Real-Time PCR Assay for Detection of Kingella kingae in Children

Theresa Madigan; Scott A. Cunningham; Poornima Ramanan; Micah M. Bhatti; Robin Patel

doi:10.1055/s-0038-1641603

Journal of Pediatric Infectious Diseases, Table of Contents

J Pediatr Infect Dis 2018; 13(03): 216-223
DOI: 10.1055/s-0038-1641603

Original Article

Georg Thieme Verlag KG Stuttgart · New York

Real-Time PCR Assay for Detection of Kingella kingae in Children

Theresa Madigan

¹Division of Pediatric Infectious Diseases, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, United States

,

Scott A. Cunningham

²Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, United States

,

Poornima Ramanan

²Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, United States

,

Micah M. Bhatti

³Clinical Microbiology Laboratory, Department of Laboratory Medicine, The University of Texas, MD Anderson Cancer Center, Houston, Texas, United States

,

Robin Patel

²Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, United States

⁴Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota, United States

› Author Affiliations

Abstract

Background Kingella kingae is a known cause of osteoarticular infections in children younger than 4 years of age, but it is not always recoverable in culture. Molecular methods are increasingly used for diagnosis.

Methods To facilitate diagnosis of K. kingae septic arthritis, we developed a real-time polymerase chain reaction (PCR) assay for the detection of K. kingae that targets the repeat-in-toxin gene (rtxB).

Results We present three pediatric patients with K. kingae septic arthritis at our institution who were diagnosed using the real-time PCR assay. All underwent arthrotomy with irrigation and debridement and were symptom-free after 3 weeks of therapy with β-lactam antibiotics. Cultures of synovial fluid or tissue grew K. kingae in two of three; K. kingae real-time PCR was positive in all three patients. In addition, 11 cases of K. kingae osteoarticular infection were diagnosed through Mayo Medical Laboratories using this assay. The limit of detection of the real-time PCR assay was 73.7 colony-forming unit (CFU)/µL for tissue and 1.3 CFU/µL for synovial fluid.

Conclusions PCR-based detection methods are faster and more sensitive than conventional culture-based methods for the diagnosis of K. kingae osteoarticular infections in children.

Keywords

Kingella kingae - real-time PCR - children

Full Text

References

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