Bacteria in Throat May Indicate Joint Infection Risk in Kids

Two pediatric centers, one in Canada and the other in Switzerland have shown that the presence of the bacterium Kingella kingae in children’s throats was strongly linked to bone and joint infection with the same bacterium.  Their study (“Association between Oropharyngeal Carriage of Kingella kingae and Osteoarticular Infection in Young Children: A Case–Control Study”) appears in CMAJ (Canadian Medical Association Journal).

“Kingella kingae has been increasingly identified in patients with osteoarticular infections. Our main objective was to evaluate the association between carriage of K. kingae in the oropharynx of preschool children and osteoarticular infections,” write the investigators. “Detection of oropharyngeal K. kingae was strongly associated with osteoarticular infection among children presenting with symptoms suggestive of such infection.”

Bone and joint bacterial infections are particularly dangerous in children with the potential for severely hampering long-term mobility and causing death. Most infections were thought to be caused by Staphylococcus, Streptococcus, and Haemophilus influenzae type b bacteria and were treated with long-term antibiotics and/or surgery. Now it’s possible to determine more precisely which bacteria responsible for these infections.

The study included 77 children aged 6 months to 4 years of age admitted for suspected bone or joint infection and 286 controls. Of the suspected infections, 65 children had confirmed bone or joint infection.

“Using improved diagnostic methods, our study found that the vast majority of children younger than 4 years old suffering from a bone or joint infection were infected by Kingella kingae bacteria,” says Jocelyn Gravel, M.D., Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montréal, Quebec. “More importantly, we discovered that 70% of children who had a bone/joint infection carried these bacteria in their throats, while it is uncommon in uninfected children (only 6%).”

This research is critical, he adds, because the proportion of unknown pathogen was very high in previous studies and the team’s work demonstrated K. kingae is not uncommon. It turns out to be the most common pathogen for bone or joint infection in children.

“Based on this study, we plan to change the way we investigate children at risk of bone/joint infection, because the identification of K. kingae in the throat of a child with a suspected bone infection will point towards K. kingae as the culprit,” continues Dr. Gravel. “This may decrease the number of other tests performed to identify the pathogen.”