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Kingella denitrificans - Top 30 Publications

Bacteremia due to Kingella denitrificans in a child followed-up for bone marrow failure syndrome.

Kingella denitrificans is a non-pathogenic micro-organism present in oropharyngeal flora. This germ has been recently recognized as responsible for opportunistic invasive infections mainly affecting immunosuppressed patients. We here report the case of a child aged 3 years and 7 months followed-up since the age of one year for bone marrow failure syndrome associated with pancytopenia of undetermined origin who had bacteremia due to Kingella denitrificans, a group of difficult to culture gram-negative bacteria rarely described in the literature. Clinicians and microbiologists should suspect the presence of this germ especially in immunosuppressed patients. The use of blood culture bottle contributes in a significant way to the detection of this germ.

Low prevalence of Kingella kingae carriage in children aged 6-48 months in Sydney, Australia.

A prospective observational study was conducted to estimate the prevalence of oropharyngeal carriage of Kingella kingae in healthy Australian pre-school children.

HACEK endocarditis: state-of-the-art.

The HACEK group of bacteria - Haemophilus parainfluenzae, Aggregatibacter spp. (A. actinomycetemcomitans, A. aphrophilus, A. paraphrophilus, and A. segnis), Cardiobacterium spp. (C. hominis, C. valvarum), Eikenella corrodens, and Kingella spp. (K. kingae, K. denitrificans) - are fastidious gram-negative bacteria, part of the normal microbiota of oral and upper respiratory tract in humans. Although their pathogenicity is limited, they are responsible for 1-3% of all infective endocarditis. HACEK endocarditis mostly affect patients with underlying heart disease or prosthetic valves, and are characterized by an insidious course, with a mean diagnosis delay of 1 month (Haemophilus spp.) to 3 months (Aggregatibacter and Cardiobacterium spp.). The advent of continuously monitored blood culture systems with enriched media has erased the need for extended incubation for the diagnosis of HACEK endocarditis. Medical treatment relies on third-generation cephalosporin, with a favorable outcome in 80-90% of cases, with or without cardiac surgery.

Structural analysis of haemoglobin binding by HpuA from the Neisseriaceae family.

The Neisseriaceae family of bacteria causes a range of diseases including meningitis, septicaemia, gonorrhoea and endocarditis, and extracts haem from haemoglobin as an important iron source within the iron-limited environment of its human host. Herein we report crystal structures of apo- and haemoglobin-bound HpuA, an essential component of this haem import system. The interface involves long loops on the bacterial receptor that present hydrophobic side chains for packing against the surface of haemoglobin. Interestingly, our structural and biochemical analyses of Kingella denitrificans and Neisseria gonorrhoeae HpuA mutants, although validating the interactions observed in the crystal structure, show how Neisseriaceae have the fascinating ability to diversify functional sequences and yet retain the haemoglobin binding function. Our results present the first description of HpuA's role in direct binding of haemoglobin.

A case of suppurative peritonitis by a commensal oral organism, Kingella denitrificans, in an adult peritoneal dialysis patient.

Peritoneal dialysis-related peritonitis due to Kingella denitrificans: the first case report.

Colonization of an acid resistant Kingella denitrificans in the stomach may contribute to gastric dysbiosis by Helicobacter pylori.

In the stomach of a gastric ulcer patient who had been administered an anti-acid, a gram-negative and urease-negative bacillus similar in size to Helicobacter pylori was infected together with H. pylori. According to biochemical test and 16S rRNA gene analysis, the urease-negative bacterium was identified as Kingella denitrificans, a human nasopharyngeal commensal. In contrast to the standard strain of K. denitrificans, the isolate showed catalase activity, did not produce acid from glucose, and exhibited acid tolerance. Acid tolerance of H. pylori was increased by cocultivation with the K. denitrificans isolate, but not with other isolates of K. denitrificans. Disruption of physiological and immunological niche by dysbiotic colonization of bacterium may provide pathological attributes to human stomach. Collectively, a careful administration of anti-acids to the elderly, especially those with atrophic gastritis, is necessary to avoid repression of the gastric barrier to bacteria.

Mycoplasma edwardii peritonitis in a patient on maintenance peritoneal dialysis.

Mycoplasma edwardii (M. edwardii) is an anthropozoonotic microorganism found in the upper respiratory and urogenital tracts of dogs. M. edwardii was one of the microbes isolated from peritoneal fluid of a 10-year-old child diagnosed with polymicrobial peritonitis following a puncture of dialysis tubing by a pet dog. Other unique pathogens representative of canine oral microflora isolated from this patient on peritoneal dialysis were Kingella denitrificans, Actinomycetes species and Capnocytophaga cynodegmi.

Dialects of the DNA uptake sequence in Neisseriaceae.

In all sexual organisms, adaptations exist that secure the safe reassortment of homologous alleles and prevent the intrusion of potentially hazardous alien DNA. Some bacteria engage in a simple form of sex known as transformation. In the human pathogen Neisseria meningitidis and in related bacterial species, transformation by exogenous DNA is regulated by the presence of a specific DNA Uptake Sequence (DUS), which is present in thousands of copies in the respective genomes. DUS affects transformation by limiting DNA uptake and recombination in favour of homologous DNA. The specific mechanisms of DUS-dependent genetic transformation have remained elusive. Bioinformatic analyses of family Neisseriaceae genomes reveal eight distinct variants of DUS. These variants are here termed DUS dialects, and their effect on interspecies commutation is demonstrated. Each of the DUS dialects is remarkably conserved within each species and is distributed consistent with a robust Neisseriaceae phylogeny based on core genome sequences. The impact of individual single nucleotide transversions in DUS on meningococcal transformation and on DNA binding and uptake is analysed. The results show that a DUS core 5'-CTG-3' is required for transformation and that transversions in this core reduce DNA uptake more than two orders of magnitude although the level of DNA binding remains less affected. Distinct DUS dialects are efficient barriers to interspecies recombination in N. meningitidis, N. elongata, Kingella denitrificans, and Eikenella corrodens, despite the presence of the core sequence. The degree of similarity between the DUS dialect of the recipient species and the donor DNA directly correlates with the level of transformation and DNA binding and uptake. Finally, DUS-dependent transformation is documented in the genera Eikenella and Kingella for the first time. The results presented here advance our understanding of the function and evolution of DUS and genetic transformation in bacteria, and define the phylogenetic relationships within the Neisseriaceae family.

Retropharyngeal abscess from an unusual organism-Kingella denitrificans-in a patient on low-dose methotrexate.

Retropharyngeal abscess can be a life-threatening emergency with potential for airway compromise. We report a case of retropharyngeal abscess caused by Kingella denitrificans in a 66-year-old Caucasian man taking low-dose methotrexate for psoriatic arthritis. K denitrificans has not been previously reported as a cause of retropharyngeal abscess. K denitrificans, along with other Kingella species, is often found to be part of the normal upper respiratory tract flora. Potentially life-threatening complications of retropharyngeal abscess can occur in immunocompromised patients. Although complications of immunosuppression are thought to be rare with the use of low-dose pulse methotrexate for non-neoplastic conditions, such complications with prolonged use of low-dose pulse methotrexate may be seen.

Isolation of Kingella denitrificans from a corneal ulcer.

To report a case of a corneal ulcer caused by an unusual pathogen.

Identification and characterization of an RTX toxin in the emerging pathogen Kingella kingae.

Kingella kingae is an emerging bacterial pathogen that is increasingly recognized as the causative agent of a variety of pediatric diseases, including septic arthritis and osteomyelitis. The pathogenesis of K. kingae disease is believed to begin with colonization of the upper respiratory tract. In the present study, we examined interactions between K. kingae and cultured respiratory epithelial cells and observed potent cytotoxicity, detected by both microscopy and lactic acid dehydrogenase (LDH) release assays. Experiments with synovial and macrophage cell lines revealed cytotoxicity for these cell types as well. Using mariner mutagenesis and a screen for loss of cytotoxicity, a genetic locus encoding an RTX toxin system was identified. Disruption of the K. kingae RTX locus resulted in a loss of cytotoxicity for respiratory epithelial, synovial, and macrophage cell lines. DNA sequence analysis demonstrated that the RTX locus is flanked by insertion elements and has a reduced G+C content compared to that of the whole genome. Two relatively less invasive Kingella species, K. oralis and K. denitrificans, were found to be noncytotoxic and to lack the RTX region, as determined by LDH release assays and Southern blotting. We concluded that K. kingae expresses an RTX toxin that has wide cellular specificity and was likely acquired horizontally. The possible roles for this toxin in the pathogenesis of K. kingae disease include breaching of the epithelial barrier and destruction of target tissues, such as synovium (joint lining).

Phylogenetic analysis of Alysiella and related genera of Neisseriaceae: proposal of Alysiella crassa comb. nov., Conchiformibium steedae gen. nov., comb. nov., Conchiformibium kuhniae sp. nov. and Bergeriella denitrificans gen. nov., comb. nov.

A phylogenetic analysis based on 16S rRNA gene sequences reveals that Alysiella filiformis belongs to the family Neisseriaceae. The genus Simonsiella is phylogenetically separated by the genera Kingella and Neisseria. The species Simonsiella crassa and A. filiformis show a close phylogenetic relationship, with the 16S rDNA sequence similarity and the DNA-DNA hybridization representing 98.7% and 35%, respectively. Therefore, S. crassa should be transferred from the genus Simonsiella to the genus Alysiella as Alysiella crassa comb. nov. Simonsiella steedae and Simonsiella sp. of cat origin show strong genetic affinities and are distantly related with the type species of Simonsiella, S. mulleri. Thus, a new genus, Conchiformibium is proposed; Conchiformibium steedae comb. nov. and Conchiformibium kuhniae sp. nov. are accommodated in this new genus. On the basis of the phylogenetic, phenotypic and chemotaxonomic distinction from the genus Neisseria, N. denitrificans should be reclassified, for which a new genus and new combination Bergeriella denitrificans are proposed.

Identification of the conjugative mef gene in clinical Acinetobacter junii and Neisseria gonorrhoeae isolates.

The mef gene, originally described for gram-positive organisms and coding for an efflux pump, has been identified in clinical isolates of Acinetobacter junii and Neisseria gonorrhoeae. These strains could transfer the mef gene at frequencies ranging from 10(-6) to 10(-9) into one or more of the following recipients: gram-negative Moraxella catarrhalis, Neisseria perflava/sicca and Neisseria mucosa and gram-positive Enterococcus faecalis. Three Streptococcus pneumoniae strains could transfer the mef gene into Eikenella corrodens, Haemophilus influenzae, Kingella denitrificans, M. catarrhalis, Neisseria meningitidis, N. perflava/sicca, and N. mucosa at similar frequencies. The mef gene can thus be transferred to and expressed in a variety of gram-negative recipients.

Prosthetic endocarditis caused by Kingella denitrificans in a patient with diabetes mellitus.

Infective endocarditis caused by Kingella denitrificans occurs rarely. A review of the literature reveals only 6 cases of endocarditis caused by the bacillus. K. denitrificans is normally a commensal of the upper respiratory airways, may exceptionally be responsible for endocarditis. A case of possible prosthetic endocarditis caused by K. denitrificans is presented. A 78-year-old male with Type II diabetes was admitted to the hospital complaining of fever, a sore throat and arthralgia. He underwent replacement surgery of a St. Jude medical prosthesis for aortic stenosis at the age of 75. The only physical findings at admission were a temperature of 38.2 degrees C and murmurs of mild mitral regurgitation. The liver and spleen were not palpable, and there were no skin or eye lesions. Laboratory findings were as follows: white blood cell count 9500/microliters with 77% neutrophils, erythrocyte sedimentation rate 71 mm/h (Westergren), blood urea nitrogen 50.2 mg/dl, serum creatinine 1.7 mg/dl and C-reactive protein 22.2 mg/dl. The Gram-negative bacillus isolated from the blood was identified as K. denitrificans by the identification system, namely ID test.FN-20 rapid (Nissui, Japan). Although an echocardiogram detected no vegetation, infective endocarditis was diagnosed because the same bacillus was detected by separate blood cultures and an obvious source of infection was not found other than the prosthetic valve. Initial treatment was flomoxef, which was changed to Ampicillin 2 g/day after K. denitrificans was identified. Ampicillin continued for 6 weeks. The clinical course was good and he did not require further surgery. He has been afebrile for 2 years after completing treatment. This case represents the first report of prosthetic valve endocarditis caused by K. denitrificans in Japan.

Type-4 pili of Kingella denitrificans.

Kingella denitrificans possess type-4 pili, and the type strain, ATCC 33394, contains at least four complete copies of type-4 pilin-encoding genes. Previously reported hybridization patterns of K. denitrificans chromosomal DNA seen using a Neisseria gonorrhoeae pilin gene region probe, had been interpreted as representing possible partial, silent gene loci. This now appears to be due to cross-reaction to multiple copies of 18-bp inverted repeat structures. Data are presented on a variety of colony variants which have changed from a spreading-corroding (SC) phenotype to a nonspreading-noncorroding (N) phenotype. Interestingly, while the SC to N transition is most often associated with loss of piliation in other bacteria containing type-4 pili, many of the K. denitrificans N variants still produce pilin, and some still produce pili.

Identification of four complete type 4 pilin genes in a single Kingella denitrificans genome.

We have cloned and sequenced four complete type 4 pilin genes from the type strain (ATCC 33394) of Kingella denitrificans. Two of these pilin genes, kdpB and kdpD, are in tandem, oriented in the same direction, and encode pilins of only 50% amino acid identity. The kdpA and kdpC loci are separately located from the kdpB-kdpD locus and from each other. At the DNA level kdpA and kdpC are nearly identical to kdpB and encode pilin proteins that are identical to KdpB. Bands of multiple hybridization previously hypothesized to be due to partial silent pilin gene loci are now shown to be due to the presence of 18-bp repeat sequences (IR18) associated with the pilin gene coding regions. These IR18 sequences exist most often as inverted repeats separated by 8 bp. IR18 sequences are structurally similar to the repetitive extragenic palindromic sequences of Escherichia coli, although they have different DNA sequences. The IR18 sequences also demonstrate homology to the DNA uptake sequences of Neisseria gonorrhoeae and may serve a similar function for K. denitrificans.

Detection of two groups of 25.2 MDa Tet M plasmids by polymerase chain reaction of the downstream region.

Forty-four Neisseria gonorrhoeae, 12 N. meningitidis, four Kingella denitrificans and one Eikenella corrodens carrying 25.2 MDa Tet M plasmids were analysed using polymerase chain reaction (PCR) to the downstream region of the incomplete Tet M transposon. From each isolate, one of two different PCR fragments of approximately 700 or 1600 bp were obtained. The two different sized PCR fragments had > or = 90% DNA sequence identity with Ureaplasma urealyticum Tet M downstream sequences. The difference between the large PCR fragment and the smaller PCR fragment was a deletion of over 800 bp in the smaller fragment. Both PCR fragments were found in plasmids isolated from N. gonorrhoeae and K. denitrificans. The smaller PCR fragment was found in N. meningitidis plasmids and the larger PCR fragment was found in the E. corrodens plasmid.

Endocarditis caused by Kingella denitrificans.

We report the case of a 48-year-old man with native valve endocarditis caused by Kingella denitrificans. He was successfully treated with a combination of beta-lactam antibiotics and aminoglycosides, after which he underwent valve replacement surgery. This case represents the first report in the literature of elective native valve replacement. Previously reported cases are discussed together with management options, including suggestions for the treatment of patients with beta-lactam allergy and those infected with beta-lactamase producing strains.

Vaginitis caused by Kingella denitrificans in a 3-year-old female patient.

Phylogeny of species in the family Neisseriaceae isolated from human dental plaque and description of Kingella oralis sp. nov corrected.

Fourteen human periodontal isolates recovered from a purported Eikenella corrodens-selective medium containing 1 microgram of clindamycin per ml displayed biochemical traits which differed from those described for E. corrodens. These organisms were gram-negative rods which corroded agar. The isolates were oxidase positive and urease, indole, and esculin negative. They differed from E. corrodens in catalase, nitrate reduction, lysine decarboxylase, and ornithine decarboxylase activities. One isolate, strain UB-294, was presumptively identified as Kingella denitrificans. A second isolate, strain UB-204, differed from E. corrodens by being catalase positive and nitrate reduction negative. Twelve isolates, including strain UB-38T (T = type strain), were phenotypically similar to Kingella kingae except that they did not produce acid from maltose and were not beta-hemolytic. Essentially complete (1,480-base) 16S rRNA sequences were determined for strains UB-38T, UB-204, and UB-294 and the type strains of Neisseria animalis, Neisseria canis, Neisseria denitrificans, Neisseria elongata, Neisseria flavescens, Neisseria macaca, and Neisseria polysaccharea. These sequences were compared with the previously published sequences of six other species belonging to the family Neisseriaceae. On the basis of the results of the comparative sequence analysis, UB-294 was confirmed as a K. denitrificans strain, UB-204 was identified as a member of a new species which may belong in the genus Eikenella, and UB-38T was identified as a member of a new species of the genus Kingella, for which we propose the name Kingella oralis [corrected]. Since strain UB-204 was the only representative of a new species, it was not named.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparison of monoclonal antibody methods and a ribosomal ribonucleic acid probe test for Neisseria gonorrhoeae culture confirmation.

Recently, a chemiluminescent nucleic acid probe test that specifically detects the ribosomal ribonucleic acid of Neisseria gonorrhoeae has been released for clinical laboratory use (AccuProbe Neisseria gonorrhoeae). In this study, three coagglutination tests (GonoGen I, Meritec GC, and GC Omni), the GonoGen II immunofiltration method and the Micro Trak Neisseria gonorrhoeae fluorescent monoclonal antibody test were compared with AccuProbe for identification of gonococci. Strains tested (n = 376) included 194 Neisseria gonorrhoeae, 82 Neisseria meningitidis, 32 Neisseria lactamica, 32 Neisseria species, 32 Moraxella catarrhalis, 2 Moraxella spp. and 2 Kingella denitrificans. The GonoGen I, Meritec GC and GC Omni coagglutination tests produced clearly positive results for 93.8%, 92.3% and 95.9% of the gonococci, respectively. The GonoGen II unequivocally identified 91.8% and the MicroTrak fluorescent antibody test identified 90.7% with 2+ or greater fluorescence. AccuProbe identified 100% of the gonococci tested. GonoGen I and GonoGen II were 98% specific, Meritec GC was 99% specific and the specificity of the GC Omni, MicroTrak fluorescent antibody and AccuProbe tests was 100%. While antibody-based tests were reliable when results were clearly interpretable, the AccuProbe was the only confirmatory test that was 100% accurate. Serotyping studies indicate that an array of beta-lactamase positive and negative gonococcal serotypes fail to react with the monoclonal antibody-based tests in general and with the fluorescent antibody test in particular.

Kingella denitrificans as a cause of granulomatous disease in a patient with AIDS.

Identification of type 4 pili in Kingella denitrificans.

Kingella denitrificans is an occasionally pathogenic member of the family Neisseriaceae and is a member of the normal respiratory flora. Electron microscopy, colony morphology types, DNA transformation patterns, and immunoblots suggest that K. denitrificans and K. kingae have type 4 pili. This was confirmed by N-terminal amino acid sequencing for K. denitrificans.

Isolation of Kingella denitrificans from amniotic fluid in a woman with chorioamnionitis. A case report.

Kingella denitrificans and Streptococcus agalactiae were isolated from the amniotic fluid of a woman with chorioamnionitis. She was treated with intravenous ampicillin/sulbactam, with a good response.

Neisseria elongata subsp. nitroreducens subsp. nov., formerly CDC group M-6, a gram-negative bacterium associated with endocarditis.

CDC group M-6 is the vernacular name given to a gram-negative, oxidase-positive, aerobic, nonmotile, rod-shaped bacterium. This organism is biochemically similar to Kingella denitrificans and displays a cellular fatty acid profile consistent with CDC groups M-5 and EF-4 and with Neisseria elongata. Of the 95 M-6 strains referred to the Centers for Disease Control (CDC) for identification, 32 (64%) of the first 50 were from the throat or sputum and only 3 (6%) were from blood; only 5 (11%) of the next 45 isolates were from the upper respiratory tract and 23 (51%) were from blood, with many of these (15 or 65%) being associated with endocarditis. The major characteristics of CDC group M-6 include reduction of nitrate and nitrite with no gas formation; positive reaction for oxidase; negative reactions for catalase, urease, indole, and motility; and no acid production from carbohydrates. Guanine-plus-cytosine content determined spectrophotometrically by thermal denaturation was 55 to 58 mol % for six M-6 strains tested: 56 mol % for the N. elongata subsp. elongata type strain and for the N. elongata subsp. glycolytica type strain. By the hydroxyapatite method, DNAs from 24 M-6 strains showed an average of 78% relatedness to M-6 reference strain B1019 in reactions at 60 degrees C and 73% relatedness in reactions at 75 degrees C. M-6 strain B1019 was 79% related to the N. elongata type strain at 60 degrees C and 71% related at 75 degrees C; it was 75% related to the type strain N. elongata subsp. glycolytica at 60 degrees C and was 66% related at 75 degrees C. DNAs from CDC group EF-4, K. denitrificans, and CDC group M-5 were all less than 14% related to CDC group M-6 at 75 degrees C. The DNA relatedness data showed conclusively that all the M-6 strains belong in the species N. elongata. M-6 is different from N. elongata subsp. elongata in that M-6 reduces nitrate and sometimes weakly acidifies D-glucose, and it is different from N. elongata subsp. glycolytica in that it reduces nitrate and is negative for glucose and catalase. Because of the apparent clinical significance of M-6 compared with the clinical significance of N. elongata subsp. elongata and N. elongata subsp. glycolytica and the ease in distinguishing it biochemically, we propose M-6 as a third subspecies of N.elongata, N. elongata subsp. nitroreducens subsp. nov.

Kingella denitrificans endocarditis on an aortic valve prosthesis.

Kingella denitrificans is a Gram-negative bacillus which does not grow readily on the usual media. This organism, normally a commensal of the upper airways, may exceptionally be responsible for endocarditis. We report here the sixth case known in the literature. Cure was obtained with an intravenous combination of vancomycin and rifampicin.

Empyema caused by Kingella denitrificans and Peptostreptococcus spp. in a patient with bronchogenic carcinoma.

Empyema caused by Kingella denitrificans and Peptostreptococcus spp. was diagnosed in a patient with bronchogenic carcinoma. This appears to be the third report providing evidence of a pathogenic role for K. denitrificans, and the first concerning infection in the pleural space and in a patient with underlying immunosuppressive disease. K. denitrificans should be added to the list of fastidious gram-negative bacteria associated with opportunistic infections in the compromised host.

Cellular fatty acid composition of Kingella species, Cardiobacterium hominis, and Eikenella corrodens.

We determined the cellular fatty acid composition of reference strains and clinical isolates of each of the three Kingella species, Cardiobacterium hominis, and Eikenella corrodens by using capillary gas chromatography. Kingella denitrificans and Kingella kingae contained myristic (14:0) and palmitic (16:0) acids as major acids, whereas cis-vaccenic (18:1 omega 7c) and palmitic acids were the major acids in Kingella indologenes, C. hominis, and E. corrodens. C. hominis differed from the other four species by the absence of 3-hydroxylauric (3-OH-12:0) acid, from K. indologenes by the presence of 3-hydroxypalmitic (3-OH-16:0) acid, and from E. corrodens by the presence of 3-hydroxymyristic (3-OH-14:0) acid. E. corrodens contained a small amount (2%) of myristic acid, while the other four species contained moderate to large amounts (11 to 31%) of this acid.

High-level tetracycline resistance resulting from TetM in strains of Neisseria spp., Kingella denitrificans, and Eikenella corrodens.

Similar to Neisseria gonorrhoeae, tetracycline-resistant isolates of N. meningitidis, Kingella denitrificans, and Eikenella corrodens contained 25.2-megadalton plasmids carrying the TetM determinant. In contrast, tetracycline-resistant N. subflava biovar perflava-N. sicca and N. mucosa isolates carried the TetM determinant in the chromosome.