Kingella kingae is studied to produce a virulence factor like RTX toxin, which improves its colonization and fitness disrupting the oropharyngeal epithelium of the host. This RTX toxin also enables the survival of K. kingae in the blood stream and also invasion in skeletal system tissues, so it has a disease promoting effect.

Kingella kingae is usually susceptible to cephalosporin, it is used and administered to children with suspected skeletal system infections. The treatment for skeletal system infections consists of intravenous administration of cephalosporin and additional therapeutic options such as cefuroxime or ceftriaxone, for septic arthritis is should be administered for 2-3 weeks or 10 consecutive days (oral), while for osteomyelitis it may vary from 3 weeks to 6 months. Most of the isolates of the Kingella species are susceptible to penicillin, and it is also a treatment for Kingella kingae.

References:

Mahon, C.R., Lehman, D.C., Manuselis, G. (2014). Textbook of Diagnostic Microbiology (5th ed.). New York: Saunders.

Towns, M.L. and Yagupsky, P. (n.d.). Kingella species. Antimicrobe. Retrieved from:

http://www.antimicrobe.org/b66.asp#:~:text=weeks%20(64).-,Bacteremia,week%20antibiotic%20course%20(64).

Yagupsky, P. (2015). Kingella kingae: Carriage, Transmission, and Disease. Clinical Microbiology Reviews, 28(1), 54–79. https://doi.org/10.1128/cmr.00028-14

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Presence of Kingella leads to bacteremia that may invade Bone like other commoner ones like Staph aureus...

Metaphysis of Bone is common site of acute osteomyelitis which generally follows distant infections like nose, throat or mouth infections. The reason for metaphyseal reason being more prone are various like - presence of hair-pin like arrangement of blood vessels that make bacteria stasis, lack of cellular defense mechanism like reticuloendothelial system within metaphysis, presence of debris as it is growing area, high vascularity area with thin single-cell lined walls of vessels in that region and more importantly the truama that may cause localised he aroma formation attracting bacteria as it acts as good culture for them to flourish...

Above reasons make osteomyelitis to occur and may result from any organism..