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As oropharynx colonization JQ1 mw is the first step of Kingella kingae invasion, we prospectively investigated the possibility of cultivating it from throat swabs, in children hospitalized for K.?kingae arthritis. Throat culture was 5.6-fold more sensitive than joint fluid cultures in isolating K.?kingae (66.7% vs. 11.9% respectively, p?E-64 susceptibility tests and the oral therapy is frequently based on aminopenicillin, or on trimethoprim-sulphamethoxazole or ciprofloxacin in the case of beta-lactam allergy [4,5]. However, beta-lactamase production has been reported in some isolates [6,7] and sporadic resistance to trimethoprim-sulphamethoxazole or ciprofloxacin has been also described [8]. Although clinical and biological features of osteoarticular infections due to K.?kingae are most often mild [9,10], severe infections have been described, and lack of targeted antibiotic therapy may worsen the prognosis [9]. The pathophysiology of K.?kingae infection is believed to begin by colonization of the posterior pharynx, followed by translocation to the blood [4]. Yagupsky et?al. [11] showed that K.?kingae can be isolated from the throat in young patients with K.?kingae invasive disease. Moreover, using pulsed-field Protein Tyrosine Kinase inhibitor gel electrophoresis, these authors demonstrated that the K.?kingae isolates obtained from throat swabs were identical to those isolated in blood. However, this study was only performed on three patients with K.?kingae invasive infection [11]. In the present study, we investigated the use of throat swab cultures to detect K.?kingae in a series of children hospitalized for K.?kingae septic arthritis diagnosed by PCR. In addition, in order to determine whether the throat isolate was responsible for the arthritis, the sequence of the polymorphic virulence gene rtxA [12,13] of each pharyngeal isolate was compared with that obtained from the corresponding joint-fluid DNA extract. In a retrospective analysis, the microbiology laboratory register was used to identify all patients with K.?kingae arthritis diagnosed by positive culture and/or real-time PCR performed on synovial fluid as previously described [1]. After approval by the Institutional Review Board (IRB00006477), throat swabs were prospectively obtained from every child
