Outbreaks of Kingella kingae infections in daycare facilities

Emerg Infect Dis. 2014 May;20(5):746-53. doi: 10.3201/eid2005.131633.


During the past decade, transmission of the bacterium Kingella kingae has caused clusters of serious infections, including osteomyelitis, septic arthritis, bacteremia, endocarditis, and meningitis, among children in daycare centers in the United States, France, and Israel. These events have been characterized by high attack rates of disease and prevalence of the invasive strain among asymptomatic classmates of the respective index patients, suggesting that the causative organisms benefitted from enhanced colonization fitness, high transmissibility, and high virulence. After prophylactic antibacterial drugs were administered to close contacts of infected children, no further cases of disease were detected in the facilities, although test results showed that some children still carried the bacterium. Increased awareness of this public health problem and use of improved culture methods and sensitive nucleic acid amplification assays for detecting infected children and respiratory carriers are needed to identify and adequately investigate outbreaks of K. kingae disease.

Keywords: France; Israel; Kingella kingae; United States; antibacterial drugs; antibiotic prophylaxis; antibiotics; bacteremia; bacteria; carriage; daycare facilities; epidemiology; invasive disease; transmission.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Antibiotic Prophylaxis
  • Child
  • Child Day Care Centers*
  • Child, Preschool
  • Disease Outbreaks*
  • Disease Reservoirs
  • Humans
  • Incidence
  • Kingella kingae*
  • Neisseriaceae Infections / diagnosis
  • Neisseriaceae Infections / drug therapy
  • Neisseriaceae Infections / epidemiology*
  • Neisseriaceae Infections / prevention & control


  • Anti-Bacterial Agents