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Tang X, Wang N, Liu G, Tan H, Li AM, Gao YQ, Yao MY, Wang N, Jing HD, Di QG, Chen L, Wang R, Li XY, Li Y, Yuan X, Zhao Y, Li Q, Tong ZH, Sun B. Psittacosis caused severe community-acquired pneumonia accompanied by acute hypoxic respiratory failure: a multicenter retrospective cohort study from China. BMC Infect Dis 2023; 23:532. [PMID: 37580698 PMCID: PMC10426048 DOI: 10.1186/s12879-023-08283-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 04/26/2023] [Indexed: 08/16/2023] Open
Abstract
INTRODUCTION Psittacosis can cause severe community-acquired pneumonia (CAP). The clinical manifestations of psittacosis range from subclinical to fulminant psittacosis with multi-organ failure. It is essential to summarize the clinical characteristic of patients with severe psittacosis accompanied by acute hypoxic respiratory failure (AHRF). METHODS This retrospective study included patients with severe psittacosis caused CAP accompanied by AHRF from 19 tertiary hospitals of China. We recorded the clinical data, antimicrobial therapy, respiratory support, complications, and outcomes. Chlamydia psittaci was detected on the basis of metagenomic next-generation sequencing performed on bronchoalveolar lavage fluid samples. Patient outcomes were compared between the treatment methods. RESULTS This study included 45 patients with severe CAP and AHRF caused by psittacosis from April 2018 to May 2021. The highest incidence of these infections was between September and April. There was a history of poultry contact in 64.4% of the patients. The median PaO2/FiO2 of the patients was 119.8 (interquartile range, 73.2 to 183.6) mmHg. Four of 45 patients (8.9%) died in the ICU, and the median ICU duration was 12 days (interquartile range, 8 to 21) days. There were no significant differences between patients treated with fluoroquinolone initially and continued after the diagnosis, fluoroquinolone initially followed by tetracycline, and fluoroquinolone combined with tetracycline. CONCLUSION Psittacosis caused severe CAP seems not rare, especially in the patients with the history of exposure to poultry or birds. Empirical treatment that covers atypical pathogens may benefit such patients, which fluoroquinolones might be considered as an alternative.
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Affiliation(s)
- Xiao Tang
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Na Wang
- Department of Pulmonary and critical care medicine, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Gang Liu
- Department Pulmonary and critical care medical center, Xinqiao hospital, Army Medical University, the Chinese People's Liberation Army Respiratory Disease Institute, Chongqing, China
| | - Hai Tan
- Department of Respiratory and Critical Care Medicine, General Hospital of Ningxia Medical University, Ningxia Hui Autonomous Region, Xi Ning, China
| | - Ai-Min Li
- Respiratory and Critical Care Medicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Yan-Qiu Gao
- Respiratory Intensive Care Unit, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan Province, China
| | - Meng-Ying Yao
- Department of Respiratory Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Na Wang
- Department of Pulmonary, The first hospital of Fangshan district, Beijing, China
| | - Hui-Dan Jing
- Department of Intensive Care Unit, Daping Hospital, Army Medical University, Chongqing, China
| | - Qing-Guo Di
- Department of Pulmonary and Critical Care Medicine, Cangzhou Central Hospital, Cangzhou, Hebei Province, China
| | - Liang Chen
- Department of Respiratory and Critical Care Medicine, Beijing Jingmei Group General Hospital, Beijing, China
| | - Rui Wang
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xu-Yan Li
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Ying Li
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xue Yuan
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Yu Zhao
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Qi Li
- Department Pulmonary and critical care medical center, Xinqiao hospital, Army Medical University, the Chinese People's Liberation Army Respiratory Disease Institute, Chongqing, China.
| | - Zhao-Hui Tong
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
| | - Bing Sun
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
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Cao J, Xie X, Lei Y, Li S, Song X, Lei Y, An Q, Zhang B. Epidemiological and clinical characteristics of a family cluster of psittacosis: A case report. IDCases 2023; 33:e01845. [PMID: 37492645 PMCID: PMC10365937 DOI: 10.1016/j.idcr.2023.e01845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/05/2023] [Accepted: 07/05/2023] [Indexed: 07/27/2023] Open
Abstract
Psittacosis accounts for 1-2 % of community-acquired pneumonia. In recent years, reports of psittacosis are increasing. Most reported cases of psittacosis are sporadic. Here, we report a familial cluster of five patients infected with Chlamydophila in a northwest Chinese region and share our diagnosis and treatment experience. The epidemiological characteristics, clinical features, laboratory examinations of family cluster psittacosis were collected and analyzed. We closely followed up all the family members and analyzed their clinical outcome. Five cases of family clustered pneumonia were mainly characterized by fever, cough and fatigue. mNGS rapidly identified the infecting agent as Chlamydophila in case 1 followed by RT-PCR analysis. A newly purchased pet parrot, which had diarrhea, was probably the primary source of infection. The main change of inflammation index in five patients was the decrease of lymphocyte counts. Chest CT showed peripheral or subpleural involvement of patchy high-density shadows with bronchial ventilation signs and blurred edges, mostly unilateral lesions. Five cases were completely cured with moxifloxacin and azithromycin. Our findings suggest that a familial cluster of Chlamydophila infection maybe caused by contact with sick pet parrot or human to human transmission in one close family. For this community-acquired pneumonia, epidemiological characteristics and use of mNGS is very important for improving accuracy in the early diagnosis.
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Affiliation(s)
- Jing Cao
- Department of Pulmonary Medicine, Air Force No. 986 Hospital, Air Force Medical University, Xi'an, China
| | - Xiaoyan Xie
- Department of Pulmonary Medicine, Air Force No. 986 Hospital, Air Force Medical University, Xi'an, China
| | - Yan Lei
- Department of Pulmonary Medicine, Air Force No. 986 Hospital, Air Force Medical University, Xi'an, China
| | - Shuangshuang Li
- Department of Pulmonary Medicine, Air Force No. 986 Hospital, Air Force Medical University, Xi'an, China
| | - Xuan Song
- Department of Pulmonary Medicine, Air Force No. 986 Hospital, Air Force Medical University, Xi'an, China
| | - Yingfeng Lei
- Department of Medical Microbiology and Parasitology, Air Force Medical University, Xi'an, China
| | - Qunxing An
- Department of Transfusion Medicine, The First Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Binghua Zhang
- Department of Pulmonary Medicine, Air Force No. 986 Hospital, Air Force Medical University, Xi'an, China
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Sachse K, Hölzer M, Vorimore F, Barf LM, Sachse C, Laroucau K, Marz M, Lamkiewicz K. Genomic analysis of 61 Chlamydia psittaci strains reveals extensive divergence associated with host preference. BMC Genomics 2023; 24:288. [PMID: 37248517 DOI: 10.1186/s12864-023-09370-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 05/09/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND Chlamydia (C.) psittaci, the causative agent of avian chlamydiosis and human psittacosis, is a genetically heterogeneous species. Its broad host range includes parrots and many other birds, but occasionally also humans (via zoonotic transmission), ruminants, horses, swine and rodents. To assess whether there are genetic markers associated with host tropism we comparatively analyzed whole-genome sequences of 61 C. psittaci strains, 47 of which carrying a 7.6-kbp plasmid. RESULTS Following clean-up, reassembly and polishing of poorly assembled genomes from public databases, phylogenetic analyses using C. psittaci whole-genome sequence alignment revealed four major clades within this species. Clade 1 represents the most recent lineage comprising 40/61 strains and contains 9/10 of the psittacine strains, including type strain 6BC, and 10/13 of human isolates. Strains from different non-psittacine hosts clustered in Clades 2- 4. We found that clade membership correlates with typing schemes based on SNP types, ompA genotypes, multilocus sequence types as well as plasticity zone (PZ) structure and host preference. Genome analysis also revealed that i) sequence variation in the major outer membrane porin MOMP can result in 3D structural changes of immunogenic domains, ii) past host change of Clade 3 and 4 strains could be associated with loss of MAC/perforin in the PZ, rather than the large cytotoxin, iii) the distinct phylogeny of atypical strains (Clades 3 and 4) is also reflected in their repertoire of inclusion proteins (Inc family) and polymorphic membrane proteins (Pmps). CONCLUSIONS Our study identified a number of genomic features that can be correlated with the phylogeny and host preference of C. psittaci strains. Our data show that intra-species genomic divergence is associated with past host change and includes deletions in the plasticity zone, structural variations in immunogenic domains and distinct repertoires of virulence factors.
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Affiliation(s)
- Konrad Sachse
- RNA Bioinformatics and High-Throughput Analysis, Friedrich Schiller University Jena, 07743, Jena, Germany.
| | - Martin Hölzer
- Methodology and Research Infrastructure, Bioinformatics, Robert Koch Institute, 13353, Berlin, Germany
| | - Fabien Vorimore
- Laboratory for Animal Health, Identypath, ANSES Maisons-Alfort, Paris-Est University, 94706, Paris, France
| | - Lisa-Marie Barf
- RNA Bioinformatics and High-Throughput Analysis, Friedrich Schiller University Jena, 07743, Jena, Germany
| | - Carsten Sachse
- Ernst-Ruska Centre 3 / Structural Biology, Forschungszentrum Jülich, Wilhelm-Johnen-Straße, 52425, Jülich, Germany
- Institute for Biological Information Processing 6 / Structural Cellular Biology, Forschungszentrum Jülich, Wilhelm-Johnen-Straße, 52425, Jülich, Germany
- Department of Biology, Heinrich Heine University, Universitätsstr. 1, 40225, Düsseldorf, Germany
| | - Karine Laroucau
- Laboratory for Animal Health, Bacterial Zoonosis Unit, ANSES Maisons-Alfort, Paris-Est University, 94706, Paris, France
| | - Manja Marz
- RNA Bioinformatics and High-Throughput Analysis, Friedrich Schiller University Jena, 07743, Jena, Germany
| | - Kevin Lamkiewicz
- RNA Bioinformatics and High-Throughput Analysis, Friedrich Schiller University Jena, 07743, Jena, Germany
- JRG Analytical MicroBioinformatics, Friedrich Schiller University Jena, 07743, Jena, Germany
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Liu J, Gao Y. Tigecycline in the treatment of severe pneumonia caused by Chlamydia psittaci: A case report and literature review. Front Med (Lausanne) 2022; 9:1040441. [PMID: 36507520 PMCID: PMC9730873 DOI: 10.3389/fmed.2022.1040441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 11/10/2022] [Indexed: 11/27/2022] Open
Abstract
Psittacosis is a zoonotic disease caused by Chlamydia psittaci. Systemic infections are mainly transmitted through the respiratory tract. The most common related disease is human atypical pneumonia, which is a rare pathogen of community-acquired pneumonia. Due to the difficulty of diagnosis, there have been few reports of C. psittaci pneumonia in the past. In recent years, with the widespread application of metagenomic next-generation sequencing (mNGS), the number of reported cases of C. psittaci has increased year by year. However, at present, most hospitals have little understanding of C. psittaci, especially for severe patients, and lack experience in diagnosis and treatment. Herein, we report the case of a 71-year-old woman with severe pneumonia that caused by C. psittaci. This patient was diagnosed through mNGS and was treated with tigecycline successfully. The level of IL-6 in the BALF was significantly increased. We discontinued tigecycline after mNGS of the blood was negative. In this review, we analyzed 53 cases to summarize the etiology, clinical manifestations, diagnosis and treatment strategies of severe C. psittaci pneumonia and hope to raise clinicians' awareness of this disease.
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Muroni G, Pinna L, Serra E, Chisu V, Mandas D, Coccollone A, Liciardi M, Masala G. A Chlamydia psittaci Outbreak in Psittacine Birds in Sardinia, Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14204. [PMID: 36361084 PMCID: PMC9658638 DOI: 10.3390/ijerph192114204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/23/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
Chlamydia psittaci is an intracellular bacterium belonging to the Chlamydiaceae family. It is the ethiologic agent of psittacosis, an occupational zoonotic disease that mainly concerns people who work in close contact with birds that represent the main infection route for human transmission. In Italy, information about this disease is lacking. This study is the first case of avian chlamydiosis reported from a pet shop in Sardinia, Italy. Chlamydia psittaci detected in psittacine birds by molecular analysis, direct immunofluorescence test together with anatomo-pathological observed lesions, highlighted the importance of focusing the attention over this underestimated zoonosis in a "One Health" prospective.
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Affiliation(s)
- Gaia Muroni
- Zoonotic Pathology and OIEReference Laboratory for Echinococcosis, National Reference Center for Echinococcosis (CeNRE), Istituto Zooprofilattico Sperimentale della Sardegna, Via Duca degli Abruzzi n. 8, 07100 Sassari, Italy
| | - Luigia Pinna
- S.C. Complex Territorial Diagnostic Structure of Cagliari, Istituto Zooprofilattico Sperimentale della Sardegna, 09067 Cagliari, Italy
| | - Elisa Serra
- Zoonotic Pathology and OIEReference Laboratory for Echinococcosis, National Reference Center for Echinococcosis (CeNRE), Istituto Zooprofilattico Sperimentale della Sardegna, Via Duca degli Abruzzi n. 8, 07100 Sassari, Italy
| | - Valentina Chisu
- Zoonotic Pathology and OIEReference Laboratory for Echinococcosis, National Reference Center for Echinococcosis (CeNRE), Istituto Zooprofilattico Sperimentale della Sardegna, Via Duca degli Abruzzi n. 8, 07100 Sassari, Italy
| | - Daniela Mandas
- S.C. Complex Territorial Diagnostic Structure of Cagliari, Istituto Zooprofilattico Sperimentale della Sardegna, 09067 Cagliari, Italy
| | - Annamaria Coccollone
- S.C. Complex Territorial Diagnostic Structure of Cagliari, Istituto Zooprofilattico Sperimentale della Sardegna, 09067 Cagliari, Italy
| | - Manuel Liciardi
- S.C. Complex Territorial Diagnostic Structure of Cagliari, Istituto Zooprofilattico Sperimentale della Sardegna, 09067 Cagliari, Italy
| | - Giovanna Masala
- Zoonotic Pathology and OIEReference Laboratory for Echinococcosis, National Reference Center for Echinococcosis (CeNRE), Istituto Zooprofilattico Sperimentale della Sardegna, Via Duca degli Abruzzi n. 8, 07100 Sassari, Italy
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6
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Yang M, Yang DH, Yang H, Ding SZ, Liu CH, Yin HM, Liu D, Chen P, Luo H. Clinical Characteristics of Chlamydia psittaci Pneumonia Infection in Central South China. Infect Dis Ther 2022; 11:1631-1647. [PMID: 35723864 PMCID: PMC9207437 DOI: 10.1007/s40121-022-00662-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/23/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Chlamydia psittaci pneumonia has been a global public health hotspot in recent years. Although some scattered cases of C. psittaci pneumonia have been reported, there is a lack of large case studies worldwide. Methods In this multicenter, observational study, we recruited all consecutive patients with confirmed C. psittaci pneumonia from October 4, 2018, to October 23, 2020, in nine tertiary general hospitals in Central-South China. Epidemiologic and clinical data from patients’ electronic medical records were collected and analyzed. Results One hundred and sixteen patients with C. psittaci pneumonia were included in the study. The mean age was 59.7 years. Fever (96.6%) and cough (65.5%) were the most common clinical symptoms. Most patients presented with an increase in the proportion of neutrophils, neutrophil to lymphocyte ratio, LDH, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) and a significant decrease in lymphocytes. The main CT lung findings were consolidation (81%) and pleural effusion (35.3%), and bilateral lung consolidation was mainly found in severe patients. Chlamydia psittaci DNA was detected in BALF (bronchoalveolar lavage fluid) or blood samples by metagenomic next-generation sequencing (mNGS) in all patients. Use of quinolone was associated with shorter length of hospital stay and fever duration after antibiotic use. Multivariate logistic regression analysis indicated that respiratory support was associated with both severe pneumonia and in-hospital death. Conclusions The clinical phenotype of C. psittaci pneumonia is complex and variable. mNGS is helpful in the diagnosis and treatment of C. psittaci pneumonia, and early treatment with quinolone may benefit patients. Supplementary Information The online version contains supplementary material available at 10.1007/s40121-022-00662-4.
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Affiliation(s)
- Min Yang
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
- Research Unit of Respiratory Disease, Central South University, Changsha, 410011, Hunan, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, 410011, Hunan, China
| | - Dan-Hui Yang
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
- Research Unit of Respiratory Disease, Central South University, Changsha, 410011, Hunan, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, 410011, Hunan, China
| | - Huan Yang
- Department of Respiratory Medicine, Hunan Provincial People's Hospital (the First Affiliated Hospital of Normal University), Changsha, 410011, Hunan, China
| | - Shui-Zi Ding
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
- Research Unit of Respiratory Disease, Central South University, Changsha, 410011, Hunan, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, 410011, Hunan, China
| | - Cai-Hong Liu
- Department of Respiratory Medicine, The Third Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Hui-Ming Yin
- Department of Respiratory Medicine, The First Affiliated Hospital of Hunan Medical College (Huaihua Third People's Hospital), Huaihua, 418001, Hunan, China
| | - Dan Liu
- Department of Respiratory Medicine, Changsha Hospital of Traditional Chinese Medicine (Changsha Eighth Hospital), Changsha, 410100, China
| | - Ping Chen
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
- Research Unit of Respiratory Disease, Central South University, Changsha, 410011, Hunan, China.
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, 410011, Hunan, China.
| | - Hong Luo
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
- Research Unit of Respiratory Disease, Central South University, Changsha, 410011, Hunan, China.
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, 410011, Hunan, China.
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Ravichandran K, Anbazhagan S, Karthik K, Angappan M, Dhayananth B. A comprehensive review on avian chlamydiosis: a neglected zoonotic disease. Trop Anim Health Prod 2021; 53:414. [PMID: 34312716 PMCID: PMC8313243 DOI: 10.1007/s11250-021-02859-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 07/09/2021] [Indexed: 01/12/2023]
Abstract
Avian chlamydiosis is one of the important neglected diseases with critical zoonotic potential. Chlamydia psittaci, the causative agent, affects most categories of birds, livestock, companion animals, and humans. It has many obscured characters and epidemiological dimensions, which makes it unique among other bacterial agents. Recent reports on transmission from equine to humans alarmed the public health authorities, and it necessitates the importance of routine screening of this infectious disease. High prevalence of spill-over infection in equines was associated with reproductive losses. Newer avian chlamydial species are being reported in the recent years. It is a potential biological warfare agent and the disease is an occupational hazard mainly to custom officers handling exotic birds. Prevalence of the disease in wild birds, pet birds, and poultry causes economic losses to the poultry industry and the pet bird trade. Interestingly, there are speculations on the ‘legal’ and ‘illegal’ bird trade that may be the global source of some of the most virulent strains of this pathogen. The mortality rate generally ranges from 5 to 40% in untreated cases, but it can sometimes be higher in co-infection. The intracellular lifestyle of this pathogen makes the diagnosis more complicated and there is also lack of accurate diagnostics. Resistance to antibiotics is reported only in some pathogens of the Chlamydiaceae family, but routine screening may assess the actual situation in all pathogens. Due to the diverse nature of the pathogen, the organism necessitates the One Health partnerships to have complete understanding. The present review focuses on the zoonotic aspects of avian chlamydiosis with its new insights into the pathogenesis, transmission, treatment, prevention, and control strategies. The review also briefs on the basic understandings and complex epidemiology of avian chlamydiosis, highlighting the need for research on emerging one health perspectives.
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Affiliation(s)
- Karthikeyan Ravichandran
- Division of Public Health and Epidemiology, ICAR-Indian Veterinary Research Institute, Izatnagar, India.
| | - Subbaiyan Anbazhagan
- Division of Bacteriology and Mycology, ICAR-Indian Veterinary Research Institute, Izatnagar, India
| | - Kumaragurubaran Karthik
- Central University Laboratory, Tamil Nadu Veterinary and Animal Sciences University, Chennai, India
| | - Madesh Angappan
- Division of Public Health and Epidemiology, ICAR-Indian Veterinary Research Institute, Izatnagar, India
| | - Balusamy Dhayananth
- Division of Public Health and Epidemiology, ICAR-Indian Veterinary Research Institute, Izatnagar, India
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Hogerwerf L, Roof I, de Jong MJK, Dijkstra F, van der Hoek W. Animal sources for zoonotic transmission of psittacosis: a systematic review. BMC Infect Dis 2020; 20:192. [PMID: 32131753 PMCID: PMC7057575 DOI: 10.1186/s12879-020-4918-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 02/26/2020] [Indexed: 12/19/2022] Open
Abstract
Background Human psittacosis, caused by Chlamydia (C.) psittaci, is likely underdiagnosed and underreported, since tests for C. psittaci are often not included in routine microbiological diagnostics. Source tracing traditionally focuses on psittacine pet birds, but recently other animal species have been gaining more attention as possible sources for human psittacosis. This review aims to provide an overview of all suspected animal sources of human psittacosis cases reported in the international literature. In addition, for each animal species the strength of evidence for zoonotic transmission was estimated. Methods A systematic literature search was conducted using four databases (Pubmed, Embase, Scopus and Proquest). Articles were included when there was mention of at least one human case of psittacosis and a possible animal source. Investigators independently extracted data from the included articles and estimated strength of evidence for zoonotic transmission, based on a self-developed scoring system taking into account number of human cases, epidemiological evidence and laboratory test results in human, animals, and the environment. Results Eighty articles were included, which provided information on 136 different situations of possible zoonotic transmission. The maximum score for zoonotic transmission was highest for turkeys, followed by ducks, owls, and the category ‘other poultry’. Articles reporting about zoonotic transmission from unspecified birds, psittaciformes and columbiformes provided a relatively low strength of evidence. A genotypical match between human and animal samples was reported twenty-eight times, including transmission from chickens, turkeys, guinea fowl, peafowl, pigeons, ducks, geese, songbirds, parrot-like birds and owls. Conclusions Strong evidence exists for zoonotic transmission from turkeys, chickens and ducks, in addition to the more traditionally reported parrot-like animal sources. Based on our scoring system, the evidence was generally stronger for poultry than for parrot-like birds. Psittaciformes should not be disregarded as an important source of human psittacosis, still clinicians and public health officials should include poultry and birds species other than parrots in medical history and source tracing.
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Affiliation(s)
- Lenny Hogerwerf
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Inge Roof
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
| | - Marianne J K de Jong
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.,Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - Frederika Dijkstra
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Wim van der Hoek
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
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Fernández P, Iborra MA, Simón M, Segovia M. Outbreak of Chlamydia psittaci pneumonia in the Region of Murcia. Enferm Infecc Microbiol Clin 2020; 38:300-301. [PMID: 32057555 DOI: 10.1016/j.eimc.2020.01.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 12/26/2019] [Accepted: 01/03/2020] [Indexed: 11/16/2022]
Affiliation(s)
- Pablo Fernández
- Servicio de Microbiología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España.
| | - M Asunción Iborra
- Servicio de Microbiología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España; Departamento de Genética y Microbiología, Universidad de Murcia, Murcia, España
| | - Marina Simón
- Servicio de Microbiología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - Manuel Segovia
- Servicio de Microbiología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España; Departamento de Genética y Microbiología, Universidad de Murcia, Murcia, España
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