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Test Code KKRP Kingella kingae, Molecular Detection, PCR, Varies

Useful For

Aiding in the diagnosis of Kingella kingae infection using tissue or synovial fluid specimens

Method Name

Real-Time Polymerase Chain Reaction (PCR)

Reporting Name

Kingella kingae PCR

Specimen Type

Varies


Necessary Information


Specimen source is required.



Specimen Required


The high sensitivity of amplification by polymerase chain reaction 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:

1. Collect fresh tissue specimen.

2. Submit tissue only, do not add fluid to tissue

3. Refrigerate or freeze specimen.

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

 

Preferred Paraffin-embedded tissue block:

Specimen Type: Formalin-fixed, paraffin-embedded tissue block (FFPE)

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

Supplies: Tissue Block Container (T553)

Container/Tube: Tissue block

Collection Instructions: Submit a formalin-fixed, paraffin-embedded tissue block to be cut and returned.

Specimen Stability Information: Ambient (preferred)/Refrigerated

 

Acceptable Paraffin-embedded tissue block:

Specimen Type: Formalin-fixed, paraffin-embedded tissue block (FFPE)

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

Container/Tube: Sterile container for each individual cut section (scroll).

Collection Instructions: Perform microtomy and prepare five separate 10-micron sections. Each section (scroll) must be placed in a separate sterile container for submission.

Specimen Stability Information: Ambient (preferred)/Refrigerated


Specimen Minimum Volume

Fluid/fresh tissue or biopsy: See Specimen Required
Paraffin-embedded tissue block: Two 10-micron sections

Specimen Stability Information

Specimen Type Temperature Time Special Container
Varies Varies

Reject Due To

Tissue in formalin, formaldehyde, or acetone Decalcified bone Bone marrow
Slides		 Reject

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 polymerase chain reaction is a useful tool for the diagnosis of some cases of K kingae infection.

Reference Values

Not applicable

Interpretation

A positive result indicates the presence of Kingella kingae DNA.

 

A negative result indicates the absence of detectable K kingae DNA but does not negate the presence of the organism and may occur due to inhibition of PCR, sequence variability underlying primers or probes, or the presence of K kingae DNA in quantities less than the limit of detection of the assay.

Cautions

Test results should be used as an aid in diagnosis. The single assay should not be used as the only criteria to form a clinical conclusion, but results should be correlated with patient symptoms and clinical presentation. A negative result does not negate the presence of the organism or active disease.

 

This assay does not detect species of Kingella other than kingae or negevensis (see Supportive Data).

 

This assay cross-reacts with Kingella negevensis.(1)

Day(s) Performed

Monday through Friday

Report Available

2 to 7 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US 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

Forms

If not ordering electronically, complete, print, and send a Microbiology Test Request (T244)with the specimen.