Epidémiologie du portage oropharyngé de Kingella kingae chez l'adulte sain

K. kingae est un germe commensal de la flore oropharyngée, fréquemment resposanble d'infections invasives chez l'enfant de moins de 4 ans. Cette thèse porte sur une étude conduite chez des adultes sains pour évaluer le risque de portage et par conséquent de transmission du germe à des enfants à risque de développer des infections invasives. Les résultats montrent un taux de portage de 2% chez l'adulte sain. La distribution des porteurs, exclusivement des parents d'enfants de moins de 4 ans, et donc exposés à une population connue pour un haut taux de portage, évoque plutôt une transmission des enfants vers les adultes. Ce résultat confirme les hypothèses épidémiologiques déjà présentes dans la littérature mais jamais confirmées formellement auparavant

First report of Kocuria marina spontaneous peritonitis in a child

BackgroundSpontaneous bacterial peritonitis (SBP) is a rare affection in the pediatric population. It usually occurs when concurrent conditions are present, such as nephrotic syndrome, peritoneal dialysis or liver disease. We report a case of spontaneous bacterial peritonitis due to Kocuria marina in a 2-year-old child with no underlying risk factor. This is both the first description of an infection caused by this rare pathogen in a child and the first reported case of primary peritonitis caused by K. marina in a patient with no predisposing condition.Case descriptionA 2 year-old boy presented to the Pediatric Emergency Department with clinical signs of peritonitis. Laparoscopic surgical exploration confirmed purulent, generalized peritonitis without perforation. Culture of the peritoneal fluid revealed the presence of Kocuria marina, a Gram-positive coccoid environmental bacteria. After peritoneal lavage and appropriate antibiotic treatment, the patient improved and was discharged without sequel.ConclusionThe present report illustrates the first clinical presentation of Kocuria marina SBP in a child with no underlying risk factor. Although never previously described in healthy patients, this pathogen may therefore be considered as a possible cause of SBP in a child. This unusual finding extends the spectrum of infectious diseases caused by Kocuria marina beyond the scope of the previously described susceptible population