Distinguishing <i>Kingella kingae</i> from Pyogenic Acute Septic Arthritis in Young Portuguese Children
(1) <b>Background</b>: We aim to identify clinical and laboratorial parameters to distinguish <i>Kingella kingae</i> from pyogenic septic arthritis (SA). (2) <b>Methods</b>: A longitudinal, observational, single-centre study of children < 5 years old with micro...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-06-01
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| Series: | Microorganisms |
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| Online Access: | https://www.mdpi.com/2076-2607/10/6/1233 |
| _version_ | 1797484190469455872 |
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| author | Catarina Gouveia Ana Subtil Susana Norte Joana Arcangelo Madalena Almeida Santos Rita Corte-Real Maria João Simões Helena Canhão Delfin Tavares |
| author_facet | Catarina Gouveia Ana Subtil Susana Norte Joana Arcangelo Madalena Almeida Santos Rita Corte-Real Maria João Simões Helena Canhão Delfin Tavares |
| author_sort | Catarina Gouveia |
| collection | DOAJ |
| description | (1) <b>Background</b>: We aim to identify clinical and laboratorial parameters to distinguish <i>Kingella kingae</i> from pyogenic septic arthritis (SA). (2) <b>Methods</b>: A longitudinal, observational, single-centre study of children < 5 years old with microbiological positive SA admitted to a paediatric hospital from 2013–2020 was performed. Clinical and laboratorial data at admission and at 48 h, as well as on treatment and evolution, were obtained. (3) <b>Results</b>: We found a total of 75 children, 44 with <i>K. kingae</i> and 31 with pyogenic infections (mostly MSSA, <i>S. pneumoniae</i> and <i>S. pyogenes)</i>. <i>K. kingae</i> affected younger children with low or absent fever, low inflammatory markers and a favourable prognosis. In the univariate analyses, fever, septic look, CRP and ESR at admission and CRP at 48 h were significantly lower in <i>K. kingae</i> SA. In the multivariate analyses, age > 6 months ≤ 2 years, apyrexy and CRP ≤ 100 mg/L were significative, with an overall predictive positive value of 86.5%, and 88.4% for <i>K. kingae</i>. For this model, ROC curves were capable of differentiating (AUC 0.861, 95% CI 0.767–0.955) <i>K. kingae</i> SA from typical pathogens. (4) <b>Conclusions</b>: Age > 6 months ≤ 2 years, apyrexy and PCR ≤ 100 mg/L were the main predictive factors to distinguish <i>K. kingae</i> from pyogenic SA < 5 years. These data need to be validated in a larger study. |
| first_indexed | 2024-03-09T22:58:54Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2076-2607 |
| language | English |
| last_indexed | 2024-03-09T22:58:54Z |
| publishDate | 2022-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Microorganisms |
| spelling | doaj.art-3d923e7c3aa3468e9b15fde942a5bb662023-11-23T18:05:16ZengMDPI AGMicroorganisms2076-26072022-06-01106123310.3390/microorganisms10061233Distinguishing <i>Kingella kingae</i> from Pyogenic Acute Septic Arthritis in Young Portuguese ChildrenCatarina Gouveia0Ana Subtil1Susana Norte2Joana Arcangelo3Madalena Almeida Santos4Rita Corte-Real5Maria João Simões6Helena Canhão7Delfin Tavares8Infectious Diseases Unit, Hospital de Dona Estefânia, Centro Hospitalar Universitário Lisboa Central, 1169-045 Lisbon, PortugalNOVA National School of Public Health, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, 1600-560 Lisbon, PortugalPediatric Orthopedic Unit, Área de Pediatria, Hospital de Dona Estefânia, Centro Hospitalar Universitário Lisboa Central, 1169-050 Lisbon, PortugalPediatric Orthopedic Unit, Área de Pediatria, Hospital de Dona Estefânia, Centro Hospitalar Universitário Lisboa Central, 1169-050 Lisbon, PortugalLaboratory of Molecular Biology, Department of Clinical Pathology, Centro Hospitalar Universitário Lisboa Central, 1169-050 Lisbon, PortugalLaboratory of Molecular Biology, Department of Clinical Pathology, Centro Hospitalar Universitário Lisboa Central, 1169-050 Lisbon, PortugalDepartment of Infectious Diseases, National Institute of Health Dr. Ricardo Jorge, 1600-609 Lisbon, PortugalNova Medical School, Faculdade de Ciências Médicas, 1169-056 Lisbon, PortugalPediatric Orthopedic Unit, Área de Pediatria, Hospital de Dona Estefânia, Centro Hospitalar Universitário Lisboa Central, 1169-050 Lisbon, Portugal(1) <b>Background</b>: We aim to identify clinical and laboratorial parameters to distinguish <i>Kingella kingae</i> from pyogenic septic arthritis (SA). (2) <b>Methods</b>: A longitudinal, observational, single-centre study of children < 5 years old with microbiological positive SA admitted to a paediatric hospital from 2013–2020 was performed. Clinical and laboratorial data at admission and at 48 h, as well as on treatment and evolution, were obtained. (3) <b>Results</b>: We found a total of 75 children, 44 with <i>K. kingae</i> and 31 with pyogenic infections (mostly MSSA, <i>S. pneumoniae</i> and <i>S. pyogenes)</i>. <i>K. kingae</i> affected younger children with low or absent fever, low inflammatory markers and a favourable prognosis. In the univariate analyses, fever, septic look, CRP and ESR at admission and CRP at 48 h were significantly lower in <i>K. kingae</i> SA. In the multivariate analyses, age > 6 months ≤ 2 years, apyrexy and CRP ≤ 100 mg/L were significative, with an overall predictive positive value of 86.5%, and 88.4% for <i>K. kingae</i>. For this model, ROC curves were capable of differentiating (AUC 0.861, 95% CI 0.767–0.955) <i>K. kingae</i> SA from typical pathogens. (4) <b>Conclusions</b>: Age > 6 months ≤ 2 years, apyrexy and PCR ≤ 100 mg/L were the main predictive factors to distinguish <i>K. kingae</i> from pyogenic SA < 5 years. These data need to be validated in a larger study.https://www.mdpi.com/2076-2607/10/6/1233<i>Kingella kingae</i>acute septic arthritispyogenic infections |
| spellingShingle | Catarina Gouveia Ana Subtil Susana Norte Joana Arcangelo Madalena Almeida Santos Rita Corte-Real Maria João Simões Helena Canhão Delfin Tavares Distinguishing <i>Kingella kingae</i> from Pyogenic Acute Septic Arthritis in Young Portuguese Children Microorganisms <i>Kingella kingae</i> acute septic arthritis pyogenic infections |
| title | Distinguishing <i>Kingella kingae</i> from Pyogenic Acute Septic Arthritis in Young Portuguese Children |
| title_full | Distinguishing <i>Kingella kingae</i> from Pyogenic Acute Septic Arthritis in Young Portuguese Children |
| title_fullStr | Distinguishing <i>Kingella kingae</i> from Pyogenic Acute Septic Arthritis in Young Portuguese Children |
| title_full_unstemmed | Distinguishing <i>Kingella kingae</i> from Pyogenic Acute Septic Arthritis in Young Portuguese Children |
| title_short | Distinguishing <i>Kingella kingae</i> from Pyogenic Acute Septic Arthritis in Young Portuguese Children |
| title_sort | distinguishing i kingella kingae i from pyogenic acute septic arthritis in young portuguese children |
| topic | <i>Kingella kingae</i> acute septic arthritis pyogenic infections |
| url | https://www.mdpi.com/2076-2607/10/6/1233 |
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