Yagupsky Pablo, Erlich Yifat, Ariela Slonim, Trefler Ronit, Porat Nurith
Clinical Microbiology Laboratory, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Pediatr Infect Dis J. 2006 Jun;25(6):526-32. doi: 10.1097/01.inf.0000215243.42501.4f.
The objective of this study is to describe the investigation of an outbreak of one culture-proven and two presumptive cases of Kingella kingae osteomyelitis detected within a 15-day period in a daycare center in Israel.
Surveillance pharyngeal cultures were obtained from all attendees at the index daycare center and from two neighboring facilities. Combined amoxicillin-rifampin prophylaxis was administered to all children aged 6 to 30 months living in the community. K. kingae isolates were typed by pulsed field gel electrophoresis, random amplified polymorphic DNA analysis and sequencing of the rRNA genes.
Surveillance cultures showed that four of 11 attendees at the index facility as well as five of 12 and one of 15 attendees at neighboring daycare centers carried K. kingae. Typing of isolates showed that the isolate from a child with osteomyelitis was identical to all other isolates from the same daycare center and different from organisms derived from the other facilities. Administration of prophylactic antibiotics resulted in partial eradication of the organism.
Dissemination of K. kingae in a susceptible pediatric population may result in an outbreak of invasive disease. Our experience suggests the need for increased alertness for clusters of K. kingae infections among children in daycare.
本研究的目的是描述在以色列一家日托中心15天内检测到的1例经培养证实和2例疑似金氏金杆菌骨髓炎病例的暴发调查情况。
从该日托中心所有儿童以及另外两家相邻机构的所有儿童中采集咽拭子培养样本。对社区内所有6至30个月大的儿童联合使用阿莫西林-利福平进行预防。通过脉冲场凝胶电泳、随机扩增多态性DNA分析和rRNA基因测序对金氏金杆菌分离株进行分型。
监测培养显示，该日托中心11名儿童中有4名、相邻日托中心12名儿童中有5名以及15名儿童中有1名携带金氏金杆菌。分离株分型显示，骨髓炎患儿的分离株与同一日托中心的所有其他分离株相同，与其他机构的菌株不同。预防性抗生素的使用导致该菌部分清除。
金氏金杆菌在易感儿童群体中的传播可能导致侵袭性疾病的暴发。我们的经验表明，需要提高对日托中心儿童中金氏金杆菌感染聚集情况的警惕性。
