{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T02:57:06Z","timestamp":1789095426326,"version":"build-2803163510"},"reference-count":44,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,7,14]],"date-time":"2021-07-14T00:00:00Z","timestamp":1626220800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:p>The management of septic arthritis in children requires the prompt administration of antibiotic therapy and the identification of the causative pathogen. In the past, <jats:italic>Staphylococcus aureus<\/jats:italic>, <jats:italic>Streptococcus pyogenes<\/jats:italic>, <jats:italic>Streptococcus pneumoniae<\/jats:italic> and <jats:italic>Haemophilus influenzae<\/jats:italic> type b were considered the main causative agents of the disease, but a substantial fraction of presumptive joint infections remained unconfirmed by conventional bacteriologic cultures. In the last two decades, our knowledge of the aetiology of paediatric infectious arthritis has substantially changed as the result of the implementation of vaccination programmes against <jats:italic>H. influenzae<\/jats:italic> type b and pneumococci, and by the use of improved detection methods. In 1988, the inoculation of synovial fluid aspirates into blood culture vials revealed that <jats:italic>Kingella kingae<\/jats:italic>, a commensal member of the oropharyngeal microbiota, was the prime aetiology of skeletal system infections in children aged 6\u201348\u2009months. The clinical presentation of <jats:italic>K. kingae<\/jats:italic> arthritis is subtle, and the disease is frequently missed by classic clinical and laboratory diagnostic criteria. Many children are afebrile, the acute phase reactants levels and the white blood cell counts in the blood and synovial fluid specimens are frequently normal, requiring a high clinical acumen. Increasing use of sensitive molecular methods in recent years, and particularly nucleic acid amplification tests that target <jats:italic>K. kingae<\/jats:italic>\u2010specific genes, has further improved the detection of this elusive pathogen, demonstrated that it is responsible for 30\u201393% of all cases of septic arthritis below 4\u2009years of age and reduced the fraction of culture\u2010negative infections.<\/jats:p>","DOI":"10.1111\/jpc.15654","type":"journal-article","created":{"date-parts":[[2021,7,14]],"date-time":"2021-07-14T11:34:11Z","timestamp":1626262451000},"page":"1560-1563","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Changing aetiology of paediatric septic arthritis"],"prefix":"10.1111","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4101-2609","authenticated-orcid":false,"given":"Pablo","family":"Yagupsky","sequence":"first","affiliation":[{"name":"Clinical Microbiology Laboratory Soroka University Medical Center, Ben\u2010Gurion University of the Negev  Beer\u2010Sheva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,7,14]]},"reference":[{"key":"e_1_2_2_2_1","doi-asserted-by":"publisher","DOI":"10.1586\/eri.11.140"},{"key":"e_1_2_2_3_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.38.6.966"},{"key":"e_1_2_2_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.75.2.254"},{"key":"e_1_2_2_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1045-1870(97)80018-0"},{"key":"e_1_2_2_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-198611000-00014"},{"key":"e_1_2_2_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpids\/piy034"},{"key":"e_1_2_2_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2005.11.011"},{"key":"e_1_2_2_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004694-199909000-00020"},{"key":"e_1_2_2_10_1","first-page":"189","article-title":"Comparison of the characteristics of culture\u2010negative versus culture\u2010positive septic arthritis in children","volume":"38","author":"Chang WS","year":"2005","journal-title":"J. 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