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Test Code KKRP Kingella kingae, Molecular Detection, PCR

Secondary ID

65201

Useful For

Aids in diagnosing Kingella kingae infection

Method Name

Real-Time Polymerase Chain Reaction (PCR)

(PCR is utilized pursuant to a license agreement with Roche Molecular Systems, Inc.)

Reporting Name

Kingella kingae PCR

Specimen Type

Varies


Necessary Information


Specimen source is required.



Specimen Required


The high sensitivity of amplification by PCR requires the specimen to be processed in an environment in which contamination of the specimen by Kingella kingae DNA is unlikely.

 

Submit only 1 of the following specimens:

 

Specimen Type: Synovial fluid

Preferred: Lavender top (EDTA)

Acceptable: Pink top (EDTA), royal blue top (EDTA), sterile vial containing EDTA-derived aliquot, red clot tube (no anticoagulant), or sterile container

Specimen Volume: 0.5 mL

Collection Instructions: Send specimen in original tube (preferred).

Specimen Stability Information: Refrigerated (preferred) <7 days /Frozen <7 days

 

Specimen Type: Fresh tissue or biopsy

Sources: Bone, joint, synovium, heart valve, aorta, or endocardium

Container/Tube: Sterile container

Specimen Volume: Entire collection or 5 mm(3)- approximately the size of a pencil eraser

Collection Instructions: Collect fresh tissue specimen.

Specimen Stability Information: Refrigerated (preferred) <7 days/ Frozen <7 days

 

Specimen Type: Formalin-fixed, paraffin-embedded tissue block

Sources: Bone, joint, synovium, heart valve, aorta, or endocardium

Container/Tube: Sterile vial

Specimen Volume: Submit formalin-fixed paraffin-embedded tissue block to be cut and returned; or two to five 10-micron sections in a sterile container (Minimum volume: two 10-micron sections).

Specimen Stability Information: Ambient (preferred)/Refrigerated


Specimen Minimum Volume

Fluid: 0.5 mL
Tissue: 5 mm(3) or two 10-micron sections

Specimen Stability Information

Specimen Type Temperature Time
Varies Varies

Reject Due To

Hemolysis

NA

Lipemia

NA

Icterus

NA

Other

Tissue in formalin, formaldehyde, or acetone; anticoagulants other than EDTA, green top (heparin) tube, blue top (citrate) tube, yellow top (ACD) tube, serum separator tube (SST); bone marrow; slides

Clinical Information

Kingella kingae is a fastidious short Gram-negative bacillus that may colonize the oropharynx of young children. Colonization may occasionally lead to invasive disease via hematogenous dissemination, primarily in children younger than 4 years of age. This most commonly results in bone and joint infection; K kingae is the most frequent cause of osteomyelitis and septic arthritis in children aged 6 to 36 months. K kingae may also cause endocarditis, involving both native and prosthetic valves, in patients of any age and is considered part of the HACEK (Haemophilus species, Aggregatibacter species, Cardiobacterium hominis, Eikenella corrodens, and Kingella species) group of organisms, known for causing culture-negative endocarditis. K kingae produces a repeat-in-toxin (RTX) toxin.

 

Diagnosis of K kingae infection may be challenging due to the fastidious nature of the organism in culture. Evaluation of cardiac, bone, joint tissue, or fluid by PCR is a useful tool for the diagnosis of some cases of K kingae infection.

Reference Values

Not applicable

Interpretation

A positive test is strongly suggestive of Kingella kingae infection.

 

A negative test indicates the absence of detectable K kingae DNA, but does not negate the presence of the organism or recent disease and may occur due to sequence variability underlying primers and probes, or the presence of K kingae in quantities below the limit of detection of the assay.

Clinical Reference

1. Murphy TF: In Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. Edited by GL Mandell, JE Bennett, R Dolin. Seventh edition. Philadelphia, Churchill Livingstone/Elsevier, 2010, pp 2774-2776

2. Zbinden R: Aggregatibacter, Capnocytophaga, Eikenella, Kingella, Pasteurella, and Other Fastidious or Rarely Encountered Gram-Negative Rods. In Manual of Clinical Microbiology. Edited by JH Jorgensen, KC Carroll, G Funke, MA Pfaller. 11th edition. Washington DC. ASM Press 2015, pp 652-666

3. Yagupsky P: Kingella kingae: carriage, transmission, and disease. Clin Microbiol Rev 2015 Jan;28(1):54-79

Day(s) and Time(s) Performed

Varies; Batched 3 times per week

Analytic Time

2 days

Performing Laboratory

Mayo Medical Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

87798

LOINC Code Information

Test ID Test Order Name Order LOINC Value
KKRP Kingella kingae PCR 65809-6

 

Result ID Test Result Name Result LOINC Value
KKSRC Specimen Source 31208-2
48324 Kingella kingae PCR 65809-6