Clinical Microbiology Laboratory, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Clin Infect Dis. 2012 Oct;55(8):1074-9. doi: 10.1093/cid/cis622. Epub 2012 Jul 17.
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.
A collection of 181 invasive K. kingae strains, isolated between 1991 and 2012 from Israeli patients with bacteremia, skeletal system infections, or endocarditis, were typed by pulsed-field gel electrophoresis (PFGE). In addition, the correspondence between PFGE, multilocus sequence types (MLSTs), and rtxA gene sequencing results was also examined for organisms belonging to the predominant PFGE clones isolated from asymptomatic carriers and patients with invasive infections.
A total of 32 different K. kingae clones were identified by PFGE, of which 5 (B, H, K, N, and P) caused 72.9% of all invasive infections, and were recovered during the 21-year period from different regions of the country. Clone K was significantly associated with bacteremia, clone N with skeletal system infections, and clone P with bacterial endocarditis. Strains belonging to the same PFGE clone, either carried asymptomatically or causing different invasive infections, shared MLST complexes and exhibited identical or closely related rtxA alleles.
Although K. kingae exhibits noteworthy genetic heterogeneity, a limited number of distinct clones cause the majority of invasive infections in Israel, exhibiting genetic stability, long-term persistence, and wide geographic dispersal. K. kingae strains also show significant association with specific clinical syndromes.
尽管金氏金菌（Kingella kingae）作为儿童早期重要病原体的地位日益得到认可，但该菌不同菌株的相对频率和侵袭性尚未得到研究。本研究旨在确定金氏金菌基因型与特定临床综合征之间的关联，以及侵袭性克隆的时间和地理分布。
收集了 1991 年至 2012 年间从以色列血培养阳性、骨骼系统感染或心内膜炎患者中分离的 181 株侵袭性金氏金菌，通过脉冲场凝胶电泳（PFGE）进行分型。此外，还对属于从无症状携带者和侵袭性感染患者中分离的主要 PFGE 克隆的生物体的 PFGE、多位点序列分型（MLST）和 rtxA 基因测序结果之间的相关性进行了研究。
PFGE 共鉴定出 32 种不同的金氏金菌克隆，其中 5 种（B、H、K、N 和 P）引起了 72.9%的所有侵袭性感染，并且在 21 年的时间里从该国不同地区分离得到。克隆 K 与菌血症显著相关，克隆 N 与骨骼系统感染相关，克隆 P 与细菌性心内膜炎相关。属于同一 PFGE 克隆的菌株，无论是无症状携带还是引起不同的侵袭性感染，均具有相同的或密切相关的 MLST 复合体，且 rtxA 等位基因也相同或密切相关。
尽管金氏金菌表现出显著的遗传异质性，但少数几种不同的克隆导致了以色列大多数侵袭性感染，具有遗传稳定性、长期持续性和广泛的地理分布。金氏金菌菌株还与特定的临床综合征显著相关。
