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Review Question - QID 3444

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QID 3444 (Type "3444" in App Search)
A 2-year-old child is diagnosed with a septic hip. Initially, no organisms grew on the standard blood agar plate. However, after 1 week, the offending organism was recovered in an aerobic blood culture medium. Which of the following organisms was the most likely cause?

Kingella kingae

80%

2633/3286

Mycobacterium tuberculosis

6%

188/3286

Mycobacterium avium

2%

82/3286

Neisseria

7%

215/3286

E-coli

4%

144/3286

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Kingella kingae is a fastidious organism which is recovered on blood culture medium, recently with the addition of the BACTEC blood culture system (Illustration A). Mycobacterium tuberculosis is grown on Lowenstein Jensen (LJ) medium, while Mycobacterium avium can be grown on the LJ or Middlebrook medium. Neisseria is typically grown on the Thayer-Martin medium. E-coli is grown on the Luria Bertani medium.

Petti et al studied the use of standard and extended blood culture incubation for Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, and Kingella (HACEK) bacteria. Although all are fastidious organisms, they determined that standard incubation time on a blood culture medium is sufficient to recover HACEK bacteria.

Yugupsky et al investigated the recovery of Kingella kinage in solid media and the BACTEC automated blood culture system. The BACTEC system is shown in Illustration A. They concluded that the BACTEC blood culture system enhances the recovery of the bacteria in joint fluid over solid mediums. They concluded that Kingella kingae is a more common cause of pediatric septic arthritis than previously reported.

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