Kingella kingae’s Sequence-type Complex-23/25 Exhibits Cardiac and Central Nervous System Tropism
Bibliographic record
Abstract
To the Editors: I read with great interest the recent report of Kingella kingae meningitis in an otherwise healthy 26-month-old Greek child published in the Journal.1 The case is noticeable in that no evidence of preceding or concomitant endocarditis was found, and the K. kingae isolate belonged to the multilocus sequence typing–sequence type (ST) 25. K. kingae exhibits a remarkable genomic variety; up to date, 76 distinct STs have been described in the species.2 To study K. kingae’s population structure and determine the genomic relatedness of isolates, STs that differ at no more than 1 locus from other STs are grouped into sequence-type complexes (STCs). The ST with the highest number of neighboring single locus variants within each STC is considered the STC founder. The founder STs of STC-23 and STC-25 are closely related, differing only at 2 loci. Therefore, these 2 STCs have recently merged into a single STC named STC-23/25.2 K. kingae isolates widely differ in virulence. While some STs and STC strains are carried on the oropharynx without causing disease, others are over-represented among patients with invasive infections. Members of the STC-23/25 have been detected in 82 of 324 (25.3%) invasive strains isolated in the USA, Canada, Iceland, Norway, France, Spain and Israel between 1966 and 2014.3 In addition to sporadic infections, ST-23/25 organisms have caused outbreaks of disease among day-care center attendees, endocarditis in 2 French patients,2,4 and have been identified in 8 of 18 (44.4%) endocarditis-associated isolates in a recent study.2 The report by Syrogiannopoulos et al confirms that STC-23/25 is highly virulent, has circulated during a prolonged period, disseminated worldwide, reaching the Balkans and shows a dangerous tropism towards the central nervous system and cardiac tissues.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.015 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.003 | 0.001 |
| Research integrity | 0.006 | 0.009 |
| Insufficient payload (model declined to judge) | 0.003 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".