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I read with interest the recently published report by Lebjkowicz et al. on the isolation of Kingella kingae from a BacT/Alert blood culture bottle seeded with synovial fluid (3). For most of 3 decades that lapsed since the first characterization of the organism by Elizabeth King, K. kingae was considered a rare cause of human infection (4). Inoculation of synovial fluid specimens into blood culture bottles resulted in improved isolation of the organism and recognition of K. kingae as a common cause of skeletal infections in young children (1, 2, 5–7). In the last few years, K. kingae has been successfully recovered from joint taps of pediatric patients with septic arthritis by using the radiometric BACTEC 460, the BACTEC 660NR (nonradiometric), and the BACTEC 9240 blood culture systems as well as the Isolator 1.5 Microbial Tube (1, 2, 5, 7). The report by Lebjkowicz et al. adds another blood culture system to the list of nonconventional culture methods that enable detection of K. kingae from synovial fluid, whereas primary cultures on routine solid media frequently fail to isolate the bacterium (1–3, 5, 7). It should be pointed out that in Lebjkowicz's experience as well as in other studies, the organism was recovered in subcultures of the broth performed on the same media without difficulties, excluding the possibility that solid media do not support bacterial growth (1–3, 5, 7).

Use of Blood Culture Systems for Isolation of Kingella kingae from Synovial Fluid