Kingella spp

  • K. denitrificans
  • K. kingae
  • K. oralis
  • K. potus

Gram Stain

  •  Gram negative bacilli short with square ends in pairs or clusters (facultative anaerobic)

Clinical Significance

These organisms are part of the commensal flora of the upper respiratory tract (especially of children).

K. kingae - associated with endocarditis, bacteremia, and bone and joint infections. Bone and joint infections occur almost exclusively in children < 4 years of age and are typically not associated with bacteremia. Other more rare infections include pneumonia, epiglottitis, meningitis, and ophthalmic infections.

K. denitrificans - associated with endocarditis. It can cause granulomatous disease in patients with end stage HIV infection.

K. oralis - associated with periodontitis.

K. potus - associated with wound infections in South and Central America.

 

Usual Susceptibility Pattern

Kingella spp. are typically susceptible to penicillins, cephalosporins (including cefazolin and ceftriaxone), TMP/SMX, quinolones, aminoglycosides, and tetracyclines.

Beta-lactamase production has rarely been reported (remains susceptible to amoxicillin-clavulanate).

MICs to penicillin have occasionally been found to be elevated without a positive beta-lactamase test.

Resistance to TMP/SMX, ciprofloxacin, and erythromycin has rarely been reported. 

 

They are resistant to clindamycin.

 

Empiric Therapy
Ampicillin
or
Ceftriaxone