122674101
[espondilodiskitis caused by kingella kingae in children: a case report].during the last years, spondilodiskitis due to kingella kingae has been a new target of interest, since it is the second agent that causes non tuberculous espondilodiskitis in children, after staphylococcus aureus. its clinical presentation is very inespecific, sometimes with fever, abdominal or lumbar disconfort, nocturnal pain, altered walking and sedestation. images, culture methods and pcr (polymerase chain reaction) can be helpful for diagnosis, although in an important percent of the cases ...201122052404
risk for invasive kingella kingae infections and day-care facility attendance. 201222982952
genotyping of invasive kingella kingae isolates reveals predominant clones and association with specific clinical syndromes.despite the increasing recognition of kingella kingae as an important pathogen of early childhood, the relative frequency and invasiveness of different strains of the organism has not been investigated. a study was conducted to determine the association of k. kingae genotypes with specific clinical syndromes and the temporal and geographic distribution of invasive clones.201222806593
small risk of osteoarticular infections in children with asymptomatic oropharyngeal carriage of kingella kingae.the aim of this study was to evaluate the absolute risk for children younger than 4 years of age with asymptomatic oropharyngeal carriage of kingella kingae to sustain an osteoarticular infection. the rate of k. kingae carriage in the oropharyngeal mucosa was 9% among healthy children, and the risk for an asymptomatic carrier to develop an osteoarticular infection due to k. kingae was estimated to be lower than 1%.201222572754
haematogenous acute and subacute paediatric osteomyelitis: a systematic review of the literature.a delay in the diagnosis of paediatric acute and subacute haematogenous osteomyelitis can lead to potentially devastating morbidity. there are no definitive guidelines for diagnosis, and recommendations in the literature are generally based on expert opinions, case series and cohort studies. all articles in the english literature on paediatric osteomyelitis were searched using medline, cinahl, embase, google scholar, the cochrane library and reference lists. a total of 1854 papers were identifie ...201222529075
isolation of kingella kingae in the oropharynx during k. kingae arthritis in children.kingella kingae arthritis in children is now mainly diagnosed by pcr, which has surpassed conventional culture of joint fluid. as oropharynx colonization is the first step of kingella kingae invasion, we prospectively investigated the possibility of cultivating it from throat swabs, in children hospitalized for k. kingae arthritis. throat culture was 5.6-fold more sensitive than joint fluid cultures in isolating k. kingae (66.7% vs. 11.9% respectively, p <0.001) and may be used to perform antibi ...201222390653
antibiotic susceptibility of kingella kingae isolates from children with skeletal system infections. 201222252209
[kingella kingae pediatric septic arthritis].kingella kingae is a bacterium that colonizes the upper respiratory tract. despite its low pathogenicity in this location, previous respiratory pathological processes may favor its systemic spread causing bone and joint infections, mainly in children under five years. it can be considered an emerging pathogen in osteoarticular infection in pediatric patients. we report the case of a two-year-old girl with hips pain and limitation of both abduction and extension, and fever. radiography and ultras ...201223224317
a toddler who refused to stand or walk: lumbar spondylodiscitis.a young mother presented her 19-month-old boy to the general practitioner (gp) with a 24&emsp14;h history of reluctance to stand or walk and a slightly raised temperature. the gp arranged an assessment by the paediatrician, who organised an ultrasound of the hips which was normal. approximately 1&emsp14;week later the patient became constipated as well, was seen again by another gp but no cause was found. another week later mother consulted the initial gp again as the boy had not shown any signs ...201223230243
genomic comparison of kingella kingae strains.kingella kingae is a betaproteobacterium from the order neisseriales, and it is an agent of invasive infections in children. we sequenced the genome from the septic arthritis strain 11220434. it is composed of a 1,990,794-bp chromosome but no plasmid, and it contains 2,042 protein-coding genes and 52 rna genes, including 3 rrna genes.201223045489
osteomyelitis pubis caused by kingella kingae in an adult patient: report of the first case.kingella kingae is the second most common pathogen causing paediatric arthritis and is described to be the causative bacteria in some paediatric osteomyelitis. its microbiological detection is particularly difficult due to its slow growing. to our best knowledge this is the first case description of osteomyelitis pubis caused by this microorganism.201223031309
the epidemiology of pediatric bone and joint infections in cambodia, 2007-11.there are limited data on osteoarticular infections from resource-limited settings in asia. a retrospective study of patients presenting to the angkor hospital for children, cambodia, january 2007-july 2011, identified 81 cases (28% monoarticular septic arthritis, 51% single-limb osteomyelitis and 15% multisite infections). the incidence was 13.8/100 000 hospital attendances. the median age was 7.3 years, with a male/female ratio of 1.9:1; 35% presented within 5 days of symptom onset (median 7 d ...201222977206
the epidemiology of pediatric bone and joint infections in cambodia, 2007-11.there are limited data on osteoarticular infections from resource-limited settings in asia. a retrospective study of patients presenting to the angkor hospital for children, cambodia, january 2007-july 2011, identified 81 cases (28% monoarticular septic arthritis, 51% single-limb osteomyelitis and 15% multisite infections). the incidence was 13.8/100 000 hospital attendances. the median age was 7.3 years, with a male/female ratio of 1.9:1; 35% presented within 5 days of symptom onset (median 7 d ...201222977206
childhood osteomyelitis: imaging characteristics.the purpose of this review is to illustrate the imaging findings of childhood osteomyelitis. the diagnosis of childhood osteomyelitis can be challenging. clinical presentation and laboratory results can differ and are relatively unreliable. to date, its role in the assessment of treatment efficacy is not yet clear.201222875760
actin cross-linking domain of aeromonas hydrophila repeat in toxin a (rtxa) induces host cell rounding and apoptosis.the repeat in toxin (rtx) of an environmental isolate atcc 7966 of aeromonas hydrophila consists of six genes (rtxachbde) organized in an operon similar to the gene organization found for the rtx of the vibrio species. the first gene in this operon (rtxa) encodes an exotoxin in vibrios, while other genes code for proteins needed for proper activation of rtxa and in secretion of this toxin from vibrio cholerae. however, the rtxa of atcc 7966, as well as from the clinical isolate ssu of a. hydroph ...201222814176
infective endocarditis complicated by aortic graft infection and osteomyelitis: case report and review of literature.primary aortic graft infection early after aortic graft insertion is well described in the literature. here, we present a unique case of late aortic graft infection 5 years after insertion secondary to mitral valve endocarditis, resulting from cellulitis in a patient with severe venous varicosities. a 63-year-old male presented for severe low back pain, constipation, and low-grade fever. an abdominal computed tomography scan with oral and intravenous contrast showed a normal spine and urinary tr ...201222866008
clinical characteristics and thrombolytic outcomes of infective endocarditis-associated stroke.our aim was to describe the clinical features of infective endocarditis (ie) in the acute stroke setting and outcomes following thrombolytic therapy.201223983869
multilocus sequence typing and rtxa toxin gene sequencing analysis of kingella kingae isolates demonstrates genetic diversity and international clones.kingella kingae, a normal component of the upper respiratory flora, is being increasingly recognized as an important invasive pathogen in young children. genetic diversity of this species has not been studied.201222693588
acute endocarditis in intravenous drug users: a case report and literature review.infective endocarditis (ie) is a notorious complication of intravenous drug use (idu). it typically affects the cardiac valves. among these, the tricuspid is the most common affected valve, although the mitral and/or aortic valves can also be involved. methicillin sensitive staphylococcus aureus (mssa) is the most common etiological microbial agent of ie in idu. once ie is diagnosed, antibiotic treatment should start immediately after blood cultures have been obtained. however, ie in this partic ...201223882351
dual priming oligonucleotides for broad-range amplification of the bacterial 16s rrna gene directly from human clinical specimens.broad-range amplification and sequencing of the bacterial 16s rrna gene directly from clinical specimens are offered as a diagnostic service in many laboratories. one major pitfall is primer cross-reactivity with human dna which will result in mixed chromatograms. mixed chromatograms will complicate subsequent sequence analysis and impede identification. in sybr green real-time pcr assays, it can also affect crossing threshold values and consequently the status of a specimen as positive or negat ...201222278843
defining falciparum-malaria-attributable severe febrile illness in moderate-to-high transmission settings on the basis of plasma pfhrp2 concentration.in malaria-endemic settings, asymptomatic parasitemia complicates the diagnosis of malaria. histidine-rich protein 2 (hrp2) is produced by plasmodium falciparum, and its plasma concentration reflects the total body parasite burden. we aimed to define the malaria-attributable fraction of severe febrile illness, using the distributions of plasma p. falciparum hrp2 (pfhrp2) concentrations from parasitemic children with different clinical presentations.201223136222
defining falciparum-malaria-attributable severe febrile illness in moderate-to-high transmission settings on the basis of plasma pfhrp2 concentration.in malaria-endemic settings, asymptomatic parasitemia complicates the diagnosis of malaria. histidine-rich protein 2 (hrp2) is produced by plasmodium falciparum, and its plasma concentration reflects the total body parasite burden. we aimed to define the malaria-attributable fraction of severe febrile illness, using the distributions of plasma p. falciparum hrp2 (pfhrp2) concentrations from parasitemic children with different clinical presentations.201223136222
genome sequence of kingella kingae septic arthritis isolate pykk081.kingella kingae is a human oral bacterium that can cause infections of the skeletal system in children. the bacterium is also a cardiovascular pathogen causing infective endocarditis in children and adults. we report herein the draft genome sequence of septic arthritis k. kingae strain pykk081.201222582375
antibiofilm polysaccharides.bacterial extracellular polysaccharides have been shown to mediate many of the cell-to-cell and cell-to-surface interactions that are required for the formation, cohesion and stabilization of bacterial biofilms. however, recent studies have identified several bacterial polysaccharides that inhibit biofilm formation by a wide spectrum of bacteria and fungi both in vitro and in vivo. this review discusses the composition, modes of action and potential biological roles of antibiofilm polysaccharide ...201222730907
antibiofilm polysaccharides.bacterial extracellular polysaccharides have been shown to mediate many of the cell-to-cell and cell-to-surface interactions that are required for the formation, cohesion and stabilization of bacterial biofilms. however, recent studies have identified several bacterial polysaccharides that inhibit biofilm formation by a wide spectrum of bacteria and fungi both in vitro and in vivo. this review discusses the composition, modes of action and potential biological roles of antibiofilm polysaccharide ...201222730907
reduced set of virulence genes allows high accuracy prediction of bacterial pathogenicity in humans.although there have been great advances in understanding bacterial pathogenesis, there is still a lack of integrative information about what makes a bacterium a human pathogen. the advent of high-throughput sequencing technologies has dramatically increased the amount of completed bacterial genomes, for both known human pathogenic and non-pathogenic strains; this information is now available to investigate genetic features that determine pathogenic phenotypes in bacteria. in this work we determi ...201222916122
bench-to-bedside review: rapid molecular diagnostics for bloodstream infection--a new frontier?among critically ill patients, the diagnosis of bloodstream infection poses a major challenge. current standard bacterial identification based on blood culture platforms is intrinsically time-consuming and slow. the continuous evolvement of molecular techniques has the potential of providing a faster, more sensitive and direct identification of causative pathogens without prior need for cultivation. this may ultimately impact clinical decision-making and antimicrobial treatment. this review summ ...201222647543
current concepts in laboratory testing to guide antimicrobial therapy.antimicrobial susceptibility testing (ast) is indicated for pathogens contributing to an infectious process that warrants antimicrobial therapy if susceptibility to antimicrobials cannot be predicted reliably based on knowledge of their identity. such tests are most frequently used when the etiologic agents are members of species capable of demonstrating resistance to commonly prescribed antibiotics. some organisms have predictable susceptibility to antimicrobial agents (ie, streptococcus pyogen ...201222386185
type iv pilin proteins: versatile molecular modules.type iv pili (t4p) are multifunctional protein fibers produced on the surfaces of a wide variety of bacteria and archaea. the major subunit of t4p is the type iv pilin, and structurally related proteins are found as components of the type ii secretion (t2s) system, where they are called pseudopilins; of dna uptake/competence systems in both gram-negative and gram-positive species; and of flagella, pili, and sugar-binding systems in the archaea. this broad distribution of a single protein family ...201223204365
modulation of kingella kingae adherence to human epithelial cells by type iv pili, capsule, and a novel trimeric autotransporter.kingella kingae is an emerging bacterial pathogen that is being recognized increasingly as an important etiology of septic arthritis, osteomyelitis, and bacteremia, especially in young children. colonization of the posterior pharynx is a key step in the pathogenesis of k. kingae disease. previous work established that type iv pili are necessary for k. kingae adherence to the respiratory epithelium. in this study, we set out to identify additional factors that influence k. kingae interactions wit ...201223093386
a critical role for the ccca gene product, cytochrome c2, in diverting electrons from aerobic respiration to denitrification in neisseria gonorrhoeae.neisseria gonorrhoeae is a microaerophile that, when oxygen availability is limited, supplements aerobic respiration with a truncated denitrification pathway, nitrite reduction to nitrous oxide. we demonstrate that the ccca gene of neisseria gonorrhoeae strain f62 (accession number ng0292) is expressed, but the product, cytochrome c2, accumulates to only low levels. nevertheless, a ccca mutant reduced nitrite at about half the rate of the parent strain. we previously reported that cytochromes c4 ...201323543713
accurate identification of fastidious gram-negative rods: integration of both conventional phenotypic methods and 16s rrna gene analysis.accurate identification of fastidious gram-negative rods (gnr) by conventional phenotypic characteristics is a challenge for diagnostic microbiology. the aim of this study was to evaluate the use of molecular methods, e.g., 16s rrna gene sequence analysis for identification of fastidious gnr in the clinical microbiology laboratory.201323855986
clinical features of candidiasis in patients with inherited interleukin 12 receptor β1 deficiency.interleukin 12rβ1 (il-12rβ1)-deficient patients are prone to clinical disease caused by mycobacteria, salmonella, and other intramacrophagic pathogens, probably because of impaired interleukin 12-dependent interferon γ production. about 25% of patients also display mucocutaneous candidiasis, probably owing to impaired interleukin 23-dependent interleukin 17 immunity. the clinical features and outcome of candidiasis in these patients have not been described before, to our knowledge. we report her ...201324186907
clinical features of candidiasis in patients with inherited interleukin 12 receptor β1 deficiency.interleukin 12rβ1 (il-12rβ1)-deficient patients are prone to clinical disease caused by mycobacteria, salmonella, and other intramacrophagic pathogens, probably because of impaired interleukin 12-dependent interferon γ production. about 25% of patients also display mucocutaneous candidiasis, probably owing to impaired interleukin 23-dependent interleukin 17 immunity. the clinical features and outcome of candidiasis in these patients have not been described before, to our knowledge. we report her ...201324186907
bacteria in the nose of young adults during wellness and rhinovirus colds: detection by culture and microarray methods in 100 nasal lavage specimens.patients  with  viral respiratory infections/viral rhinitis/common colds are often treated with antibiotic; however, there is little information on whether or how bacterial microbiota in the nose and nasopharynx might influence the course of viral illnesses.201323801660
functional genes to assess nitrogen cycling and aromatic hydrocarbon degradation: primers and processing matter.targeting sequencing to genes involved in key environmental processes, i.e., ecofunctional genes, provides an opportunity to sample nature's gene guilds to greater depth and help link community structure to process-level outcomes. vastly different approaches have been implemented for sequence processing and, ultimately, for taxonomic placement of these gene reads. the overall quality of next generation sequence analysis of functional genes is dependent on multiple steps and assumptions of unknow ...201324062736
patient-specific analysis of periodontal and peri-implant microbiomes.periodontally involved teeth have been implicated as 'microbial reservoirs' in the etiology of peri-implant diseases. therefore, the purpose of this investigation was to use a deep-sequencing approach to identify the degree of congruence between adjacent peri-implant and periodontal microbiomes in states of health and disease. subgingival and peri-implant biofilm samples were collected from 81 partially edentulous individuals with periodontal and peri-implant health and disease. bacterial dna wa ...201324158341
molecular mapping to species level of the tonsillar crypt microbiota associated with health and recurrent tonsillitis.the human palatine tonsils, which belong to the central antigen handling sites of the mucosal immune system, are frequently affected by acute and recurrent infections. this study compared the microbiota of the tonsillar crypts in children and adults affected by recurrent tonsillitis with that of healthy adults and children with tonsillar hyperplasia. an in-depth 16s rrna gene based pyrosequencing approach combined with a novel strategy that included phylogenetic analysis and detection of species ...201323437130
a guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2013 recommendations by the infectious diseases society of america (idsa) and the american society for microbiology (asm)(a).the critical role of the microbiology laboratory in infectious disease diagnosis calls for a close, positive working relationship between the physician and the microbiologists who provide enormous value to the health care team. this document, developed by both laboratory and clinical experts, provides information on which tests are valuable and in which contexts, and on tests that add little or no value for diagnostic decisions. sections are divided into anatomic systems, including bloodstream i ...201323845951
characterization of the kingella kingae polysaccharide capsule and exopolysaccharide.recent evidence indicates that kingella kingae produces a polysaccharide capsule. in an effort to determine the composition and structure of this polysaccharide capsule, in the current study we purified capsular material from the surface of k. kingae strain 269-492 variant kk01 using acidic conditions to release the capsule and a series of steps to remove dna, rna, and protein. analysis of the resulting material by gas chromatography and mass spectrometry revealed n-acetyl galactosamine (galnac) ...201324098695
rapid discrimination of haemophilus influenzae, h. parainfluenzae, and h. haemolyticus by fluorescence in situ hybridization (fish) and two matrix-assisted laser-desorption-ionization time-of-flight mass spectrometry (maldi-tof-ms) platforms.due to considerable differences in pathogenicity, haemophilus influenzae, h. parainfluenzae and h. haemolyticus have to be reliably discriminated in routine diagnostics. retrospective analyses suggest frequent misidentifications of commensal h. haemolyticus as h. influenzae. in a multi-center approach, we assessed the suitability of fluorescence in situ hybridization (fish) and matrix-assisted laser-desorption-ionization time-of-flight mass-spectrometry (maldi-tof-ms) for the identification of h ...201323646201
kingella kingae keratitis.we present the first two cases of kingella kingae keratitis in adults. this species is a rare isolate from ophthalmic samples for which final identification was obtained with matrix-assisted laser desorption ionization-time of flight mass spectrometry. one of the patients recovered uneventfully with topical therapy. results from the second patient cannot be confirmed as he was lost to follow-up.201323447636
mutation of the conserved calcium-binding motif in neisseria gonorrhoeae pilc1 impacts adhesion but not piliation.neisseria gonorrhoeae pilc1 is a member of the pilc family of type iv pilus-associated adhesins found in neisseria species and other type iv pilus-producing genera. previously, a calcium-binding domain was described in the c-terminal domains of pily1 of pseudomonas aeruginosa and in pilc1 and pilc2 of kingella kingae. genetic analysis of n. gonorrhoeae revealed a similar calcium-binding motif in pilc1. to evaluate the potential significance of this calcium-binding region in n. gonorrhoeae, we pr ...201324002068
characterization of tem-1 β-lactamase producing kingella kingae clinical isolates.kingella kingae is a human pathogen that causes pediatric osteoarticular infections and infective endocarditis in children and adults. the bacterium is usually susceptible to β-lactam antibiotics, although β-lactam resistance has been reported in rare isolates. this study was conducted to identify β-lactam resistant strains and characterize the resistance mechanism. screening of a set of 90 k. kingae clinical isolates obtained from different geographic locations revealed high level resistance to ...201323796935
sigma factor rpon (σ54) regulates pile transcription in commensal neisseria elongata.human-adapted neisseria includes two pathogens, neisseria gonorrhoeae and neisseria meningitidis, and at least 13 species of commensals that colonize many of the same niches as the pathogens. the type iv pilus plays an important role in the biology of pathogenic neisseria. in these species, sigma factor rpod (σ(70)), integration host factor, and repressors regf and crga regulate transcription of pile, the gene encoding the pilus structural subunit. the type iv pilus is also a strictly conserved ...201323899162
calcium binding properties of the kingella kingae pilc1 and pilc2 proteins have differential effects on type iv pilus-mediated adherence and twitching motility.kingella kingae is an emerging bacterial pathogen that is being recognized increasingly as an important etiology of septic arthritis, osteomyelitis, and bacteremia, especially in young children. the pathogenesis of k. kingae disease begins with bacterial adherence to respiratory epithelium, which is dependent on type iv pili and is influenced by two pilc-like proteins called pilc1 and pilc2. production of either pilc1 or pilc2 is necessary for k. kingae piliation and bacterial adherence. in this ...201323243304
'bobo-newton syndrome': an unwanted gift from man's best friend.capnocytophaga canimorsus is a facultative gram-negative bacillus that is typically a constituent of the oral flora of dogs and cats. it was first isolated by bobo and newton in 1976 from a man presenting with meningitis following a dog bite. transmission to humans follows various animal-related injuries, which may be gross or subtle. c canimorsus can cause a spectrum of syndromes ranging from skin and soft tissue infection to invasive disease such as meningitis or endocarditis. the present arti ...201324489563
infective endocarditis by aggregatibacter paraphrophilus: case report and literature review.aggregatibacter paraphrophilus (former name, haemophilus paraphrophilus) is a normal inhabitant of the naso- and oropharynx and has been rarely reported as a cause of human infections. a case of infective endocarditis by this organism is being reported and literature of endocarditis cases caused by aggregatibacter paraphrophilus is being reviewed.201324392406
reply to the letter to the editor: another look: is there a flaw to current hip septic arthritis diagnostic algorithms? 201324146359
reply to the letter to the editor: another look: is there a flaw to current hip septic arthritis diagnostic algorithms? 201324146359
letter to the editor: another look: is there a flaw to current hip septic arthritis diagnostic algorithms? 201324136809
letter to the editor: another look: is there a flaw to current hip septic arthritis diagnostic algorithms? 201324136809
incidence, risk factors and prediction of post-operative acute kidney injury following cardiac surgery for active infective endocarditis: an observational study.cardiac surgery is frequently needed in patients with infective endocarditis (ie). acute kidney injury (aki) often complicates ie and is associated with poor outcomes. the purpose of the study was to determine the risk factors for post-operative aki in patients operated on for ie.201324093498
two atypical cases of kingella kingae invasive infection with concomitant human rhinovirus infection.we describe two atypical cases of kingella kingae infection in children diagnosed by pcr, one case involving a soft tissue abscess and one case a femoral brodie abscess. both patients had concomitant human rhinovirus infection. k. kingae strains, isolated from an oropharyngeal swab, were characterized by multilocus sequence typing and rtxa sequencing.201323784119
repeated serum alkaline phosphatase measurements in the treatment of childhood acute bone and joint infections with high doses of antibiotics. 201324003432
a pediatric case of cardiobacterium hominis endocarditis.gram negative endocarditis is relatively rare in pediatrics but when they occur they are most frequently caused by one of the hacek (haemophilus species, actinobacillus actinomycetemcomitans, c. hominis, eikenella corrodens and kingella kingae) group of microorganisms. within the hacek group of microorganisms there have been approximately 100 cases of cardiobacterium hominis endocarditis reported in the literature, but only 2 previous cases of endocarditis and one case of pericarditis have been ...201324470958
prosthetic valve endocarditis and bloodstream infection due to mycobacterium chimaera.prosthetic valve endocarditis (pve) due to fast-growing nontuberculous mycobacteria (ntm) has been reported anecdotally. reports of pve with slowly growing ntm, however, are lacking. we present here one case of pve and one case of bloodstream infection caused by mycobacterium chimaera. randomly amplified polymorphic dna (rapd)-pcr indicated a relatedness of the two m. chimaera strains. both patients had heart surgery 2 years apart from each other. a nosocomial link was not detected.201323536407
septic arthritis caused by noncapsulated haemophilus influenzae.since the introduction of type b haemophilus influenzae vaccination, noncapsulated h. influenzae has become responsible for most cases of invasive h. influenzae diseases. in our two cases of septic arthritis, we isolated strains with β-lactamase-positive amoxicillin-clavulanate resistance (blpacr). thus, the increasing prevalence of blpacr should be taken into account when empirical therapy is chosen for septic arthritis.201323515545
hacek-induced endocarditis.a 61-year-old patient with diabetes had a bio-prosthetic aortic valve replacement 3 years before admission. he complained of lethargy, night sweats, decreased appetite and erratic blood glucose with no weight loss. he had splinter haemorrhage and a systolic ejection murmur at the aortic area. chest and abdominal examination revealed no abnormality. the erythrocyte sedimentation rate and c reactive protein were raised. he had several sets of blood cultures and he was started on empirical vancomyc ...201323682079
antibiofilm activity of actinobacillus pleuropneumoniae serotype 5 capsular polysaccharide.cell-free extracts isolated from colony biofilms of actinobacillus pleuropneumoniae serotype 5 were found to inhibit biofilm formation by staphylococcus aureus, s. epidermidis and aggregatibacter actinomycetemcomitans, but not by a. pleuropneumoniae serotype 5 itself, in a 96-well microtiter plate assay. physical and chemical analyses indicated that the antibiofilm activity in the extract was due to high-molecular-weight polysaccharide. extracts isolated from a mutant strain deficient in the pro ...201323691104
a case of kingella kingae endocarditis complicated by native mitral valve rupture.we report a case of kingella kingae endocarditis in a patient with a history of recent respiratory tract infection and dental extraction. this case is remarkable for embolic and vasculitic phenomena in association with a large valve vegetation and valve perforation. kingella kingae is an organism known to cause endocarditis, however early major complications are uncommon. our case of kingella endocarditis behaved in a virulent fashion necessitating a combined approach of intravenous antibiotic t ...201323671460
antimicrobial susceptibilities of clinical isolates of hacek organisms.the "hacek" organisms are a group of fastidious gram-negative bacteria that cause a variety of infections, including infective endocarditis. antimicrobial susceptibility testing is not universally available, and therapy for these infections is often empirical. we report the antimicrobial susceptibilities of 70 clinical hacek isolates to 18 antimicrobials. all isolates were susceptible to ceftriaxone and levofloxacin, indicating that these agents remain appropriate empirical choices for the treat ...201323403420
infective endocarditis developing serious multiple complications.a 20-year-old female patient with no history of heart disease presented to the hospital with high fever, cough and sputum. on the third day of hospitalisation, left facial paralysis developed and cranial revealed an infarct in the right frontoparietotemporal lobe. transthoracic echocardiography revealed 1.5 × 2 cm-sized vegetation on the mitral valve and severe mitral regurgitation. on the 11th day of hospitalisation, multiple emboli were shown to be present in the left iliac artery. since the p ...201323362066
construction of new cloning, lacz reporter and scarless-markerless suicide vectors for genetic studies in aggregatibacter actinomycetemcomitans.to elucidate the putative function of a gene, effective tools are required for genetic characterization that facilitate its inactivation, deletion or modification on the bacterial chromosome. in the present study, the nucleotide sequence of the escherichia coli/aggregatibacter actinomycetemcomitans shuttle vector pygk was determined, allowing us to redesign and construct a new shuttle cloning vector, pjt4, and promoterless lacz transcriptional/translational fusion plasmids, pjt3 and pjt5. plasmi ...201323353051
prevalence of pharyngeal carriage of kingella kingae in young children and risk factors for colonization.the carriage rate of kingella kingae among jewish and bedouin children living in southern israel paralleled the age-related incidence of invasive infections. age 6-29 months was a significant risk factor for k. kingae colonization in both ethnic groups; day-care attendance was a risk factor in jewish children, whereas living in a shanty town was negatively associated with carriage in bedouins.201323014360
prospective survey of acute osteoarticular infections in a french paediatric orthopedic surgery unit.the epidemiology of acute paediatric osteoarticular infections (oai) has recently evolved, mainly due to the improvement of microbiological diagnosis. we conducted a prospective study to analyse the recent epidemiology and the clinical evolution of paediatric oai in order to validate the adequacy of our probabilistic first-line antibiotic treatment (intraveinous cefamandole + gentamicin). all children suspected of community acquired oai were included and followed-up for 3 years. the etiologic di ...201323957786
oropharyngeal colonization density of kingella kingae. 201323838786
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