KINGELLA AS A CAUSE OF SEPTIC ARTHRITIS IN CHILDREN: THE BENEFIT OF MOLECULAR TECHNIQUES FOR MICROBIOLOGICAL DIAGNOSIS
ESPID Education. Saavedra-Lozano J. Jun 7, 2011; 7724
Dr. Jesus Saavedra-Lozano
Dr. Jesus Saavedra-Lozano

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KINGELLA AS A CAUSE OF SEPTIC ARTHRITIS IN CHILDREN: THE BENEFIT OF MOLECULAR TECHNIQUES FOR MICROBIOLOGICAL DIAGNOSIS
Saavedra-Lozano J, Miranda C, Marín M, Villa A, Santos Sebastián M, Navarro Gómez ML, Cervera P, Malo de Molina A, González JL, Hernández-Sampelayo T.
Background. Septic arthritis (SA) is a potentially severe disease in children. Kingella is a common cause of this infection in young children but it is often underdiagnosed by classical microbiological procedures. The aim of this study was to evaluate the effect of molecular techniques in the diagnosis of this infection. Methods. We compared the clinical and diagnostic characteristics of children with SA before (retrospectively) and after (prospectively) the implementation of bacterial PCR in synovial fluid for the diagnosis of this infection. Results. Fourty nine children diagnosed with SA were evaluated between 2002-2010. Thirty two of them were diagnosed before the PCR analysis was implemented in our hospital (2009) and 17 after that. The microbiological diagnosis was achieved in 31% during the first period vs 59% in the second period (p=0.12), or 90% increased. Kingella was isolated in 7 of 10 cases in the second period but in none in the first period. Children with Kingella were younger (13 vs 27 months; p=0.059), had fever more often (100% vs 43%; p= 0.01), and higher ESR at admission (74 vs 50; p=0.031), but the duration of hospitalization (7 vs 11 days; p=0.06) and IV antibiotics (6 vs 10 days; p=0.01) were shorter. However, total duration of antibiotics was similar (31 vs 36 days). There were no sequelae in children with Kingella SA vs 20% in children with other type of SA (p=0.58). Conclusions. Kingella is an important cause of SA in children that may be underdiagnosed with classical microbiological procedures. Although Kingella SA may be severe at presentation, it seems to respond optimally to therapy without sequelae.
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