摩洛哥首例儿童骨与关节感染金氏金菌的报告。

First report of Kingella kingae diagnosed in pediatric bone and joint infections in Morocco.

机构信息

Laboratoire Pathologie Humaine Biomédecine et Environnement, Faculté de Médecine et de Pharmacie de Fès (FMPF), Université Sidi Mohammed Ben Abdellah (USMBA), Fès, Morocco.

Service de traumato-orthopédie pédiatrique, CHU Hassan II. Laboratoire Pathologie humaine Biomédecine et Environnement. Faculté de Médecine et de Pharmacie, Université Sidi Mohamemd Ben Abdellah, Fès, Morocco.

出版信息

BMC Infect Dis. 2021 Jul 20;21(1):697. doi: 10.1186/s12879-021-06361-8.

DOI:10.1186/s12879-021-06361-8

PMID:34284735

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8293485/

Abstract

BACKGROUND

The progress of diagnostic strategies and molecular methods improved the detection of Kingella kingae in bone and joint infections, and now, Kingella kingae is being increasingly recognized as the most frequent cause of bone and joint infection BJI in early childhood. The main objective of this prospective study is to report the frequency of Kingella Kingae in negative culture bone and joint pediatric infections, and to describe the clinical and biologic features of these children.

METHODS

From December 2016 to June 2019, we selected all hospitalized patients with suspected BJI. When culture was negative on the fifth day, children under 10 years were subsequently included in the study, and PCR assay was performed systematically for researching K. kingae specific gene cpn60. Microbial culture and identification were made using standard bacteriological methods. The demographics, clinical, laboratory, radiographic and clinical features were reviewed from medical records.

RESULTS

We enrolled 65 children with culture negative BJI, 46 of them having under 10 years old have been screened for the cpn60 gene. Thus, the gene encoding Kingella kingae was positive for 27 BJI cases (58.7%). The mean age of children was 3.02 years, 55.6% were aged 6 months-4 years and 29.6% of them were aged 5-10 years. The male to female ratio was 1.7 and 16 cases (59.26%) occurred during the fall-winter period. The most frequent BJI type was septic arthritis (77.8%) and the most affected sites were knee (51.9%) and hip (37.0%). We recorded a mild clinical picture with normal to mildly raised inflammatory markers. All patients had good clinical and functional outcomes, with no serious orthopedic sequelae..

CONCLUSION

K kingae is an important pathogen of culture-negative BJI in Moroccan children. PCR testing should be performed in culture-negative cases of children not only in the typical age range of 6 months to 4 years. When implemented in the routine clinical microbiology laboratory, a specific K. kingae PCR assay can provide a better diagnostic performance of BJI.

摘要

背景

诊断策略和分子方法的进步提高了对金氏金氏菌引起的骨和关节感染的检测能力，现在，金氏金氏菌被越来越多地认为是幼儿骨和关节感染（BJI）的最常见原因。本前瞻性研究的主要目的是报告阴性培养骨和关节儿科感染中 Kingella Kingae 的频率，并描述这些儿童的临床和生物学特征。

方法

从 2016 年 12 月至 2019 年 6 月，我们选择了所有疑似 BJI 的住院患者。当第五天培养为阴性时，我们随后将 10 岁以下的儿童纳入研究，并系统地进行 PCR 检测以研究 K. kingae 特异性基因 cpn60。微生物培养和鉴定采用标准细菌学方法。从病历中回顾人口统计学、临床、实验室、影像学和临床特征。

结果

我们纳入了 65 例培养阴性的 BJI 患儿，其中 46 例年龄在 10 岁以下，对 cpn60 基因进行了筛查。因此，Kingella kingae 基因编码的基因在 27 例 BJI 病例中呈阳性（58.7%）。儿童的平均年龄为 3.02 岁，55.6%的年龄在 6 个月至 4 岁之间，29.6%的年龄在 5-10 岁之间。男女比例为 1.7，16 例（59.26%）发生在秋季-冬季。最常见的 BJI 类型是化脓性关节炎（77.8%），最常受累的部位是膝盖（51.9%）和臀部（37.0%）。我们记录了一个轻度的临床症状，炎症标志物正常或轻度升高。所有患者均有良好的临床和功能结局，无严重的骨科后遗症。