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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
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
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
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
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
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
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
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
[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
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
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
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
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
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
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
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
[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
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
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
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
[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
abiotrophia defectiva knee prosthesis infection: a case report.abstract:201121896178
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
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
[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
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
Kingella kingae Infections in Children: An Update. 201122125036
Predictive score to discriminate Kingella kingae from Staphylococcus aureus arthritis in France. 201122105423
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
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
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
[kingella kingae spondilodiscitis in an adult]. 201021093187
[isolated bacteraemia caused by kingella kingae]. 201020006566
invasive pediatric kingella kingae infections: a nationwide collaborative study.kingella kingae is a gram-negative coccobacillus, increasingly recognized as an invasive pediatric pathogen. to date, only few small series of invasive k. kingae infections have been published, mostly from single medical centers. a nationwide multicenter study was performed to investigate the epidemiologic, clinical, and laboratory features of children with culture-proven k. kingae infections.201020182400
aortic homograft endocarditis caused by cardiobacterium hominis and complicated by agranulocytosis due to ceftriaxone.the present report describes a very rare case of an aortic homograft valve endocarditis caused by cardiobacterium hominis. the case was complicated by an agranulocytosis after 3 weeks of antibiotic treatment induced by ceftriaxone. alternative oral treatment with ciprofloxacin and rifampicin was successful, no surgical intervention was needed and homograft function could be preserved.201022797477
actinobacillus actinomycetemcomitans endocarditis in a 1.5 year old toddler.the authors report a 1.5-year-old girl who developed actinobacillus actinomycetemcomitans (aa) endocarditis involving the pulmonic valve. she had a congenital cardiac abnormality, but no history of dental manipulation. the case illustrates an uncomplicated course with three unique features; the youngest reported infant with endocarditis caused by aa with vegetation on the pulmonic valve. she underwent a benign course with complete recovery. the authors report a 1.5-year-old girl who developed aa ...201022767569
procession to pediatric bacteremia and sepsis: covert operations and failures in diplomacy.despite advances in diagnosis and treatment, bacterial sepsis remains a major cause of pediatric morbidity and mortality, particularly among neonates, the critically ill, and the growing immunocompromised patient population. sepsis is the end point of a complex and dynamic series of events in which both host and microbial factors drive high morbidity and potentially lethal physiologic alterations. in this article we provide a succinct overview of the events that lead to pediatric bloodstream inf ...201020566606
fastidious gram-negatives: identification by the vitek 2 neisseria-haemophilus card and by partial 16s rrna gene sequencing analysis.taxonomy and identification of fastidious gram negatives are evolving and challenging. we compared identifications achieved with the vitek 2 neisseria-haemophilus (nh) card and partial 16s rrna gene sequence (526 bp stretch) analysis with identifications obtained with extensive phenotypic characterization using 100 fastidious gram negative bacteria. seventy-five strains represented 21 of the 26 taxa included in the vitek 2 nh database and 25 strains represented related species not included in th ...201021347215
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
matrix-assisted laser desorption ionization-time of flight mass spectrometry as an alternative to 16s rrna gene sequencing for identification of difficult-to-identify bacterial strains.conventional methods are sometimes insufficient to identify human bacterial pathogens, and alternative techniques, often molecular, are required. matrix-assisted laser desorption ionization-time of flight mass spectrometry (maldi-tof ms) identified with a valid score 45.9% of 410 clinical isolates from 207 different difficult-to-identify species having required 16s rrna gene sequencing. maldi-tof ms might represent an alternative to 16s rrna gene sequencing.201021106794
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
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
filifactor alocis--involvement in periodontal biofilms.bacteria in periodontal pockets develop complex sessile communities that attach to the tooth surface. these highly dynamic microfloral environments challenge both clinicians and researchers alike. the exploration of structural organisation and bacterial interactions within these biofilms is critically important for a thorough understanding of periodontal disease. in recent years, filifactor alocis, a fastidious, gram-positive, obligately anaerobic rod was repeatedly identified in periodontal les ...201020193074
rapid differentiation of francisella species and subspecies by fluorescent in situ hybridization targeting the 23s rrna.francisella (f.) tularensis is the causative agent of tularemia. due to its low infectious dose, ease of dissemination and high case fatality rate, f. tularensis was the subject in diverse biological weapons programs and is among the top six agents with high potential if misused in bioterrorism. microbiological diagnosis is cumbersome and time-consuming. methods for the direct detection of the pathogen (immunofluorescence, pcr) have been developed but are restricted to reference laboratories.201020205957
kingella kingae osteoarticular infections in young children: clinical features and contribution of a new specific real-time pcr assay to the diagnosis.kingella kingae is an emerging pathogen that may be recognized as the most common bacteria responsible for osteoarticular infections (oai) in young children. however, its diagnosis remains a challenge and thus little evoked in infants, because k. kingae is a difficult germ to isolate on solid medium, and clinical signs are often mild. the main objective of this prospective study is to describe the clinical, biologic, and radiologic features of children with oai caused by k. kingae. in addition, ...201020357599
subtle bacterial endocarditis due to kingella kingae in an infant: a case report.a 9-month-old infant presented with fever, dyspnoea, and a murmur. echocardiography showed a mitral vegetation with significant regurgitation. mitral valve plasty was performed on day 6, and was polymerase chain reaction positive for kingella kingae. the cardiac outcome was favourable. this case illustrates a subtle presentation of k. kingae mitral valve infective endocarditis in a normal-cardaic infant, treated with early surgery, and the agent belonged to the hacek (haemophilus spp actinobacil ...201020465860
[sacroiliitis due to kingella kingae in an adult: updates on this pathogen].we report here the case of a sacro-iliitis due to kingella kingae in a 35 year-old patient. this case report points out the pathogenic potency in adults of this organism which is known as a cause of invasive infections in young children. inoculation of blood culture vials with clinical specimens and the use of nucleic acid amplification have recently improved the sensitivity to identify kingella kingae and to diagnose infections which need an efficient antimicrobial therapy.201020478779
evaluation of the analytical performance of the xpert mtb/rif assay.we performed the first studies of analytic sensitivity, analytic specificity, and dynamic range for the new xpert mtb/rif assay, a nucleic acid amplification-based diagnostic system that detects mycobacterium tuberculosis and rifampin (rif) resistance in under 2 h. the sensitivity of the assay was tested with 79 phylogenetically and geographically diverse m. tuberculosis isolates, including 42 drug-susceptible isolates and 37 rif-resistant isolates containing 13 different rpob mutations or mutat ...201020504986
first report of septic arthritis caused by klebsiella oxytoca.klebsiella oxytoca is known to be a pathogen in immunodeficient adults and children. here we report the first case of a k. oxytoca infection associated with spontaneous arthritis of the knee in a child with no history of immunosuppressive therapy or previous bacterial infections. despite an initial antibiotic treatment failure, a second treatment led to a cure of the infection with no joint sequelae.201020573877
clinical disease caused by klebsiella in 2 unrelated patients with interleukin 12 receptor beta1 deficiency.patients with interleukin 12 (il-12)p40 or il-12 receptor β1 (il12rβ1) deficiencies are prone to develop infections caused by mycobacteria and salmonella; other infections have only been rarely observed. in this report we describe 2 unrelated patients with complete autosomal recessive il12rβ1 deficiency who suffered from sepsis attributable to klebsiella pneumoniae. a mexican boy suffered from disseminated bacille calmette-guérin disease and infections caused by k pneumoniae and candida albicans ...201020855390
infections of people with complement deficiencies and patients who have undergone splenectomy.the complement system comprises several fluid-phase and membrane-associated proteins. under physiological conditions, activation of the fluid-phase components of complement is maintained under tight control and complement activation occurs primarily on surfaces recognized as "nonself" in an attempt to minimize damage to bystander host cells. membrane complement components act to limit complement activation on host cells or to facilitate uptake of antigens or microbes "tagged" with complement fra ...201020930072
gangliosides block aggregatibacter actinomycetemcomitans leukotoxin (ltxa)-mediated hemolysis.aggregatibacter actinomycetemcomitans is an oral pathogen and etiologic agent of localized aggressive periodontitis. the bacterium is also a cardiovascular pathogen causing infective endocarditis. a. actinomycetemcomitans produces leukotoxin (ltxa), an important virulence factor that targets white blood cells (wbcs) and plays a role in immune evasion during disease. the functional receptor for ltxa on wbcs is leukocyte function antigen-1 (lfa-1), a ß-2 integrin that is modified with n-linked car ...201022069577
rtx proteins: a highly diverse family secreted by a common mechanism.repeats-in-toxin (rtx) exoproteins of gram-negative bacteria form a steadily growing family of proteins with diverse biological functions. their common feature is the unique mode of export across the bacterial envelope via the type i secretion system and the characteristic, typically nonapeptide, glycine- and aspartate-rich repeats binding ca(2+) ions. in this review, we summarize the current state of knowledge on the organization of rtx loci and on the biological and biochemical activities of t ...201020528947
crystal structure analysis reveals pseudomonas pily1 as an essential calcium-dependent regulator of bacterial surface motility.several bacterial pathogens require the "twitching" motility produced by filamentous type iv pili (t4p) to establish and maintain human infections. two cytoplasmic atpases function as an oscillatory motor that powers twitching motility via cycles of pilus extension and retraction. the regulation of this motor, however, has remained a mystery. we present the 2.1 a resolution crystal structure of the pseudomonas aeruginosa pilus-biogenesis factor pily1, and identify a single site on this protein r ...201020080557
crystal structure analysis reveals pseudomonas pily1 as an essential calcium-dependent regulator of bacterial surface motility.several bacterial pathogens require the "twitching" motility produced by filamentous type iv pili (t4p) to establish and maintain human infections. two cytoplasmic atpases function as an oscillatory motor that powers twitching motility via cycles of pilus extension and retraction. the regulation of this motor, however, has remained a mystery. we present the 2.1 a resolution crystal structure of the pseudomonas aeruginosa pilus-biogenesis factor pily1, and identify a single site on this protein r ...201020080557
management of acute hematogenous osteomyelitis in children.in children, osteomyelitis is primarily hematogenous in origin and acute in nature. the principal cause of osteomyelitis in children is staphylococcus aureus, and both the epidemiology and pathogenesis of s. aureus infections, including osteomyelitis, have changed in recent years owing to the emergence of community-associated methicillin-resistant s. aureus. this review focuses on advances in the diagnosis and overall management of acute hematogenous osteomyelitis in children with these changes ...201020109047
examination of type iv pilus expression and pilus-associated phenotypes in kingella kingae clinical isolates.kingella kingae is a gram-negative bacterium that is being recognized increasingly as a cause of septic arthritis and osteomyelitis in young children. previous work established that k. kingae expresses type iv pili that mediate adherence to respiratory epithelial and synovial cells. pila1 is the major pilus subunit in k. kingae type iv pili and is essential for pilus assembly. to develop a better understanding of the role of k. kingae type iv pili during colonization and invasive disease, we exa ...201020145101
pharyngeal colonization by kingella kingae in children with invasive disease.kingella kingae organisms isolated from the blood of 3 children with invasive infections were identical by pulsed field gel electrophoresis and random amplified polymorphic dna-polymerase chain reaction analysis to those recovered from the patients' pharynx, demonstrating the likely role of upper respiratory tract colonization in the pathogenesis of the disease caused by this bacterium.200919106774
diversity and site-specificity of the oral microflora in the elderly.the purpose of the present study was to describe the bacterial diversity in the oral cavity of the elderly without root caries using bacterial microarrays, and to determine the site- and subject-specificity of bacterial colonization. samples were collected from the tongue dorsum, mucosa of the buccal fold, hard palate, supragingival plaque from sound root surfaces, and subgingival plaque from the same roots. a new 16 s rrna gene-based microarray method was used for the simultaneous detection of ...200919373498
expression of kingella kingae type iv pili is regulated by sigma54, pils, and pilr.kingella kingae is a member of the neisseriaceae and is being recognized increasingly as an important cause of serious disease in children. recent work has demonstrated that k. kingae expresses type iv pili that mediate adherence to respiratory epithelial and synovial cells and are selected against during invasive disease. in the current study, we examined the genome of k. kingae strain 269-492 and identified homologs of the rpon and the pils and pilr genes that are essential for pilus expressio ...200919465661
dissemination of kingella kingae in the community and long-term persistence of invasive clones.although kingella kingae is being increasingly recognized as an important pediatric pathogen, our current understanding of the transmission of the organism is limited. the dissemination of k. kingae in the community was studied in 2 ethnic groups living side-by-side in southern israel.200919593253
kingella kingae prosthetic valve endocarditis complicated by a paravalvular abscess. 200919603602
comparisons of subgingival microbial profiles of refractory periodontitis, severe periodontitis, and periodontal health using the human oral microbe identification microarray.this study compared the subgingival microbiota of subjects with refractory periodontitis (rp) to those in subjects with treatable periodontitis (grs = good responders) or periodontal health (ph) using the human oral microbe identification microarray (homim).200919722792
effects of preincubation temperature on the detection of fastidious organisms in delayed-entry samples in the bact/alert 3d blood culture system.this study evaluates the effect of preincubation on delayed-entry samples for fastidious organisms including the hacek group, streptococcus species, neisseria meningitidis, haemophilus species and corynebacterium species for the bact/alert 3d system (biomérieux) using the fa (aerobic) medium. bottles were inoculated with two different concentrations (0.5 mcfarland and a 1:100,000 dilution) of each organism and either loaded into the system immediately or stored at 4 degrees c, room temperature ( ...200919733598
moraxella lacunata septic arthritis in a patient with lupus nephritis.moraxella lacunata is a rare, usually commensal gram-negative rod most commonly associated with eye infections. we report a unique case of noniatrogenic m. lacunata bacteremia and septic knee arthritis in a patient with class iii-iv lupus nephritis and speculate on the association between invasive moraxella infection and renal impairment.200919794049
an adult case of urinary tract infection with kingella kingae: a case report.kingella kingae, though part of the normal upper respiratory tract and genitourinary tract, is increasingly being recognized as an important human pathogen. during the past decade, it has emerged as a significant pathogen in the pediatric age group primarily causing bacteremia and osteoarticular infections. adult infection usually occurs in individuals who are severely immunocompromised and most infections have taken the form of septicemia or septic arthritis. bacteremia due to k. kingae has bee ...200919830146
acute haemophilus parainfluenzae endocarditis: a case report.numerous pathogens can cause infective endocarditis, including haemophilus parainfluenzae. h. parainfluenzae is part of the h. aphrophilus, actinobacillus actinomycetemcomitans, cardiobacterium hominis, eikenella corrodens, and kingella kingae group that may cause about 3% of the total endocarditis cases, and is characterized by a subacute course and large vegetations.200919830211
kingella kingae endocardial abscess and cerebral infarction in a previously well immunocompetent child.kingella kingae is an emerging paediatric pathogen that most commonly is associated with relatively benign osteoarticular disease in children. this report concerns a 1-year-old child with kingella kingae endocarditis and perivalvular abscess complicated by septic cerebral emboli and osteomyelitis leading to long-term neurological sequelae, highlighting the capacity of this organism to cause severe invasive disease in children.200922190987
rapid universal identification of bacterial pathogens from clinical cultures by using a novel sloppy molecular beacon melting temperature signature technique.a real-time pcr assay with the ability to rapidly identify all pathogenic bacteria would have widespread medical utility. current real-time pcr technologies cannot accomplish this task due to severe limitations in multiplexing ability. to this end, we developed a new assay system which supports very high degrees of multiplexing. we developed a new class of mismatch-tolerant "sloppy" molecular beacons, modified them to provide an extended hybridization range, and developed a multiprobe, multimelt ...200919923485
rapid universal identification of bacterial pathogens from clinical cultures by using a novel sloppy molecular beacon melting temperature signature technique.a real-time pcr assay with the ability to rapidly identify all pathogenic bacteria would have widespread medical utility. current real-time pcr technologies cannot accomplish this task due to severe limitations in multiplexing ability. to this end, we developed a new assay system which supports very high degrees of multiplexing. we developed a new class of mismatch-tolerant "sloppy" molecular beacons, modified them to provide an extended hybridization range, and developed a multiprobe, multimelt ...200919923485
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