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Yang S, Zeng J, Yu J, Sun R, Tuo Y, Bai H. Insights into Chlamydia Development and Host Cells Response. Microorganisms 2024; 12:1302. [PMID: 39065071 PMCID: PMC11279054 DOI: 10.3390/microorganisms12071302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 06/15/2024] [Accepted: 06/23/2024] [Indexed: 07/28/2024] Open
Abstract
Chlamydia infections commonly afflict both humans and animals, resulting in significant morbidity and imposing a substantial socioeconomic burden worldwide. As an obligate intracellular pathogen, Chlamydia interacts with other cell organelles to obtain necessary nutrients and establishes an intracellular niche for the development of a biphasic intracellular cycle. Eventually, the host cells undergo lysis or extrusion, releasing infectious elementary bodies and facilitating the spread of infection. This review provides insights into Chlamydia development and host cell responses, summarizing the latest research on the biphasic developmental cycle, nutrient acquisition, intracellular metabolism, host cell fates following Chlamydia invasion, prevalent diseases associated with Chlamydia infection, treatment options, and vaccine prevention strategies. A comprehensive understanding of these mechanisms will contribute to a deeper comprehension of the intricate equilibrium between Chlamydia within host cells and the progression of human disease.
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Affiliation(s)
| | | | | | | | | | - Hong Bai
- Tianjin Key Laboratory of Cellular and Molecular Immunology (The Educational Ministry of China), Tianjin Institute of Immunology, Department of Immunology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin 300070, China; (S.Y.); (J.Z.); (J.Y.); (R.S.); (Y.T.)
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Zhang A, Liang J, Lao X, Xia X, Liang J. Pneumonia Caused by Chlamydia psittaci and SARS-CoV-2 Coinfection Diagnosed Using Metagenomic Next-Generation Sequencing: A Case Report. Int Med Case Rep J 2024; 17:187-194. [PMID: 38529114 PMCID: PMC10962458 DOI: 10.2147/imcrj.s458131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 03/18/2024] [Indexed: 03/27/2024] Open
Abstract
We report a case of pneumonia caused by coinfection with Chlamydia psittaci and the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron XBB.1 variant, confirmed using metagenomic next-generation sequencing (mNGS) and quantitative polymerase chain reaction (qPCR). C. psittaci and SARS-CoV-2 were detected in bronchoalveolar lavage fluid using mNGS. Additionally, mNGS detected C. psittaci in blood and nasopharyngeal specimens and was more sensitive than qPCR. The patient recovered after treatment with moxifloxacin. This report highlights the use of coinfections of C. psittaci and SARS-CoV-2, as mNGS has already been recognized to be a diagnostic tool for identifying coinfections.
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Affiliation(s)
- Anbing Zhang
- Department of Respiratory and Critical Care Medicine, Zhongshan People’s Hospital, Zhongshan, Guangdong Province, People’s Republic of China
| | - Jinguang Liang
- Department of Respiratory and Critical Care Medicine, Zhongshan Huangpu People’s Hospital, Zhongshan, Guangdong Province, People’s Republic of China
| | - Xiaoli Lao
- Department of Respiratory and Critical Care Medicine, Zhongshan People’s Hospital, Zhongshan, Guangdong Province, People’s Republic of China
- Graduate School, Guangdong Medical University, Zhanjiang, Guangdong Province, People’s Republic of China
| | - Xiuqiong Xia
- Department of Respiratory and Critical Care Medicine, Zhongshan People’s Hospital, Zhongshan, Guangdong Province, People’s Republic of China
| | - Jianping Liang
- Department of Respiratory and Critical Care Medicine, Zhongshan People’s Hospital, Zhongshan, Guangdong Province, People’s Republic of China
- Graduate School, Guangdong Medical University, Zhanjiang, Guangdong Province, People’s Republic of China
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Kilduff S, Steinman B, Xie Y, Kiss-Farengo T, Foca M, Hayde N. Pet safety guidelines for pediatric transplant recipients. Pediatr Transplant 2024; 28:e14527. [PMID: 37550270 DOI: 10.1111/petr.14527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/06/2023] [Accepted: 03/13/2023] [Indexed: 08/09/2023]
Abstract
Approximately 70% (90.5 million) of United States (US) households own at least one pet. Dogs are the most common, making up about 38% of all household pets, followed by cats, which make up 25%. Other pets such as fish, birds, reptiles, and small animals such as hamsters, gerbils, and rabbits are less common household members. Pets are often considered a part of the family and there are significant medical and psychosocial benefits to pet ownership; however, the possibility of disease transmission exists related to the type of animal and infectious organism, and specific human risk factors. Immunocompromised individuals may be at increased risk of serious illness from zoonotic infections. During the transplant evaluation and routinely posttransplant, the multidisciplinary team should inquire about pet ownership and animal exposures to guide on potential risks. This review discusses the most common diseases seen in various household pets including dogs, cats, birds, fish, and some farm animals. We will also present guidelines for pet safety and include strategies to decrease the risk of infection while supporting the benefits of pet ownership after transplant.
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Affiliation(s)
- Stella Kilduff
- Division of Pediatric Nephrology, Children's Hospital at Montefiore, Bronx, New York, USA
| | - Benjamin Steinman
- Division of Pediatric Nephrology, Children's Hospital at Montefiore, Bronx, New York, USA
| | - Yuping Xie
- Division of Pediatric Nephrology, Children's Hospital at Montefiore, Bronx, New York, USA
| | - Tomas Kiss-Farengo
- Department of Social Work, Children's Hospital at Montefiore, Bronx, New York, USA
| | - Marc Foca
- Divison of Pediatric Infectious Diseases, Children's Hospital at Montefiore, Bronx, New York, USA
| | - Nicole Hayde
- Division of Pediatric Nephrology, Children's Hospital at Montefiore, Bronx, New York, USA
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Zhang Y, Hu H, Xu Y, Chen Y, Liu B, Chen J, Nie W, Zhong S, Ma J, Liu C. Venous-arterial extracorporeal membrane oxygenation for psittacosis pneumonia complicated with cardiogenic shock: case report and literature review. BMC Cardiovasc Disord 2024; 24:6. [PMID: 38166547 PMCID: PMC10763678 DOI: 10.1186/s12872-023-03669-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 12/11/2023] [Indexed: 01/04/2024] Open
Abstract
INTRODUCTION Dilated cardiomyopathy (DCM) is characterized by the enlargement of the left ventricle or biventricular, accompanied by myocardial systolic dysfunction. Chlamydia psittacosis (CP) is a zoonotic pathogen, which can cause severe pneumonia, respiratory failure, and acute organ dysfunction. The deterioration of DCM caused by CP infection is extremely rare, and few cases of successful management were reported. CASE PRESENTATION We reported a 67-year-old male patient with DCM and chronic heart failure. Who was admitted to ICU with severe pneumonia, acute hypoxemic respiratory failure, acute decompensated heart failure, arrhythmia, and cardiogenic shock. Mechanical ventilation (MV) and venous-arterial extracorporeal membrane oxygenation (VA-ECMO) were established for respiratory and circulatory support. Broncho alveolar lavage fluid(BALF)was collected for culture and metagenomics next-generation sequencing (mNGS) test. Repeated mNGS tests indicated the high possibility of CP pneumonia, thereafter, moxifloxacin and doxycycline were prescribed. After targeted antibiotics and organ support treatment, pneumonia, respiratory and circulatory failure were gradually resolved, patient was successfully weaned from MV and VA-ECMO. Finally, the patient was recovered and discharged alive. CONCLUSIONS Severe respiratory and circulatory failure caused by CP infection in DCM patients is a rare life-threatening clinical condition. Early accurate diagnosis, targeted antibiotic therapy, coupled with extracorporeal life support posed positive impact on the patient's disease course and outcome.
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Affiliation(s)
- Yanting Zhang
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 430071, Wuhan, China
- Clinical Research Center of Hubei Critical Care Medicine, 430071, Wuhan, China
| | - Hongtao Hu
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 430071, Wuhan, China
- Clinical Research Center of Hubei Critical Care Medicine, 430071, Wuhan, China
| | - Ying Xu
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 430071, Wuhan, China
- Clinical Research Center of Hubei Critical Care Medicine, 430071, Wuhan, China
| | - Yi Chen
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 430071, Wuhan, China
- Clinical Research Center of Hubei Critical Care Medicine, 430071, Wuhan, China
| | - Biao Liu
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 430071, Wuhan, China
- Clinical Research Center of Hubei Critical Care Medicine, 430071, Wuhan, China
| | - Jun Chen
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 430071, Wuhan, China
- Clinical Research Center of Hubei Critical Care Medicine, 430071, Wuhan, China
| | - Wenfang Nie
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 430071, Wuhan, China
- Clinical Research Center of Hubei Critical Care Medicine, 430071, Wuhan, China
| | - Si Zhong
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 430071, Wuhan, China
- Clinical Research Center of Hubei Critical Care Medicine, 430071, Wuhan, China
| | - Jing Ma
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 430071, Wuhan, China
- Clinical Research Center of Hubei Critical Care Medicine, 430071, Wuhan, China
| | - Chang Liu
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 430071, Wuhan, China.
- Clinical Research Center of Hubei Critical Care Medicine, 430071, Wuhan, China.
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Yang SL, Gao Y, Han ZY, Du X, Liu W, Jin SG, Bi Y, Chen PF, Yue CS, Wu JH, Lai QQ, Tang YJ, Wang XT, Ji YY, Zhao MY, Kang K, Yu KJ. Successful treatment of near-fatal pulmonary embolism and cardiac arrest in an adult patient with fulminant psittacosis-induced severe acute respiratory distress syndrome after veno-venous extracorporeal membrane oxygenation rescue: A case report and follow-up. Heliyon 2023; 9:e20562. [PMID: 37842616 PMCID: PMC10568334 DOI: 10.1016/j.heliyon.2023.e20562] [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: 02/27/2023] [Revised: 09/16/2023] [Accepted: 09/29/2023] [Indexed: 10/17/2023] Open
Abstract
Background Veno-venous extracorporeal membrane oxygenation (ECMO) was successfully performed for the rescue of an adult patient with severe acute respiratory distress syndrome (ARDS) induced by fulminant psittacosis, and then a near-fatal pulmonary embolism (PE) and cardiac arrest (CA) of the same patient was cured through catheter-directed thrombolysis. Case presentation A 51-year-old female patient was admitted to the hospital on September 10, 2021 due to slurred speech, weakness in lower limbs, dizziness, and nausea. Subsequently, she developed confusion and was transferred to the intensive care unit (ICU), where she received anti-shock, antibiotics, invasive mechanical ventilation (IMV), and veno-venous ECMO due to the diagnosis of severe pneumonia, severe ARDS, and septic shock based on comprehensive physical examination, laboratory tests, and imaging findings. The metagenomic next-gengeration sequencing (m-NGS) in the bronchoalveolar lavage fluid (BALF) suggested that the pathogen was chlamydia psittaci, so the antibiotics were adjusted to doxycycline combined with azithromycin. After withdrawal from ECMO, ultrasound (US) re-examination of the left lower limb revealed inter-muscular vein thrombosis, following which heparin was replaced by subcutaneous injection of 0.4ml enoxaparin sodium twice daily for anti-coagulation therapy. After withdrawal from IMV, the patient suffered sudden CA and successful cardiopulmonary resuscitation (CPR), and emergency pulmonary angiography (PA) was performed to show bilateral main pulmonary artery embolism. After immediate catheter-directed thrombolysis and placement of an inferior vena cava filter, the patient's condition gradually stabilized. Conclusions Veno-venous ECMO can be successfully performed as an emergency life-saving treatment for patients with severe ARDS induced by fulminant psittacosis, and during ECMO regular examinations should be conducted to detect and manage thrombosis in time, thereby avoiding the occurrence of near-fatal PE and CA.
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Affiliation(s)
- Song-Liu Yang
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Yang Gao
- Department of Critical Care Medicine, The Sixth Affiliated Hospital of Harbin Medical University, Harbin 150028, Heilongjiang Province, China
- Institute of Critical Care Medicine, The Sino Russian Medical Research Center of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Zhi-Yang Han
- Department of Vascular Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Xue Du
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Wen Liu
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Song-Gen Jin
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Ying Bi
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Peng-Fei Chen
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Chuang-Shi Yue
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Ji-Han Wu
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Qi-qi Lai
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Yu-jia Tang
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Xin-Tong Wang
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Yuan-Yuan Ji
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Ming-Yan Zhao
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Kai Kang
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Kai-Jiang Yu
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
- Institute of Critical Care Medicine, The Sino Russian Medical Research Center of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
- Key Laboratory of Hepatosplenic Surgery, Ministry of Education, Harbin 150001, Heilongjiang Province, China
- The Cell Transplantation Key Laboratory of National Health Commission, Harbin 150001, Heilongjiang Province, China
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Ossa-Giraldo AC, Úsuga-Perilla X, Correa JS, Segura JA. Chlamydia psittaci seropositivity in workers exposed to birds and review of the literature: Evidence of circulation in Antioquia. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2023; 43:330-343. [PMID: 37871570 PMCID: PMC10629862 DOI: 10.7705/biomedica.6832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 07/19/2023] [Indexed: 10/25/2023]
Abstract
Introduction Psittacosis is a zoonotic disease caused by Chlamydia psittaci, a bacterium classified as an agent with bioterrorist potential. It has caused multiple outbreaks in exposed poultry workers around the world. Colombia has no epidemiological follow-up of the infection and a big knowledge gap. Objectives To determine the antibodies’ frequency against C. psittaci in workers with occupational exposure to birds and to review the literature on studies conducted in Colombia. Materials and methods We conducted a cross-sectional descriptive study with analytical intent on workers in contact with birds and reviewed the related literature in Colombia. IgM and IgG serum antibodies against C. psittaci were detected by microimmunofluorescence. The sociodemographic and exposure characteristics were expressed as frequencies and summary measures. Associated factors were explored by bivariate and multivariate analysis. The scientific and gray literature review was done with a structured search. Results We analyzed 54 workers in contact with birds. Antibody prevalence was 31.5%. Slaughtering and evisceration by non-veterinarians was a risk factor for antibody presence. There are only four previous studies on C. psittaci in Colombia. Conclusions Here, we present the first evidence of C. psittaci circulation among workers exposed to birds in Antioquia and the second report in the country. These findings contribute to the “One Health” public health strategy.
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Affiliation(s)
| | - Xiomara Úsuga-Perilla
- Grupo Infettare, Facultad de Medicina, Universidad Cooperativa de Colombia, Medellín, Colombia.
| | - Jhon Sebastián Correa
- Grupo Infettare, Facultad de Medicina, Universidad Cooperativa de Colombia, Medellín, Colombia.
| | - Juan A Segura
- Grupo Biociencias, Facultad de Ciencias de la Salud, Institución Universitaria Colegio Mayor de Antioquia, Medellín, Colombia.
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Miyashita N, Nakamori Y, Ogata M, Fukuda N, Yamura A, Ishiura Y. Validation of JRS atypical pneumonia score in patients with community-acquired Chlamydia psittaci pneumonia. J Infect Chemother 2023; 29:863-868. [PMID: 37207957 DOI: 10.1016/j.jiac.2023.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/25/2023] [Accepted: 05/10/2023] [Indexed: 05/21/2023]
Abstract
INTRODUCTION The Japanese Respiratory Society (JRS) atypical pneumonia score is a useful tool for the rapid presumptive diagnosis of atypical pneumonia. We investigated the clinical features of community-acquired pneumonia (CAP) due to Chlamydia psittaci and validated the JRS atypical pneumonia score in patients with C. psittaci CAP. METHODS This study was conducted at 30 institutions and assessed a total of 72 sporadic cases with C. psittaci CAP, 412 cases with Mycoplasma pneumoniae CAP, and 576 cases with Streptococcus pneumoniae CAP. RESULTS Sixty-two of 72 patients with C. psittaci CAP had a history of avian exposure. Among the six parameters of the JRS score, matching rates of four parameters were significantly lower in the C. psittaci CAP than the M. pneumoniae CAP in the following parameters: age <60 years, no or minor comorbid illness, stubborn or paroxysmal cough, and absence of chest adventitious sounds. The sensitivity of the diagnosis of atypical pneumonia in patients with C. psittaci CAP was significantly lower than the M. pneumoniae CAP (65.3% and 87.4%, p < 0.0001). When the diagnostic sensitivity was analyzed for different ages, the diagnostic sensitivities for the C. psittaci CAP were 90.5% for non-elderly patients and 30.0% for elderly patients. CONCLUSIONS The JRS atypical pneumonia score is a useful tool for distinguishing between C. psittaci CAP and bacterial CAP in patients aged <60 years, but not in patients aged ≥60 years. A history of avian exposure in middle-aged patients with normal white blood cell count may be suggestive of C. psittaci pneumonia.
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Affiliation(s)
- Naoyuki Miyashita
- First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University, Japan.
| | - Yasushi Nakamori
- Department of Emergency Medicine, Kansai Medical University Medical Center, Japan
| | - Makoto Ogata
- First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University, Japan
| | - Naoki Fukuda
- First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University, Japan
| | - Akihisa Yamura
- First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University, Japan
| | - Yoshihisa Ishiura
- First Department of Internal Medicine, Division of Respiratory Medicine, Oncology and Allergology, Kansai Medical University Medical Center, Japan
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Marchese S, Marchese G, Paviglianiti G, Lapi M, Ottoveggio G, Pipitone G, Corsello G. A pediatric case of Chlamydia psittaci caused severe Acute Respiratory Distress Syndrome (ARDS) in Italy. Ital J Pediatr 2023; 49:107. [PMID: 37649055 PMCID: PMC10468848 DOI: 10.1186/s13052-023-01497-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 07/11/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND This case of psittacosis in children, is the first described in literature, in Italy. This respiratory infection can be transmitted to humans from the inhalation of respiratory secretions, feces and plumage aerosol of infected birds (and other animals). Usually it can have an asymptomatic or paucisymptomatic course, and the onset is often flu-like, but in this case the child risked his life for a severe respiratory failure. This report is unique because in children psittacosis is rare, and always misdiagnosed, or could cause a delayed diagnosis because of lack of awareness among the paediatricians and physicians. Furthermore, psittacosis enters a differential diagnosis with SARS-COV2 infection because both diseases may determine dyspnea and atypical pneumonia, up to acute respiratory failure. CASE PRESENTATION This clinical case talks about a three-and-a-half-year-old male child affected by psittacosis (or ornithosis), with severe dyspnea and systemic symptoms who required oro-tracheal intubation for acute respiratory failure. The child had slept in a room at home, with some recently bought parrots affected by psittacosis. Initially the child was treated with empiric antibiotic therapy (i.v.ceftriaxone and teicoplanin), but after having isolated the DNA of the germ "Chlamydia psittaci" in both serological and through bronchoalveolar lavage (BAL), he was treated with targeted antibiotic therapy: tetracyclines (doxicillin). CONCLUSIONS Psittacosis is an extremely contagious disease, caused by an intracellular germ, called "Chlamydia psittaci", a Gram-negative bacterium, transmitted to humans in particular by infected birds, responsible for atypical pneumonia, with acute and chronic respiratory symptoms, sometimes with multi-organ failure and disseminated intravascular coagulation. Even if it is a rare respiratory disease among children, a good doctor must think about psittacosis as cause of respiratory symptoms (and not only flu or SARS-COV2), above all through a correct medical history, in order to provide a targeted antibiotic therapy. An interesting case of psittacosis in a child is being reported here, which has been treated successfully with doxycillin.
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Affiliation(s)
- Serena Marchese
- Emergency and Admission Medicine and Surgery, Childrens'Hospital, ISMEP-Arnas Civico-Benfratelli- Di Cristina, Palermo, Italy.
| | | | | | - Maria Lapi
- Anesthesia and Pediatric Resuscitation with Trauma Center, ISMEP-Arnas Civico-Benfratelli- Di Cristina, Palermo, Italy
| | - Gaetano Ottoveggio
- Anesthesia and Pediatric Resuscitation with Trauma Center, ISMEP-Arnas Civico-Benfratelli- Di Cristina, Palermo, Italy
| | - Giuseppe Pipitone
- Systemic and immune-suppressed associated infection Disease Unit, INMI Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Giovanni Corsello
- Unit of General Pediatrics, Childrens'Hospital, ISMEP-Arnas Civico-Benfratelli- Di Cristina, University of Palermo, Palermo, Italy
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Wang L, Lin C, Qi Y. Gestational psittacosis causes severe pneumonia and miscarriage: A case report and literature review. Radiol Case Rep 2023; 18:1959-1962. [PMID: 36970243 PMCID: PMC10030822 DOI: 10.1016/j.radcr.2023.02.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/07/2023] [Accepted: 02/16/2023] [Indexed: 03/19/2023] Open
Abstract
Psittacosis is an uncommon zoonotic illness, and gestational psittacosis is even rarer. The clinical signs and symptoms of psittacosis are varied, often overlooked, and swiftly identified by metagenomic next-generation sequencing. We recorded the case of a 41-year-old pregnant woman with psittacosis where the disease was not detected early on, resulting in severe pneumonia and fetal miscarriage. The clinical symptoms, diagnosis, and treatment of psittacosis in pregnancy are the subject of this case study.
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Yerramilli A, Sam M, Ashok A, Athan E. An important case of atypical pneumonia. Med J Aust 2023; 218:16-17. [PMID: 36428279 DOI: 10.5694/mja2.51791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/31/2022] [Accepted: 09/07/2022] [Indexed: 11/27/2022]
Affiliation(s)
| | | | | | - Eugene Athan
- Barwon Health, Geelong, VIC.,Deakin University, Geelong, VIC
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Li Y, Lin F, Li W, Chen G, Li S, Liu B, Li H, Song C, Lu R, Pan P. Comparison of clinical, laboratory and radiological characteristics between Chlamydia psittaci and adenovirus pneumonias: a multicenter retrospective study. Int J Infect Dis 2023; 126:114-124. [PMID: 36455811 DOI: 10.1016/j.ijid.2022.11.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 11/23/2022] [Accepted: 11/23/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Pneumonia caused by Chlamydia psittaci is a significant global public health issue. Symptom onset and laboratory characteristics may be confused with those of other respiratory viral infections, including adenovirus pneumonia. We aimed to determine differences in clinical presentations and establish a simple nomogram to differentiate C. psittaci and adenovirus pneumonias. METHODS We conducted a multicenter retrospective study in 10 tertiary general hospitals to compare patients with either C. psittaci (n = 78) or adenovirus (n = 102) pneumonia. A multivariable logistic regression model was used to identify risk factors of C. psittaci pneumonia that were used to establish a nomogram. RESULTS C. psittaci and adenovirus pneumonia showed certain similar clinical symptoms, including fever, dyspnea, and fatigue, but differed in other characteristics. The multivariate logistic regression showed that age, sex, nervous system symptoms, lymphocyte count, C-reactive protein level, and bilateral lung lesions were risk factors for C. psittaci pneumonia. After incorporating these six factors, the established nomogram achieved a good concordance value (0.949 [95% CI 0.917-0.982]) in differentiating the types of pneumonia, with well-fitting calibration curves. CONCLUSION Despite having similar clinical features, the variables of age, sex, nervous system symptoms, lymphocytes, C-reactive protein levels, and bilateral lung lesions were combined into a clinically useful nomogram for the rapid and early differentiation of C. psittaci pneumonia from adenovirus pneumonia. This nomogram may help improve treatments and clinical outcomes.
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Affiliation(s)
- Yi Li
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China; Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China; Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China; Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
| | - Fengyu Lin
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China; Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China; Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China; Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
| | - Wen Li
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China; Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China; Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China; Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
| | - Gang Chen
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China; Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China; Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China; Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
| | - Sha Li
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Ben Liu
- Department of Emergency Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Haitao Li
- First Department of Thoracic Medicine, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Chao Song
- Nosocomial Infection Control Center, Xiangya Hospital, Central South University, Changsha, China
| | - Rongli Lu
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China; Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China; Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China; Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
| | - Pinhua Pan
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China; Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China; Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China; Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China.
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12
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He Y, Wang S, Deng J, Pu Q, Chen H, Huang L. Chlamydia psittaci Pneumonia Complicated with Lower Extremity Atherosclerotic Occlusive Disease. Infect Drug Resist 2023; 16:2141-2145. [PMID: 37077253 PMCID: PMC10106326 DOI: 10.2147/idr.s393256] [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: 02/01/2023] [Accepted: 03/29/2023] [Indexed: 04/21/2023] Open
Abstract
Chlamydia is a zoonotic pathogen that mainly infects poultry and pet birds. This Gram-negative obligate intracellular parasite also causes human psittacosis, the severity of which varies from mild flu-like symptoms to life-threatening severe pneumonia, including sepsis, acute respiratory distress syndrome, and multiple organ failure. Inhalation of aerosols from contaminated bird excreta through the respiratory tract is the main route of transmission to humans. Here, we present a case of Chlamydia psittaci pneumonia accompanied by lower extremity atherosclerotic occlusive disease. A 48-year-old man was admitted to the emergency department with a four-day history of cough and dyspnea. A detailed history revealed his contact with domestic pigeons. The results of metagenomic next-generation sequencing of bronchoalveolar lavage fluid suggested C. psittaci infection. Antibacterial agents were switched to targeted doxycycline, but in the next week, skin examination revealed acrocyanosis of both lower extremities, and the remarkable palpable purpura progressively worsened. Re-examination of the lower extremity vascular ultrasound suggested left dorsalis pedis artery occlusion and right peroneal vein thrombosis, which resulted in the amputation of both legs. This case is the first report of C. psittaci pneumonia combined with arterioocclusive sclerosis of both lower extremities.
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Affiliation(s)
- YongHong He
- Department of Respiratory Medicine and Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou City, Sichuan Province, 646000, People’s Republic of China
| | - SongPing Wang
- Department of Respiratory Medicine and Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou City, Sichuan Province, 646000, People’s Republic of China
- Correspondence: SongPing Wang, Department of Respiratory Medicine and Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou City, Sichuan Province, 646000, People’s Republic of China, Email
| | - Jun Deng
- Department of Respiratory Medicine and Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou City, Sichuan Province, 646000, People’s Republic of China
| | - Qian Pu
- Department of Intensive Care Medicine, Chengdu Second People’s Hospital, ChengDu City, Sichuan Province, 610000, People’s Republic of China
| | - Hong Chen
- Department of Respiratory Medicine, Chengdu Second People’s Hospital, ChengDu City, Sichuan Province, 610000, People’s Republic of China
| | - Lan Huang
- Department of Respiratory Medicine, Chengdu Second People’s Hospital, ChengDu City, Sichuan Province, 610000, People’s Republic of China
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13
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Guscoth LB, Taylor DM, Coad F. Persistent renal replacement requirement following fulminant psittacosis infection in pregnancy. BMJ Case Rep 2022; 15:e250221. [PMID: 36524261 PMCID: PMC9748922 DOI: 10.1136/bcr-2022-250221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Chlamydia psittaci is a zoonotic bacterial infection that most commonly causes mild flu-like symptoms in humans. However, in pregnancy, it can present as fulminant psittacosis associated with systemic illness, disseminated intravascular coagulation, renal and hepatic failure. We describe a case of a veterinary nurse in her 30s who presented at 32 weeks' gestation with rapidly progressive multiorgan failure, with positive, C. psittaci serology. Further history revealed that she had delivered a number of dead lambs in the preceding weeks to her illness, highlighting the importance of a thorough social history. C. psittaci should be suspected in the differential as a causative organism for severe pneumonia with multiorgan failure particularly in pregnant women with animal or bird contacts.
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Affiliation(s)
- Layla B Guscoth
- Anaesthesia, Epsom and Saint Helier Hospital NHS Trust, Carshalton, Sutton, UK
| | | | - Felicity Coad
- Acute Medicine, Royal United Hospital Bath NHS Trust, Bath, Bath and North East Somer, UK
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14
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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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15
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Weston KM, Polkinghorne A, Branley JM. Psittacosis contagion in 1930: an old story in a new era of zoonotic disease. Microbes Infect 2022; 25:105076. [PMID: 36372317 PMCID: PMC9650517 DOI: 10.1016/j.micinf.2022.105076] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/25/2022] [Accepted: 11/06/2022] [Indexed: 11/13/2022]
Abstract
The SARS-CoV-2 pandemic has highlighted the importance of zoonotic diseases. Psittacosis, a human disease resulting from infection spill-over from Chlamydia psittaci-infected birds, is a lesser-known example of a zoonosis. Psittacosis was responsible for numerous outbreaks in the 1930s, characterised by significant human mortality and disruption to the global trade in parrots. This paper describes the epidemiological and clinical details of one family group impacted by the purchase of an infected, imported parrot. Findings are discussed in the context of a growing awareness of the health risks of global disease outbreaks, as well as social and economic impacts. Health information recorded for cases of psittacosis associated with the 1930s cluster was reviewed using contemporary knowledge of disease symptoms and epidemiology. Case details and autopsy reports were examined. Public health investigation deduced that the cluster of infections was chronologically and physically connected to the purchase and subsequent death of an imported parrot. Disease symptoms were consistent with C. psittaci infection. Epidemiological data supported the diagnoses and causes of death, despite the presenting symptoms sharing significant overlap with other common respiratory diseases. There is growing awareness of the risks of epidemiological bridges in transmitting animal diseases to humans. Historical cases are a strong reminder of the fundamental role of scientific and public health responses in the face of such contagion.
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Affiliation(s)
- Kathryn M Weston
- Graduate School of Medicine, University of Wollongong, Wollongong, 2522, New South Wales, Australia.
| | - Adam Polkinghorne
- New South Wales Health Pathology Nepean, Kingswood, 2747, New South Wales, Australia; Nepean Clinical School, Faculty of Medicine and Health, University of Sydney, Kingswood, 2747, New South Wales, Australia
| | - James M Branley
- New South Wales Health Pathology Nepean, Kingswood, 2747, New South Wales, Australia; Nepean Clinical School, Faculty of Medicine and Health, University of Sydney, Kingswood, 2747, New South Wales, Australia
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16
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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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17
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Zhang Z, Wang P, Ma C, Wang J, Li W, Quan C, Cao H, Guo H, Wang L, Yan C, Carr MJ, Meng L, Shi W. Host inflammatory response is the major factor in the progression of Chlamydia psittaci pneumonia. Front Immunol 2022; 13:929213. [PMID: 36119044 PMCID: PMC9478202 DOI: 10.3389/fimmu.2022.929213] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 08/03/2022] [Indexed: 11/13/2022] Open
Abstract
PurposeChlamydia psittaci (C. psittaci) has caused sporadic, but recurring, fatal community-acquired pneumonia outbreaks worldwide, posing a serious threat to public health. Our understanding of host inflammatory responses to C. psittaci is limited, and many bronchitis cases of psittaci have rapidly progressed to pneumonia with deterioration.MethodsTo clarify the host inflammatory response in psittacosis, we analyzed clinical parameters, and compared transcriptomic data, concentrations of plasma cytokines/chemokines, and changes of immune cell populations in 17 laboratory-confirmed psittacosis cases, namely, 8 pneumonia and 9 bronchitis individuals, in order to assess transcriptomic profiles and pro-inflammatory responses.ResultsPsittacosis cases with pneumonia were found to have abnormal routine blood indices, liver damage, and unilateral pulmonary high-attenuation consolidation. Transcriptome sequencing revealed markedly elevated expression of several pro-inflammatory genes, especially interleukins and chemokines. A multiplex-biometric immunoassay showed that pneumonia cases had higher levels of serum cytokines (G-CSF, IL-2, IL-6, IL-10, IL-18, IP-10, MCP-3, and TNF-α) than bronchitis cases. Increases in activated neutrophils and decreases in the number of lymphocytes were also observed in pneumonia cases.ConclusionWe identified a number of plasma biomarkers distinct to C. psittaci pneumonia and a variety of cytokines elevated with immunopathogenic potential likely inducing an inflammatory milieu and acceleration of the disease progression of psittaci pneumonia. This enhances our understanding of inflammatory responses and changes in vascular endothelial markers in psittacosis with heterogeneous symptoms and should prove helpful for developing both preventative and therapeutic strategies.
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Affiliation(s)
- Zhenjie Zhang
- Key Laboratory of Etiology and Epidemiology of Emerging Infectious Diseases in Universities of Shandong, Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, China
| | - Peihan Wang
- Beijing Institute of Genomics, Chinese Academy of Sciences, China National Center for Bioinformation, Beijing, China
| | - Chuanmin Ma
- Key Laboratory of Etiology and Epidemiology of Emerging Infectious Diseases in Universities of Shandong, Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, China
| | - Jing Wang
- Key Laboratory of Etiology and Epidemiology of Emerging Infectious Diseases in Universities of Shandong, Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, China
| | - Wenxin Li
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Jining Medical University, Jining, China
| | - Chuansong Quan
- Key Laboratory of Etiology and Epidemiology of Emerging Infectious Diseases in Universities of Shandong, Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, China
| | - Huae Cao
- Department of Infectious Disease, Xintai Third People’s Hospital, Xintai, China
| | - Hongfeng Guo
- Department of Infectious Disease, Xintai Third People’s Hospital, Xintai, China
| | - Liang Wang
- Key Laboratory of Etiology and Epidemiology of Emerging Infectious Diseases in Universities of Shandong, Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, China
| | - Chengxin Yan
- Department of Medical Imaging, The Second Affiliated Hospital of Shandong First Medical University, Taian, China
| | - Michael J. Carr
- National Virus Reference Laboratory, School of Medicine, University College Dublin, Dublin, Ireland
- International Collaboration Unit, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan
| | - Ling Meng
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Shandong First Medical University, Taian, China
- *Correspondence: Weifeng Shi, ; Ling Meng,
| | - Weifeng Shi
- Key Laboratory of Etiology and Epidemiology of Emerging Infectious Diseases in Universities of Shandong, Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, China
- School of Public Health, Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, China
- *Correspondence: Weifeng Shi, ; Ling Meng,
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18
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Duan Z, Gao Y, Liu B, Sun B, Li S, Wang C, Liu D, Wang K, Zhang Y, Lou Z, Xie L, Xie F. The Application Value of Metagenomic and Whole-Genome Capture Next-Generation Sequencing in the Diagnosis and Epidemiological Analysis of Psittacosis. Front Cell Infect Microbiol 2022; 12:872899. [PMID: 35734579 PMCID: PMC9207344 DOI: 10.3389/fcimb.2022.872899] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/10/2022] [Indexed: 01/16/2023] Open
Abstract
BackgroundTo evaluate the value of metagenomic next-generation sequencing (mNGS) for the early diagnosis of psittacosis, and to investigate its epidemiology by whole-genome capture.MethodsTwenty-one bronchoalveolar lavage fluid (BALF) and blood samples of 16 psittacosis patients from multiple centers during August 2019 to September 2021 were analyzed retrospectively. mNGS with normal datasets (10 M 75-bp single-end reads after sequencing) and larger datasets (30 M 150-bp paired-end reads after sequencing) as well as quantitative real-time polymerase chain reaction (qPCR) were used to detect the pathogen. Also, whole-genome capture of Chlamydophila psittaci was applied to draw the phylogenetic tree.ResultsmNGS successfully detected the pathogen in all 16 cases (100%), while qPCR was positive only in 5 out of 10 cases (50%), indicating a significantly higher sensitivity of mNGS than qPCR (p < 0.01). BALF-mNGS performed better than blood-mNGS (16/16 versus 3/5, p < 0.05). In addition, larger datasets (the read counts have tripled, and the base number was 12-fold larger compared to clinical mNGS with a normal dataset) of mNGS showed significantly increased contents of human DNA (p < 0.05) and decreased reads per million of the pathogen, suggesting no improvement. Whole-genome capture results of five samples (>60% coverage and >1 depth) were used to construct the phylogenetic tree.ConclusionSignificant advantages of mNGS with normal datasets were demonstrated in early diagnosing psittacosis. It is the first study to use whole-genome capture to analyze C. psittaci epidemiological information.
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Affiliation(s)
- Zhimei Duan
- College of Pulmonary and Critical Care Medicine, Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
| | - Yanqiu Gao
- Respiratory Intensive Care Unit, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Bin Liu
- Characteristic Medical Center, the Chinese People’s Armed Police Forces, Tianjin, China
| | - Baohua Sun
- Department of the Respiratory and Critical Care Medicine, Cangzhou Central Hospital, Cangzhou, China
| | - Shuangfeng Li
- Respiratory Intensive Care Unit, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Chenlei Wang
- Department of the Respiratory and Critical Care Medicine, Cangzhou Central Hospital, Cangzhou, China
| | - Dongli Liu
- Department of the Respiratory and Critical Care Medicine, Yan’an University Affiliated Hospital, Yan’an, China
| | - Kaifei Wang
- College of Pulmonary and Critical Care Medicine, Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
| | - Ye Zhang
- Department of Scientific Affairs, Hugobiotech Co., Ltd., Beijing, China
| | - Zheng Lou
- Department of Scientific Affairs, Hugobiotech Co., Ltd., Beijing, China
- *Correspondence: Fei Xie, ; Lixin Xie, ; Zheng Lou,
| | - Lixin Xie
- College of Pulmonary and Critical Care Medicine, Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
- *Correspondence: Fei Xie, ; Lixin Xie, ; Zheng Lou,
| | - Fei Xie
- College of Pulmonary and Critical Care Medicine, Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
- *Correspondence: Fei Xie, ; Lixin Xie, ; Zheng Lou,
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Chlamydia psittaci pneumonia complicated with organizing pneumonia: A case report and literature review. IDCases 2022; 30:e01584. [PMID: 36193103 PMCID: PMC9526182 DOI: 10.1016/j.idcr.2022.e01584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/25/2022] [Indexed: 11/26/2022] Open
Abstract
A patient with pneumonia had a fever for 2 weeks. After the initial anti-infection treatment failed, he was diagnosed with C. psittaci pneumonia complicated with organizing pneumonia, through next-generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF) and lung biopsy. He was treated with antibiotics and corticosteroids for 2 months. Chlamydia psittaci pneumonia complicated with organizing pneumonia is rare. It can be diagnosed by next-generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF) and lung biopsy. Treatment of moxifloxacin sequential to clarithromycin combined with corticosteroids is effective, and the prognosis is satisfactory. We introduce a rare case of C. psittaci pneumonia complicated with organizing pneumonia, and the treatment is successful.
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20
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Wu HH, Feng LF, Fang SY. Application of metagenomic next-generation sequencing in the diagnosis of severe pneumonia caused by Chlamydia psittaci. BMC Pulm Med 2021; 21:300. [PMID: 34556069 PMCID: PMC8461849 DOI: 10.1186/s12890-021-01673-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 09/17/2021] [Indexed: 12/25/2022] Open
Abstract
Purpose Psittacosis is a zoonotic infectious disease caused by the transmission of the bacterium Chlamydia psittaci (C. psittaci) from birds to humans. Infections in humans mainly present as community-acquired pneumonia (CAP). However, most cases are treated without diagnostic testing, and the importance of Chlamydia psittaci infection as a cause of CAP is therefore unclear. Diagnostic tools, including culture, serologic test, and PCR-based methods, are available but prone to false negative results. Metagenomic next-generation sequencing (mNGS) has been increasingly used in the diagnosis of infectious diseases, particularly when conventional diagnostic approaches have limitation. Detection of nucleic acid sequence of C. psittaci in respiratory tract samples by metagenomic next-generation sequencing (mNGS) is effective for early diagnosis of severe C. psittaci pneumonia. Timely treatment based on tetracycline can reduce unnecessary use of antibiotics and improve prognosis of patients with severe C. psittaci pneumonia. Methods Clinical data of thirteen patients with severe C. psittaci pneumonia diagnosed by mNGS were collected. Clinical manifestations, treatment and prognosis of patients were summarized. Results The typical symptoms of pneumonia caused by C. psittaci include fever, headache, myalgia, cough, and dyspnea. In the current study, all patients met the criteria for severe C. psittaci pneumonia and received mechanical ventilation, including noninvasive mechanical ventilation (five/thirteen) and invasive mechanical ventilation (eight/thirteen). The findings showed that patients with C. psittaci pneumonia presented with normal or slightly increased leucocytes and procalcitonin, and high C-reactive protein levels. Computed tomography manifestations included consolidation of lung parenchyma, with air bronchogram and pleural effusion in some patients. mNGS analysis results were obtained within 48–72 h. Eleven patients fully recovered after targeted treatment, however, two patients died from secondary multidrug-resistant Pseudomonas aeruginosa infection. Conclusions The findings of the current study show that mNGS is effective in diagnosis of C. psittaci pneumonia, and has significant diagnosis value in patients with severe infection. Patients responds well to the timely use of appropriate antibiotics.
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Affiliation(s)
- Huan-Huan Wu
- Department of Respiratory Medicine, Dongyang Hospital Affiliated to Wenzhou Medical University, Dongyang, 322100, Zhejiang Province, China.
| | - Lan-Fang Feng
- Department of Respiratory Medicine, Dongyang Hospital Affiliated to Wenzhou Medical University, Dongyang, 322100, Zhejiang Province, China
| | - Shuang-Yan Fang
- Department of Respiratory Medicine, Dongyang Hospital Affiliated to Wenzhou Medical University, Dongyang, 322100, Zhejiang Province, China
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Chaber AL, Jelocnik M, Woolford L. Undiagnosed Cases of Human Pneumonia Following Exposure to Chlamydia psittaci from an Infected Rosella Parrot. Pathogens 2021; 10:pathogens10080968. [PMID: 34451432 PMCID: PMC8399200 DOI: 10.3390/pathogens10080968] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/21/2021] [Accepted: 06/28/2021] [Indexed: 11/17/2022] Open
Abstract
This report describes two cases of occupational exposure to Chlamydia psittaci following dissection of an infected Rosella (Platycercus elegans). The C. psittaci infections (with one of them resulting in diagnosed pneumonia and hospitalisation) were undiagnosed during routine medical investigations but later established due to epidemiological and clinical evidence, and molecular testing of the archived Rosella’ specimens. This case report stresses the importance of correct application and interpretation of diagnostic tests and the need to raise awareness about this zoonotic pathogen among medical practitioners and people exposed to potential animal carriers. Our findings suggest other infected individuals might be misdiagnosed and that C. psittaci (psittacosis) is likely to be underreported in Australia. This case highlights the need to operationalise the One Health concept. We call for improved communication between human and animal health service providers to allow accurate and rapid diagnosis of this zoonotic disease and raised awareness among medical practitioners. Further targeted surveys of wild birds (and other animals) should be conducted to improve assessment of risks to the general population and people working with or exposed to wild birds.
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Affiliation(s)
- Anne-Lise Chaber
- School of Animal and Veterinary Science, University of Adelaide, Roseworthy, SA 5371, Australia;
- Correspondence:
| | - Martina Jelocnik
- Genecology Research Centre, University of the Sunshine Coast, Sippy Downs, QLD 4557, Australia;
| | - Lucy Woolford
- School of Animal and Veterinary Science, University of Adelaide, Roseworthy, SA 5371, Australia;
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Popelin-Wedlarski F, Roux A, Aaziz R, Vorimore F, Lagourette P, Crispo M, Borel N, Laroucau K. Captive Psittacines with Chlamydia avium Infection. Avian Dis 2021; 64:542-546. [PMID: 33570105 DOI: 10.1637/aviandiseases-d20-00043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/28/2020] [Indexed: 11/05/2022]
Abstract
Avian chlamydiosis is an infection caused by obligate intracellular, gram-negative bacteria belonging to the Chlamydiaceae family. Birds can be hosts of several Chlamydia species, including Chlamydia avium, which has only been detected in pigeons and psittacine birds. In this study, depression, respiratory distress, and mortality were noted among psittacines belonging to a large aviary with 35 different avian species. On the basis of immunohistochemistry and PCR testing, chlamydiosis was diagnosed in affected birds. Gross and histopathologic lesions were mainly observed in the spleen and gastrointestinal tract. Chlamydia avium was detected in four psittacines by PCR, including two dead birds and two individuals exhibiting respiratory distress. Increased aspartate aminotransferase and lactate dehydrogenase values and anemia were consistently identified in affected birds. Administration of doxycycline, combined with hepatoprotectors and vitamins, was effective in stopping mortality and bacterial shedding.
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Affiliation(s)
| | - Alexia Roux
- Bioparc de Doué la Fontaine, 49700 Doué en Anjou, France
| | - Rachid Aaziz
- University Paris-Est, Anses, Animal Health Laboratory, Bacterial Zoonoses Unit, Maisons-Alfort, France 94706
| | - Fabien Vorimore
- University Paris-Est, Anses, Animal Health Laboratory, Bacterial Zoonoses Unit, Maisons-Alfort, France 94706
| | - Pierre Lagourette
- Laboratoire d'anatomie pathologique vétérinaire, Amboise, France 37400
| | - Manuela Crispo
- Ecole Nationale Vétérinaire de Toulouse, Poultry and Swine Clinic, 23 Chemin des Capelles, Toulouse, France 31000
| | - Nicole Borel
- Institute of Veterinary Pathology, University of Zurich, Zurich, Switzerland 8057
| | - Karine Laroucau
- University Paris-Est, Anses, Animal Health Laboratory, Bacterial Zoonoses Unit, Maisons-Alfort, France 94706
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23
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Zuzek R, Green M, May S. Severe psittacosis progressing to suspected organizing pneumonia and the role of corticosteroids. Respir Med Case Rep 2021; 34:101486. [PMID: 34381682 PMCID: PMC8339220 DOI: 10.1016/j.rmcr.2021.101486] [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: 03/28/2021] [Revised: 06/26/2021] [Accepted: 07/23/2021] [Indexed: 11/30/2022] Open
Abstract
Background Psittacosis is a systemic disease usually with respiratory involvement, caused by the obligate intracellular bacterium Chlamydia psittaci. Exposure to birds, the main zoonotic reservoir, is a major risk factor for infection. The spectrum of disease is highly variable, ranging from subclinical infection to severe pneumonia requiring mechanical ventilation. There is limited data on psittacosis progressing to organizing pneumonia and management of such cases. Case presentation A 63-year-old man was referred to a rural hospital with 11 days of fevers to 39 °C, myalgia, lethargy and several days of dry cough. After initial treatment with benzylpenicillin and doxycycline for left lower pneumonia found on CXR, the patient deteriorated with extensive bilateral consolidation on chest CT requiring mechanical ventilation. Atypical pneumonia screening was negative, however, exposure to a sick bird prior to symptom onset triggered testing for C. psittaci which was positive. Doxycycline was recommenced with minimal benefit, and organizing pneumonia was later suspected. The patient slowly improved with a weaning course of corticosteroids started after 19 days and was discharged from hospital. He unfortunately was re-admitted and died several months later. Conclusion Severe pneumonia is a rare, but potentially life-threatening complication of psittacosis. We present a case of psittacosis which progressed to suspected organizing pneumonia despite appropriate antibiotics, and subsequent treatment with corticosteroids. This case suggests it may be useful to consider corticosteroids early in therapy for patients with severe psittacosis. Our paper underlines the need for further research to determine the best management of severe psittacosis to improve patient outcomes.
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Affiliation(s)
- Rachael Zuzek
- Tamworth Rural Referral Hospital, Tamworth, Australia
- Wollongong Hospital, Wollongong, Australia
- Corresponding author. Tamworth Rural Referral Hospital, Tamworth, Australia.
| | - Malcolm Green
- Tamworth Rural Referral Hospital, Tamworth, Australia
| | - Stephen May
- Tamworth Rural Referral Hospital, Tamworth, Australia
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24
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Shi Y, Chen J, Shi X, Hu J, Li H, Li X, Wang Y, Wu B. A case of chlamydia psittaci caused severe pneumonia and meningitis diagnosed by metagenome next-generation sequencing and clinical analysis: a case report and literature review. BMC Infect Dis 2021; 21:621. [PMID: 34193063 PMCID: PMC8243071 DOI: 10.1186/s12879-021-06205-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/18/2021] [Indexed: 12/19/2022] Open
Abstract
Background Psittacosis, which is also known as parrot fever, is Chlamydia psittaci (C. psittaci) caused infectious disease. The clinical manifestations vary from asymptomatic infection to severe atypical pneumonia or even fatal meningitis. Early recognition of psittacosis is difficult because of its nonspecific clinical manifestations. Culture and gene probe techniques for C. psittaci are not available for routine clinical use, which makes the diagnosis difficult too. Although psittacosis has increasingly been recognized and reported in recent years, cure of severe pneumonia complicated with meningitis, with etiologic diagnosis aided by the use of metagenomic next-generation sequencing (mNGS), is still uncommon. So, it is necessary to report and review such potentially fatal case. Case presentation This report describes a 54-year-old woman with C. psittaci caused severe atypical pneumonia and meningitis. She presented with symptoms of fever, dry cough and dyspnea, accompanied by prominent headache. Her condition deteriorated rapidly to respiratory failure and lethargy under the treatment of empirical antibacterial agents, and was treated with invasive mechanical ventilation soon. She denied contact with birds, poultry or horses, but unbiased mNGS of both the bronchoalveolar lavage fluid (BALF) and the cerebrospinal fluid (CSF) identified sequence reads corresponding to C. psittaci infection, and there was no sequence read corresponding to other probable pathogens. Combined use of targeted antimicrobial agents of tetracyclines, macrolides and fluoroquinolones was carried out, and the patient’s condition improved and she was discharged home 28 days later. Her status returned close to premorbid condition on day 60 of follow-up. Conclusions When clinicians come across a patient with atypical pneumonia accompanied by symptoms of meningitis, psittacosis should be taken into consideration. mNGS is a promising detection method in such condition and is recommended. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06205-5.
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Affiliation(s)
- Yunfeng Shi
- Medical Intensive Care Unit, Department of Respiratory and Critical Care Medicine, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China.,Institute of Respiratory Diseases, Sun Yat-Sen University, Guangzhou, China
| | - Junxian Chen
- Medical Intensive Care Unit, Department of Respiratory and Critical Care Medicine, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China.,Institute of Respiratory Diseases, Sun Yat-Sen University, Guangzhou, China
| | - Xiaohan Shi
- Medical Intensive Care Unit, Department of Respiratory and Critical Care Medicine, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China. .,Institute of Respiratory Diseases, Sun Yat-Sen University, Guangzhou, China.
| | - Jiajia Hu
- Medical Intensive Care Unit, Department of Respiratory and Critical Care Medicine, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China.,Institute of Respiratory Diseases, Sun Yat-Sen University, Guangzhou, China
| | - Hongtao Li
- Medical Intensive Care Unit, Department of Respiratory and Critical Care Medicine, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China.,Institute of Respiratory Diseases, Sun Yat-Sen University, Guangzhou, China
| | - Xiaojie Li
- Department of Laboratory Medicine, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China
| | - Yanhong Wang
- Medical Intensive Care Unit, Department of Respiratory and Critical Care Medicine, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China.,Institute of Respiratory Diseases, Sun Yat-Sen University, Guangzhou, China
| | - Benquan Wu
- Medical Intensive Care Unit, Department of Respiratory and Critical Care Medicine, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China. .,Institute of Respiratory Diseases, Sun Yat-Sen University, Guangzhou, China.
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25
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Dueck NP, Epstein S, Franquet T, Moore CC, Bueno J. Atypical Pneumonia: Definition, Causes, and Imaging Features. Radiographics 2021; 41:720-741. [PMID: 33835878 DOI: 10.1148/rg.2021200131] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Pneumonia is among the most common causes of death worldwide. The epidemiologic and clinical heterogeneity of pneumonia results in challenges in diagnosis and treatment. There is inconsistency in the definition of the group of microorganisms that cause "atypical pneumonia." Nevertheless, the use of this term in the medical and radiologic literature is common. Among the causes of community-acquired pneumonia, atypical bacteria are responsible for approximately 15% of cases. Zoonotic and nonzoonotic bacteria, as well as viruses, have been considered among the causes of atypical pneumonia in a patient who is immunocompetent and have been associated with major community outbreaks of respiratory infection, with relevant implications in public health policies. Considering the difficulty of isolating atypical microorganisms and the significant overlap in clinical manifestations, a targeted empirical therapy is not possible. Imaging plays an important role in the diagnosis and management of atypical pneumonia, as in many cases its findings may first suggest the possibility of an atypical infection. Clarifying and unifying the definition of atypical pneumonia among the medical community, including radiologists, are of extreme importance. The prompt diagnosis and prevention of community spread of some atypical microorganisms can have a relevant impact on local, regional, and global health policies. ©RSNA, 2021.
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Affiliation(s)
- Nicholas P Dueck
- From the Department of Radiology and Medical Imaging (N.P.D., S.E., J.B.) and Department of Infectious Diseases and International Health (C.C.M.), University of Virginia Medical Center, 1215 Lee St, PO Box 800170, Charlottesville, VA 22908; and Department of Radiology, Hospital de Sant Pau-Universidad Autónoma de Barcelona, Barcelona, Spain (T.F.)
| | - Samantha Epstein
- From the Department of Radiology and Medical Imaging (N.P.D., S.E., J.B.) and Department of Infectious Diseases and International Health (C.C.M.), University of Virginia Medical Center, 1215 Lee St, PO Box 800170, Charlottesville, VA 22908; and Department of Radiology, Hospital de Sant Pau-Universidad Autónoma de Barcelona, Barcelona, Spain (T.F.)
| | - Tomás Franquet
- From the Department of Radiology and Medical Imaging (N.P.D., S.E., J.B.) and Department of Infectious Diseases and International Health (C.C.M.), University of Virginia Medical Center, 1215 Lee St, PO Box 800170, Charlottesville, VA 22908; and Department of Radiology, Hospital de Sant Pau-Universidad Autónoma de Barcelona, Barcelona, Spain (T.F.)
| | - Christopher C Moore
- From the Department of Radiology and Medical Imaging (N.P.D., S.E., J.B.) and Department of Infectious Diseases and International Health (C.C.M.), University of Virginia Medical Center, 1215 Lee St, PO Box 800170, Charlottesville, VA 22908; and Department of Radiology, Hospital de Sant Pau-Universidad Autónoma de Barcelona, Barcelona, Spain (T.F.)
| | - Juliana Bueno
- From the Department of Radiology and Medical Imaging (N.P.D., S.E., J.B.) and Department of Infectious Diseases and International Health (C.C.M.), University of Virginia Medical Center, 1215 Lee St, PO Box 800170, Charlottesville, VA 22908; and Department of Radiology, Hospital de Sant Pau-Universidad Autónoma de Barcelona, Barcelona, Spain (T.F.)
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26
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Mateso GQ, Baguma M, Mwene-Batu P, Balemba GM, Nzabara F, Makali S, Bedha A, Furaha B, Minani J, Muhindo CT, Malembaka EB, Masimango MI, Shindano TA, Cikomola JC, Mubagwa K. Atypical respiratory distress in eastern Democratic Republic of the Congo prior to the COVID-19 pandemic. A case report. TROPICAL DISEASES TRAVEL MEDICINE AND VACCINES 2021; 7:9. [PMID: 33823942 PMCID: PMC8022307 DOI: 10.1186/s40794-021-00134-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 03/23/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Predictions have been made that Africa would be the most vulnerable continent to the novel Coronavirus disease 2019 (COVID-19). Interestingly, the spread of the disease in Africa seems to have been delayed and initially slower than in many parts of the world. Here we report on two cases of respiratory distress in our region before the official declaration of the disease in December 2019, cases which in the present times would be suspect of COVID-19. CASE PRESENTATION These two cases (one 55-year-old man and one 25-year-old woman) of acute respiratory distress secondary to atypical pneumonia were seen in Bukavu, in Eastern Democratic Republic of the Congo (DRC), between September and December 2019. One patient had returned from China and the other had close contacts with travellers from China in the 2 weeks prior to the onset of symptoms. In either case, the aetiology could not be accurately determined. However, the two cases presented a clinical picture (progressive dyspnoea, preceded by dry cough and fever) and laboratory changes (procalcitonin within the normal range, slight inflammation, and lymphopenia) compatible with a viral infection. The chest X-ray series of the first patient showed lesions (reticulations, ground glass, and nodules ≤6 mm) similar to those currently found in COVID-19 patients. In addition, unlike the 25-year-old female patient who had no comorbidity, the 55-year-old male patient who had hypertension as comorbidity, developed a more severe acute respiratory distress which progressed to death. CONCLUSION These cases bring to the attention the fact that COVID-19-like syndromes may have already been present in the region months before the official beginning of the pandemic. This also brings to question whether a prior presence of the disease or infections with related virus may account for the delayed and less extensive development of the pandemic in the region.
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Affiliation(s)
- Guy-Quesney Mateso
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, Democratic Republic of the Congo
| | - Marius Baguma
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, Democratic Republic of the Congo. .,Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo.
| | - Pacifique Mwene-Batu
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, Democratic Republic of the Congo.,Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo.,École Régionale de Santé Publique (ERSP), Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo
| | - Ghislain Maheshe Balemba
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, Democratic Republic of the Congo.,Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo.,École Régionale de Santé Publique (ERSP), Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo
| | - Fabrice Nzabara
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, Democratic Republic of the Congo.,Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo
| | - Samuel Makali
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, Democratic Republic of the Congo.,Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo.,École Régionale de Santé Publique (ERSP), Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo
| | - Aline Bedha
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, Democratic Republic of the Congo.,Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo
| | - Bonheur Furaha
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, Democratic Republic of the Congo
| | - Jimmy Minani
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, Democratic Republic of the Congo
| | - Christian Tshongo Muhindo
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, Democratic Republic of the Congo.,Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo
| | - Espoir Bwenge Malembaka
- Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo.,École Régionale de Santé Publique (ERSP), Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo
| | - Mannix Imani Masimango
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, Democratic Republic of the Congo.,Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo
| | - Tony Akilimali Shindano
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, Democratic Republic of the Congo.,Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo
| | - Justin Cirhuza Cikomola
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, Democratic Republic of the Congo.,Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo
| | - Kanigula Mubagwa
- Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo
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27
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Meijer R, van Biezen P, Prins G, Boiten HJ. Multi-organ failure with necrotic skin lesions due to infection with Chlamydia psittaci. Int J Infect Dis 2021; 106:262-264. [PMID: 33823280 DOI: 10.1016/j.ijid.2021.03.091] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/26/2021] [Accepted: 03/31/2021] [Indexed: 11/19/2022] Open
Abstract
Presented is a patient with dyspnea and painful ulcers finally resulting in multi-organ failure. A detailed history resulted in positive PCR testing for Chlamydia psittaci. We emphasize the importance of a definitive history in establishing the correct diagnosis. When clinicians observe dyspnea with multi-organ failure, they should be aware of psittacosis.
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Affiliation(s)
- Renske Meijer
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Paula van Biezen
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Gerrie Prins
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Intensive Care Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Henk-Jan Boiten
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Hematology, Erasmus MC, Erasmus University Medical Center, Rotterdam, The Netherlands.
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28
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Polkinghorne A, Weston KM, Branley J. Recent history of psittacosis in Australia: expanding our understanding of the epidemiology of this important globally distributed zoonotic disease. Intern Med J 2021; 50:246-249. [PMID: 32037712 DOI: 10.1111/imj.14726] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 08/27/2019] [Accepted: 08/27/2019] [Indexed: 12/13/2022]
Abstract
Psittacosis is a human systemic disease caused by infection with Chlamydia psittaci. Shortly after reports emerged of a global pandemic associated with contact with imported parrots, Australian researchers including Macfarlane Burnet and others demonstrated that C. psittaci was widespread in Australian parrots. Australian cases over the last two decades have revealed that environmental exposure and contact with infected horses are also risk factors in an increasingly complicated epidemiological picture for this zoonotic disease.
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Affiliation(s)
- Adam Polkinghorne
- Department of Microbiology and Infectious Diseases, New South Wales Health Pathology, Nepean Hospital, Penrith, New South Wales, Australia
| | - Kathryn M Weston
- School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - James Branley
- Department of Microbiology and Infectious Diseases, New South Wales Health Pathology, Nepean Hospital, Penrith, New South Wales, Australia
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Szabo KV, O’Neill CE, Clarke IN. Diversity in Chlamydial plasmids. PLoS One 2020; 15:e0233298. [PMID: 32469898 PMCID: PMC7259575 DOI: 10.1371/journal.pone.0233298] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 05/01/2020] [Indexed: 11/30/2022] Open
Abstract
Background Evolutionary studies have been conducted that have investigated the chromosomal variance in the genus of Chlamydia. However, no all-encompassing genus-wide comparison has been performed on the plasmid. Therefore, there is a gap in the current knowledge on Chlamydia plasmid diversity. Aims This project is aimed to investigate and establish the nature and extent of diversity across the entire genus of Chlamydia, by comparing the sequences of all currently available plasmid carrying strains. Methods The PUBMED database was used to identify plasmid sequences from all available strains that met the set quality criteria for their inclusion in the study. Alignments were performed on the 51 strains that fulfilled the criteria using MEGA X software. Following that Maximum Likelihood estimation was used to construct 11 phylogenetic trees of the whole plasmid sequence, the individual 8 coding sequences, the iteron and a chromosomal gene ompA as a comparator. Results The genus-wide plasmid phylogeny produced three distinct lineages labelled as alpha, beta and gamma. Nineteen genotypes were found in the initial whole plasmid analysis. Their distribution was allocated as six C. pecorum, two C. pneumoniae, one C. gallinacea, one C. avium, one C. caviae, one C. felis, two C. psittaci, one C. trachomatis, one C. muridarum, and two C. suis. The chromosomal comparative gene ompA supported this distribution, with the same number of primary clades with the same species distribution. However, ompA sequence comparison resulted in fewer genotypes due to a reduced amount of available sequences (33 out of 51). All results were statistically significant. Conclusion The results of this study indicate that the common bacterial ancestor of all the species had a plasmid, which has diverged over time. Moreover, it suggests that there is a strong evolutionary selection towards these species retaining their plasmids due to its high level of conservation across the genus, with the notable exception of C. pneumoniae. Furthermore, the evolutionary analysis showed that the plasmid and the chromosome have co-evolved.
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Affiliation(s)
- Kolos V. Szabo
- Faculty of Medicine, University of Southampton, Southampton, Hampshire, United Kingdom
- * E-mail:
| | - Colette E. O’Neill
- Molecular Microbiology Group, Clinical and Experimental Sciences, University Hospital Southampton, Southampton, Hampshire, United Kingdom
| | - Ian N. Clarke
- Molecular Microbiology Group, Clinical and Experimental Sciences, University Hospital Southampton, Southampton, Hampshire, United Kingdom
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30
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Prevalence Rate and Phylogenetic Analysis of Chlamydia psittaci in Pigeon and House Sparrow Specimens and the Potential Human Infection Risk in Chahrmahal-va-Bakhtiari, Iran. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2020. [DOI: 10.5812/archcid.67565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
: Chlamydia psittaci (C. psittaci) is an important zoonotic pathogen in birds and has been reported from urban pigeons (Columba livia) and house sparrows (Passer domesticus) worldwide. Some public areas in Iran, such as parks, have a high density of these birds; thus, they may be regarded as a zoonotic threat to humans. The current study aimed at performing the prevalence assessment as well as the phylogenetic analysis of C. psittaci in cloacal swab samples from these birds. To this aim, a total of 75 specimens of urban pigeon, 75 specimens of the house sparrow, and 30 pharyngeal swabs of humans who work in pet-markets were collected from six different zones of Chaharmal-va-Bakhtiari, a Southwestern Province of Iran. The prevalence of C. psittaci was 25.3% (19 out of 75), 18.6% (14 out of 75), and 10% (3 out of 30) among the pigeon, sparrow and the human samples, respectively. The prevalence of C. psittaci was considerably high in urban pigeons. To determine the genotype of C. psittaci, OmpA gene fragments in positive samples were amplified and sequenced. Phylogenetic analysis revealed that strains from the pigeon and sparrow positive samples belonged to the genotypes B and A, while genotyping was unsuccessful for the positive human samples. Our findings suggest that the prevalence of C. psittaci in pigeons and sparrows is high in Chahrmahal-va-Bakhtiari posing as a potential infection risk to susceptible individuals in public places and parks. Therefore, it is essential to take effective measures for the implementation of proper control programs to prevent the possible infection of people with C. psittaci.
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31
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Kozuki E, Arima Y, Matsui T, Sanada Y, Ando S, Sunagawa T, Oishi K. Human psittacosis in Japan: notification trends and differences in infection source and age distribution by gender, 2007 to 2016. Ann Epidemiol 2020; 44:60-63. [PMID: 32253059 DOI: 10.1016/j.annepidem.2020.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 01/12/2020] [Accepted: 03/08/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Psittacosis is a bacterial zoonosis caused by Chlamydia (Chlamydophila) psittaci that infects birds. Although potentially fatal, infections can be reduced by controlling the source of infection. We therefore described the epidemiology of psittacosis, focusing on the infection source. METHODS We descriptively analyzed psittacosis cases reported through national surveillance in Japan from 2007 to 2016. We also analyzed Chlamydia psittaci prevalence among captive psittaciformes during the same period. RESULTS One hundred eleven cases were reported, and the annual number and notification rate of psittacosis declined. While 58% were male and the median age was 61 years, the median age differed by gender (males: 63 years, females: 53 years), with more female cases in those aged <50 years. In addition, the most common infection source differed by gender (men: columbiformes; women: psittaciformes). The decline in notifications was associated with a decline in psittaciformes-associated cases, with a concomitant decline in female cases. The prevalence of C. psittaci among captive psittaciformes also decreased over the period. CONCLUSIONS We found important differences in the epidemiology of psittacosis by gender, and the recent decrease in notifications correlated with decreasing C. psittaci prevalence in birds. Risk communications for psittacosis should consider the current epidemiology regarding gender, age, and infection source.
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Affiliation(s)
- Eru Kozuki
- Field Epidemiology Training Program, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yuzo Arima
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan.
| | - Tamano Matsui
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yasuyuki Sanada
- Companion Bird Laboratories, Bird's Hospital Bird House, Chiba, Japan
| | - Shuji Ando
- Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tomimasa Sunagawa
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kazunori Oishi
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
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Zhang H, Zhan D, Chen D, Huang W, Yu M, Li Q, Marcos PJ, Tattevin P, Wu D, Wang L. Next-generation sequencing diagnosis of severe pneumonia from fulminant psittacosis with multiple organ failure: a case report and literature review. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:401. [PMID: 32355845 PMCID: PMC7186658 DOI: 10.21037/atm.2020.03.17] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
This study includes a retrospective analysis of the diagnosis and treatment of a case of severe pneumonia from fulminant psittacosis with multiple organ failure. Next-generation sequencing (NGS) of the pathogen was conducted. The purpose of this study was to summarize the clinical, laboratory, and imaging characteristics of the case and to improve understanding of the value of NGS in the diagnosis of severe community-acquired pneumonia (CAP). Fulminant psittacosis can be manifested as severe pneumonia with rapid progression, acute respiratory distress syndrome, sepsis, and multiple organ failure. Imaging shows unilateral lung consolidation, which is difficult to differentiate from CAP caused by common pathogens. The NGS technology can early detect rare pathogens, thus reducing unnecessary use of antibiotics and shortening the course of the disease.
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Affiliation(s)
- Heng Zhang
- Department of Respiratory and Critical Care Medicine, Shenzhen People's Hospital, First Affiliated Hospital of Southern University of Science and Technology, Second Clinical Medical College of Jinan University, Shenzhen Institute of Respiratory Diseases, Shenzhen Key Laboratory of Respiratory Diseases, Shenzhen 518020, China
| | - Danting Zhan
- Department of Respiratory and Critical Care Medicine, Shenzhen People's Hospital, First Affiliated Hospital of Southern University of Science and Technology, Second Clinical Medical College of Jinan University, Shenzhen Institute of Respiratory Diseases, Shenzhen Key Laboratory of Respiratory Diseases, Shenzhen 518020, China
| | - Dandan Chen
- Department of Respiratory and Critical Care Medicine, Shenzhen People's Hospital, First Affiliated Hospital of Southern University of Science and Technology, Second Clinical Medical College of Jinan University, Shenzhen Institute of Respiratory Diseases, Shenzhen Key Laboratory of Respiratory Diseases, Shenzhen 518020, China
| | - Weibin Huang
- Department of Respiratory and Critical Care Medicine, Shenzhen People's Hospital, First Affiliated Hospital of Southern University of Science and Technology, Second Clinical Medical College of Jinan University, Shenzhen Institute of Respiratory Diseases, Shenzhen Key Laboratory of Respiratory Diseases, Shenzhen 518020, China
| | - Min Yu
- Department of Respiratory and Critical Care Medicine, Shenzhen People's Hospital, First Affiliated Hospital of Southern University of Science and Technology, Second Clinical Medical College of Jinan University, Shenzhen Institute of Respiratory Diseases, Shenzhen Key Laboratory of Respiratory Diseases, Shenzhen 518020, China
| | - Qiuwen Li
- Department of Respiratory and Critical Care Medicine, Shenzhen People's Hospital, First Affiliated Hospital of Southern University of Science and Technology, Second Clinical Medical College of Jinan University, Shenzhen Institute of Respiratory Diseases, Shenzhen Key Laboratory of Respiratory Diseases, Shenzhen 518020, China
| | - Pedro J Marcos
- Pneumology Service, Institute of Biomedical Research of A Coruña (INIBIC), University Hospital Complex of A Coruña (CHUAC), Universidade da Coruna (UDC), A Coruña, Spain
| | - Pierre Tattevin
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - Di Wu
- Department of Respiratory and Critical Care Medicine, Shenzhen People's Hospital, First Affiliated Hospital of Southern University of Science and Technology, Second Clinical Medical College of Jinan University, Shenzhen Institute of Respiratory Diseases, Shenzhen Key Laboratory of Respiratory Diseases, Shenzhen 518020, China
| | - Lingwei Wang
- Department of Respiratory and Critical Care Medicine, Shenzhen People's Hospital, First Affiliated Hospital of Southern University of Science and Technology, Second Clinical Medical College of Jinan University, Shenzhen Institute of Respiratory Diseases, Shenzhen Key Laboratory of Respiratory Diseases, Shenzhen 518020, China
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Katsura D, Tsuji S, Kimura F, Tanaka T, Eguchi Y, Murakami T. Gestational psittacosis: A case report and literature review. J Obstet Gynaecol Res 2020; 46:673-677. [PMID: 32077210 DOI: 10.1111/jog.14217] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 02/07/2020] [Indexed: 11/30/2022]
Abstract
Gestational psittacosis is a rare disease that is associated with significant maternal and fetal morbidity and mortality. Currently, there is no examination method which allows for a quick diagnosis. We report a case of gestational psittacosis that could not be diagnosed as psittacosis during treatment and resulted in maternal and fetal death despite intensive treatment. We also reviewed 23 cases of gestational psittacosis. Fetal and maternal mortality was 82.6% (19/23) and 8.7% (2/23), respectively. In pregnant women with high fever and flu-like symptoms, we should suspect Chlamydia psittaci infection if at least one of the following is present; contact with sheep, parrots, parakeets or goats; normal or moderately decreased leucocyte count, thrombocytopenia and hepatic and/or renal dysfunction; cough and/or lobe consolidation or infiltration on chest X-ray. Antibiotic therapy with macrolide prenatally, macrolide or tetracycline postnatally and termination of pregnancy should be considered.
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Affiliation(s)
- Daisuke Katsura
- Department of Obstetrics and Gynecology, Shiga University of Medical Science Hospital, Otsu, Japan
| | - Shunichiro Tsuji
- Department of Obstetrics and Gynecology, Shiga University of Medical Science Hospital, Otsu, Japan
| | - Fuminori Kimura
- Department of Obstetrics and Gynecology, Shiga University of Medical Science Hospital, Otsu, Japan
| | - Tomoki Tanaka
- Department of Emergency and Critical Care Medicine, Shiga University of Medical Science Hospital, Otsu, Japan
| | - Yutaka Eguchi
- Department of Emergency and Critical Care Medicine, Shiga University of Medical Science Hospital, Otsu, Japan
| | - Takashi Murakami
- Department of Obstetrics and Gynecology, Shiga University of Medical Science Hospital, Otsu, Japan
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Abstract
Chlamydiae are obligate intracellular bacterial pathogens of humans. Infections in animals are also widespread with some species, such as Chlamydia psittaci, long recognised as a serious threat to human health. Critical to the public health response of any zoonotic disease outbreaks is reliable and up-to-date information on the epidemiology of the target pathogen. Aided by advances in the use of quantitative PCR, molecular typing and culture-independent genomic studies, significant recent work has highlighted an expanded diversity and host range of chlamydial pathogens in animals. New and unexpected cases of chlamydial zoonoses have now been recently documented in Australia and elsewhere, emphasising the importance of multi-disciplinary ‘One Health' collaboration and the use of standardised methods to detect and characterise chlamydial pathogens in humans and animals.
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35
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Jones B, Taylor K, Lucas RM, Merritt T, Chicken C, Heller J, Carrick J, Givney R, Durrheim DN. Challenges in using serological methods to explore historical transmission risk of Chlamydia psittaci in a workforce with high exposure to equine chlamydiosis. ACTA ACUST UNITED AC 2019; 43. [PMID: 31838983 DOI: 10.33321/cdi.2019.43.65] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Introduction This report describes the challenges encountered in using serological methods to study the historical transmission risk of C. psittaci from horses to humans. Methods In 2017, serology and risk factor questionnaire data from a group of individuals, whose occupations involved close contact with horses, were collected to assess the seroprevalence of antibodies to C. psittaci and identify risk factors associated with previous exposure. Results 147 participants were enrolled in the study, provided blood samples, and completed a questionnaire. On ELISA testing, antibodies to the Chlamydia genus were detected in samples from 17 participants but further specific species-specific MIF testing did not detect C. psittaci-specific antibodies in any of these samples. Conclusion No serological evidence of past C. psittaci transmission from horses to humans was found in this study cohort. There are major challenges in using serological methods to determine the prevalence of C. psittaci exposure.
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Affiliation(s)
- Belinda Jones
- Health Protection, Hunter New England Health, Wallsend, NSW; National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT
| | - Kathryn Taylor
- Health Protection, Hunter New England Health, Wallsend, NSW
| | - Robyn M Lucas
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT
| | - Tony Merritt
- Health Protection, Hunter New England Health, Wallsend, NSW
| | | | - Jane Heller
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW
| | | | | | - David N Durrheim
- Health Protection, Hunter New England Health, Wallsend, NSW; School of Medicine and Public Health, University of Newcastle, NSW
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Lin W, Chen T, Liao L, Wang Z, Xiao J, Lu J, Song C, Qin J, Chen F, Chang YF, Xie Q. A parrot-type Chlamydia psittaci strain is in association with egg production drop in laying ducks. Transbound Emerg Dis 2019; 66:2002-2010. [PMID: 31127977 DOI: 10.1111/tbed.13248] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 05/10/2019] [Accepted: 05/20/2019] [Indexed: 01/27/2023]
Abstract
Chlamydophila psittaci (C. psittaci) is an avian pathogen associated with systemic wasting disease in birds, as well as a public health risk. Although duck-related cases of psittacosis have been reported, the pathogenicity and shedding status of C. psittaci in ducks are unclear. In this study, we reported that C. psittaci (genotype A) is responsible for a disease outbreak characterized by poor laying performance and severe lesions in multiple organs of ducks. Oral administration of antibiotic, doxycycline, was found to effectively control the C. psittaci infection in laying ducks. Collectively, our new findings provide evidence that C. psittaci was the major pathogen responsible for the outbreak of this disease in ducks. In order to reduce economic losses incurred by this disease, effective control measures must be taken to prevent infection in laying duck farms.
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Affiliation(s)
- Wencheng Lin
- Guangdong Provincial Animal Virus Vector Vaccine Engineering Technology Research Center, College of Animal Science, South China Agricultural University, Guangzhou, China.,Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York
| | - Tong Chen
- Guangdong Provincial Animal Virus Vector Vaccine Engineering Technology Research Center, College of Animal Science, South China Agricultural University, Guangzhou, China.,Wen's Group Academy, Wen's Foodstuffs Group Co., Ltd., Xinxing, China
| | - Liqin Liao
- Guangdong Provincial Animal Virus Vector Vaccine Engineering Technology Research Center, College of Animal Science, South China Agricultural University, Guangzhou, China
| | - Zhanxin Wang
- Wen's Group Academy, Wen's Foodstuffs Group Co., Ltd., Xinxing, China
| | - Junfang Xiao
- Guangdong Provincial Animal Virus Vector Vaccine Engineering Technology Research Center, College of Animal Science, South China Agricultural University, Guangzhou, China
| | - Junpeng Lu
- Wen's Group Academy, Wen's Foodstuffs Group Co., Ltd., Xinxing, China
| | - Chuncheng Song
- Wen's Group Academy, Wen's Foodstuffs Group Co., Ltd., Xinxing, China
| | - Jianping Qin
- Wen's Group Academy, Wen's Foodstuffs Group Co., Ltd., Xinxing, China
| | - Feng Chen
- Guangdong Provincial Animal Virus Vector Vaccine Engineering Technology Research Center, College of Animal Science, South China Agricultural University, Guangzhou, China.,Wen's Group Academy, Wen's Foodstuffs Group Co., Ltd., Xinxing, China
| | - Yung-Fu Chang
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York
| | - Qingmei Xie
- Guangdong Provincial Animal Virus Vector Vaccine Engineering Technology Research Center, College of Animal Science, South China Agricultural University, Guangzhou, China
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37
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Difficulties in Diagnosis of Psittacosis or Ornithosis: A Case Report. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2019. [DOI: 10.5812/archcid.65779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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38
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Bommana S, Polkinghorne A. Mini Review: Antimicrobial Control of Chlamydial Infections in Animals: Current Practices and Issues. Front Microbiol 2019; 10:113. [PMID: 30778341 PMCID: PMC6369208 DOI: 10.3389/fmicb.2019.00113] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 01/18/2019] [Indexed: 12/29/2022] Open
Abstract
Chlamydia are a genus of successful obligate intracellular pathogens spread across humans, wildlife, and domesticated animals. The most common species reported in livestock in this genus are Chlamydia abortus, Chlamydia psittaci, Chlamydia suis, and Chlamydia pecorum. Chlamydial infections trigger a series of inflammatory disease-related sequelae including arthritis, conjunctivitis, pneumonia, and abortion. Other bacteria in the phylum Chlamydiae have also been reported in livestock and wildlife but their impact on animal health is less clear. Control of chlamydial infections relies on the use of macrolides, fluoroquinolones, and tetracyclines. Tetracycline resistance (TETR) reported for porcine C. suis strains in association with the use of tetracycline feed is a potentially significant concern given experimental evidence highlighting that the genetic elements inferring TETR may be horizontally transferred to other chlamydial species. As documented in human Chlamydia trachomatis infections, relapse of infections, bacterial shedding post-antibiotic treatment, and disease progression despite chlamydial clearance in animals have also been reported. The identification of novel chlamydiae as well as new animal hosts for previously described chlamydial pathogens should place a renewed emphasis on basic in vivo studies to demonstrate the efficacy of existing and new antimicrobial treatment regimes. Building on recent reviews of antimicrobials limited to C. trachomatis and C. suis, this review will explore the use of antimicrobials, the evidence and factors that influence the treatment failure of chlamydial infections in animals and the future directions in the control of these important veterinary pathogens.
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Affiliation(s)
- Sankhya Bommana
- The Animal Research Centre, University of the Sunshine Coast, Sippy Downs, QLD, Australia
| | - Adam Polkinghorne
- The Animal Research Centre, University of the Sunshine Coast, Sippy Downs, QLD, Australia
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Antimicrobial Resistance in Chlamydiales, Rickettsia, Coxiella, and Other Intracellular Pathogens. Microbiol Spectr 2018; 6. [PMID: 29651977 DOI: 10.1128/microbiolspec.arba-0003-2017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
This article will provide current insights into antimicrobial susceptibilities and resistance of an important group of bacterial pathogens that are not phylogenetically related but share lifestyle similarities in that they are generally considered to be obligate intracellular microbes. As such, there are shared challenges regarding methods for their detection and subsequent clinical management. Similarly, from the laboratory perspective, susceptibility testing is rarely undertaken, though molecular approaches might provide new insights. One should also bear in mind that the highly specialized microbial lifestyle restricts the opportunity for lateral gene transfer and, consequently, acquisition of resistance.
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40
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Mair-Jenkins J, Lamming T, Dziadosz A, Flecknoe D, Stubington T, Mentasti M, Muir P, Monk P. A Psittacosis Outbreak among English Office Workers with Little or No Contact with Birds, August 2015. PLOS CURRENTS 2018; 10. [PMID: 29854568 PMCID: PMC5951689 DOI: 10.1371/currents.outbreaks.b646c3bb2b4f0e3397183f31823bbca6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Introduction On 14th August 2015 an office manager informed Public Health England of five employees known to have been diagnosed with pneumonia over the previous three weeks. We investigated to establish whether an outbreak occurred and to identify and control the source of infection. Methods We undertook case finding for self-reported pneumonia cases at local businesses (July-August 2015). Clinical samples from a hospitalised case were tested for common respiratory pathogens, but returned negative results. Further testing confirmed Chlamydia psittaci infection in this case (serology and PCR). We subsequently undertook C. psittaci testing for all cases, redefining them as confirmed (C. psittaci PCR or high antibody titre via serology) or probable (inconclusive C. psittaci serology). Twenty-eight day exposure histories informed descriptive epidemiological analysis. We conducted an environmental investigation at the office to identify potential sources of exposure. Results We identified six office workers with pneumonia; four met case definitions (three confirmed, one probable) with symptom onset between 29th July and 4th August 2015. Workplace was the only epidemiological link and only one case reported limited, indirect bird contact. Environmental investigations identified pigeons roosting near the office which were being fed by workers (none cases). Discussion This was a probable outbreak of psittacosis with no direct bird-to-human contact reported. Cases recovered after receiving appropriate antibiotics. Feeding of pigeons was stopped. A deep clean of office ventilation systems was conducted and workers were advised to avoid bird contact. We hypothesised that indirect environmental exposure to infected pigeons was to the source of this outbreak. This work provides evidence that health professionals should consider psittacosis in the differential diagnosis of cases of severe or atypical respiratory illness even without overt bird contact.
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Affiliation(s)
- John Mair-Jenkins
- Field Epidemiology Training Programme, Public Health England, Nottingham, United Kingdom; European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden; Field Epidemiology Service, National Infection Service, Public Health England, Nottingham, United Kingdom
| | - Tracey Lamming
- Public Health England East Midlands, Nottingham, United Kingdom
| | - Andy Dziadosz
- Environmental Health, Ashfield District Council, United Kingdom, United Kingdom
| | - Daniel Flecknoe
- Public Health England East Midlands, Nottingham, United Kingdom
| | | | - Massimo Mentasti
- Bacteriology Reference Department, Respiratory and Vaccine Preventable Bacteria Reference Unit, Public Health England, London, United Kingdom
| | - Peter Muir
- Public Health Laboratory Bristol, National Infection Service, Public Health England, Bristol, United Kingdom
| | - Philip Monk
- Public Health England East Midlands, Nottingham, United Kingdom
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41
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Balsamo G, Maxted AM, Midla JW, Murphy JM, Wohrle R, Edling TM, Fish PH, Flammer K, Hyde D, Kutty PK, Kobayashi M, Helm B, Oiulfstad B, Ritchie BW, Stobierski MG, Ehnert K, Tully TN. Compendium of Measures to ControlChlamydia psittaciInfection Among Humans (Psittacosis) and Pet Birds (Avian Chlamydiosis), 2017. J Avian Med Surg 2017; 31:262-282. [DOI: 10.1647/217-265] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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42
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Scheftel JM, Elchos BL, Rubin CS, Decker JA. Review of hazards to female reproductive health in veterinary practice. J Am Vet Med Assoc 2017; 250:862-872. [PMID: 28358639 PMCID: PMC5678953 DOI: 10.2460/javma.250.8.862] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To review publications that address female reproductive health hazards in veterinary practice, summarize best practices to mitigate reproductive risks, and identify current knowledge gaps. DESIGN Systematized review. SAMPLE English-language articles describing chemical, biological, and physical hazards present in the veterinary workplace and associations with adverse reproductive outcomes or recommendations for minimizing risks to female reproductive health. PROCEDURES Searches of the CAB abstracts database were performed in July 2012 and in May 2015 with the following search terms: veterinarians AND occupational hazards and vets.id AND occupational hazards.sh. Searches of the PubMed database were conducted in November 2012 and in May 2015 with the following medical subject heading terms: occupational exposure AND veterinarians; anesthetics, inhalation/adverse effects AND veterinarians; risk factors AND pregnancy AND veterinarians; pregnancy outcome AND veterinarians; and animal technicians AND occupational exposure. Two additional PubMed searches were completed in January 2016 with the terms disinfectants/toxicity AND female AND fertility/drug effects and veterinarians/psychology AND stress, psychological. No date limits were applied to searches. RESULTS 4 sources supporting demographic trends in veterinary medicine and 118 resources reporting potential hazards to female reproductive health were identified. Reported hazards included exposure to anesthetic gases, radiation, antineoplastic drugs, and reproductive hormones; physically demanding work; prolonged standing; and zoonoses. CONCLUSIONS AND CLINICAL RELEVANCE Demographic information suggested that an increasing number of women of reproductive age will be exposed to chemical, biological, and physical hazards in veterinary practice. Information on reproductive health hazards and minimizing risk, with emphasis on developing a safety-focused work culture for all personnel, should be discussed starting in veterinary and veterinary technical schools and integrated into employee training.
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43
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Chan J, Doyle B, Branley J, Sheppeard V, Gabor M, Viney K, Quinn H, Janover O, McCready M, Heller J. An outbreak of psittacosis at a veterinary school demonstrating a novel source of infection. One Health 2017; 3:29-33. [PMID: 28616500 PMCID: PMC5454149 DOI: 10.1016/j.onehlt.2017.02.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 02/13/2017] [Accepted: 02/22/2017] [Indexed: 11/27/2022] Open
Abstract
In November 2014, New South Wales Health was notified of a cluster of respiratory illness in a veterinary school. Active case finding identified another case at a local equine stud. All cases had exposure to the equine fetal membranes of Mare A. This tissue subsequently tested positive for Chlamydia psittaci using quantitative real-time polymerase chain reaction. We conducted a cohort study of the university and stud farm staff to determine risk factors for disease. Nine people were exposed to the fetal membranes of Mare A. Of these, five cases of psittacosis were identified. Two required hospital admission. Contact with birds was not associated with illness (RR = 0.5, 95% CI = 0.09-2.73). People who had direct contact with the abnormal fetal membranes were more likely to develop disease (RR = 11.77, 95% CI = 1.02-∞). The emergence of an association between horse exposure and C. psittaci infection has important implications for the prevention and control of psittacosis. Article summary line: Investigation of an outbreak of psittacosis in a rural veterinary school demonstrates novel source of infection for psittacosis through exposure to abnormal equine fetal membranes.
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Affiliation(s)
- Jocelyn Chan
- Health Protection New South Wales (NSW), NSW Health, North Sydney, NSW, Australia.,National Centre for Epidemiology and Population Health (NCEPH), Australian National University, Canberra, Australian Capital Territory (ACT), Australia
| | - Bridget Doyle
- Public Health Unit, Murrumbidgee Local Health District, Albury, NSW, Australia
| | | | - Vicky Sheppeard
- Health Protection New South Wales (NSW), NSW Health, North Sydney, NSW, Australia
| | - Melinda Gabor
- State Veterinary Diagnostic Laboratory, Department of Primary Industry, Menangle, NSW, Australia
| | - Kerri Viney
- National Centre for Epidemiology and Population Health (NCEPH), Australian National University, Canberra, Australian Capital Territory (ACT), Australia
| | - Helen Quinn
- National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS), The Children's Hospital at Westmead, Sydney, NSW, Australia.,Discipline of Paediatrics and Child Health, University of Sydney, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Orly Janover
- Public Health Unit, Murrumbidgee Local Health District, Albury, NSW, Australia
| | | | - Jane Heller
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia
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Australian human and parrot Chlamydia psittaci strains cluster within the highly virulent 6BC clade of this important zoonotic pathogen. Sci Rep 2016; 6:30019. [PMID: 27488134 PMCID: PMC4973220 DOI: 10.1038/srep30019] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 06/27/2016] [Indexed: 12/02/2022] Open
Abstract
Chlamydia psittaci is an avian pathogen and zoonotic agent of atypical pneumonia. The most pathogenic C. psittaci strains cluster into the 6BC clade, predicted to have recently emerged globally. Exposure to infected parrots is a risk factor with limited evidence also of an indirect exposure risk. Genome sequencing was performed on six Australian human and a single avian C. psittaci strain isolated over a 9 year period. Only one of the five human patients had explicit psittacine contact. Genomics analyses revealed that the Australian C. psittaci strains are remarkably similar, clustering tightly within the C. psittaci 6BC clade suggested to have been disseminated by South America parrot importation. Molecular clock analysis using the newly sequenced C. psittaci genomes predicted the emergence of the 6BC clade occurring approximately 2,000 years ago. These findings reveal the potential for an Australian natural reservoir of C. psittaci 6BC strains. These strains can also be isolated from seriously ill patients without explicit psittacine contact. The apparent recent and global spread of C. psittaci 6BC strains raises important questions over how this happened. Further studies may reveal whether the dissemination of this important zoonotic pathogen is linked to Australian parrot importation rather than parrots from elsewhere.
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45
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[Headache, fever and myalgia: Atypical pneumonia caused by Chlamydia psittaci]. Semergen 2015; 42:338-40. [PMID: 26163871 DOI: 10.1016/j.semerg.2015.05.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 05/29/2014] [Indexed: 11/24/2022]
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46
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Laroucau K, Aaziz R, Meurice L, Servas V, Chossat I, Royer H, de Barbeyrac B, Vaillant V, Moyen JL, Meziani F, Sachse K, Rolland P. Outbreak of psittacosis in a group of women exposed to Chlamydia psittaci-infected chickens. ACTA ACUST UNITED AC 2015; 20. [PMID: 26111240 DOI: 10.2807/1560-7917.es2015.20.24.21155] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Eight cases of psittacosis due to Chlamydia psittaci were identified in May 2013 among 15 individuals involved in chicken gutting activities on a mixed poultry farm in France. All cases were women between 42 and 67 years-old. Cases were diagnosed by serology and PCR of respiratory samples. Appropriate treatment was immediately administered to the eight hospitalised individuals after exposure to birds had been discovered. In the chicken flocks, mainly C. gallinacea was detected, a new member of the family Chlamydiaceae, whereas the ducks were found to harbour predominantly C. psittaci, the classical agent of psittacosis. In addition, C. psittaci was found in the same flock as the chickens that the patients had slaughtered. Both human and C. psittaci-positive avian samples carried the same ompA genotype E/B of C. psittaci, which is widespread among French duck flocks. Repeated grassland rotations between duck and chicken flocks on the farm may explain the presence of C. psittaci in the chickens. Inspection by the veterinary service led to temporary closure of the farm. All birds had to be euthanised on site as no slaughterhouses accepted processing them. Farm buildings and grasslands were cleaned and/or disinfected before the introduction of new poultry birds.
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Affiliation(s)
- K Laroucau
- Anses, Laboratoire de Sante Animale, Unite Zoonoses Bacteriennes, Laboratoire National de Reference pour la Chlamydiose Aviaire, Maisons-Alfort, France
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47
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Mojica SA, Hovis KM, Frieman MB, Tran B, Hsia RC, Ravel J, Jenkins-Houk C, Wilson KL, Bavoil PM. SINC, a type III secreted protein of Chlamydia psittaci, targets the inner nuclear membrane of infected cells and uninfected neighbors. Mol Biol Cell 2015; 26:1918-34. [PMID: 25788290 PMCID: PMC4436835 DOI: 10.1091/mbc.e14-11-1530] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 03/06/2015] [Indexed: 12/31/2022] Open
Abstract
SINC, a new type III secreted protein of the avian and human pathogen Chlamydia psittaci, uniquely targets the nuclear envelope of C. psittaci-infected cells and uninfected neighboring cells. Digitonin-permeabilization studies of SINC-GFP-transfected HeLa cells indicate that SINC targets the inner nuclear membrane. SINC localization at the nuclear envelope was blocked by importazole, confirming SINC import into the nucleus. Candidate partners were identified by proximity to biotin ligase-fused SINC in HEK293 cells and mass spectrometry (BioID). This strategy identified 22 candidates with high confidence, including the nucleoporin ELYS, lamin B1, and four proteins (emerin, MAN1, LAP1, and LBR) of the inner nuclear membrane, suggesting that SINC interacts with host proteins that control nuclear structure, signaling, chromatin organization, and gene silencing. GFP-SINC association with the native LEM-domain protein emerin, a conserved component of nuclear "lamina" structure, or with a complex containing emerin was confirmed by GFP pull down. Our findings identify SINC as a novel bacterial protein that targets the nuclear envelope with the capability of globally altering nuclear envelope functions in the infected host cell and neighboring uninfected cells. These properties may contribute to the aggressive virulence of C. psittaci.
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Affiliation(s)
- Sergio A Mojica
- Department of Microbial Pathogenesis, University of Maryland School of Dentistry, Baltimore, MD 21201
| | - Kelley M Hovis
- Department of Microbial Pathogenesis, University of Maryland School of Dentistry, Baltimore, MD 21201
| | - Matthew B Frieman
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD 20201
| | - Bao Tran
- Mass Spectrometry Center, University of Maryland School of Pharmacy, Baltimore, MD 21201
| | - Ru-ching Hsia
- Core Imaging Facility and Department of Neural and Pain Sciences, University of Maryland School of Dentistry, Baltimore, MD 21201
| | - Jacques Ravel
- Institute for Genome Science, University of Maryland School of Medicine, Baltimore, MD 20201
| | - Clifton Jenkins-Houk
- Department of Cell Biology, Johns Hopkins University School of Medicine, Baltimore, MD 21205
| | - Katherine L Wilson
- Department of Cell Biology, Johns Hopkins University School of Medicine, Baltimore, MD 21205
| | - Patrik M Bavoil
- Department of Microbial Pathogenesis, University of Maryland School of Dentistry, Baltimore, MD 21201
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Knittler MR, Sachse K. Chlamydia psittaci: update on an underestimated zoonotic agent. Pathog Dis 2014; 73:1-15. [PMID: 25853998 DOI: 10.1093/femspd/ftu007] [Citation(s) in RCA: 139] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2014] [Indexed: 12/16/2022] Open
Abstract
Chlamydia (C.) psittaci is an economically relevant pathogen in poultry and pet birds, where it causes psittacosis/ornithosis, and also a human pathogen causing atypical pneumonia after zoonotic transmission. Despite its well-documented prevalence, the agent has received less attention by researchers than other Chlamydia spp. in the last decades. In the present paper, we review recently published data on C. psittaci infection and attempt to single out characteristic features distinguishing it from related chlamydial agents. It is remarkable that C. psittaci is particularly efficient in disseminating in the host organism causing systemic disease, which occasionally can take a fulminant course. At the cellular level, the pathogen's broad host cell spectrum (from epithelial cells to macrophages), its rapid entry and fast replication, proficient use of intracellular transport routes to mitochondria and the Golgi apparatus, the pronounced physical association of chlamydial inclusions with energy-providing cell compartments, as well as the subversive regulation of host cell survival during productive and persistent states facilitate the characteristic efficient growth and successful host-to-host spread of C. psittaci. At the molecular level, the pathogen was shown to upregulate essential chlamydial genes when facing the host immune response. We hypothesize that this capacity, in concert with expression of specific effectors of the type III secretion system and efficient suppression of selected host defense signals, contributes to successful establishment of the infection in the host. Concerning the immunology of host-pathogen interactions, C. psittaci has been shown to distinguish itself by coping more efficiently than other chlamydiae with pro-inflammatory mediators during early host response, which can, to some extent, explain the effective evasion and adaptation strategies of this bacterium. We conclude that thorough analysis of the large number of whole-genome sequences already available will be essential to identify genetic markers of the species-specific features and trigger more in-depth studies in cellular and animal models to address such vital topics as treatment and vaccination.
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Affiliation(s)
- Michael R Knittler
- Institute of Immunology, Friedrich-Loeffler-Institut, Isle of Riems, 07743 Jena, Germany
| | - Konrad Sachse
- Institute of Molecular Pathogenesis, Friedrich-Loeffler-Institut, 07743 Jena, Germany
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A novel psittacine adenovirus identified during an outbreak of avian chlamydiosis and human psittacosis: zoonosis associated with virus-bacterium coinfection in birds. PLoS Negl Trop Dis 2014; 8:e3318. [PMID: 25474263 PMCID: PMC4256287 DOI: 10.1371/journal.pntd.0003318] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 10/04/2014] [Indexed: 12/22/2022] Open
Abstract
Chlamydophila psittaci is found worldwide, but is particularly common among psittacine birds in tropical and subtropical regions. While investigating a human psittacosis outbreak that was associated with avian chlamydiosis in Hong Kong, we identified a novel adenovirus in epidemiologically linked Mealy Parrots, which was not present in healthy birds unrelated to the outbreak or in other animals. The novel adenovirus (tentatively named Psittacine adenovirus HKU1) was most closely related to Duck adenovirus A in the Atadenovirus genus. Sequencing showed that the Psittacine adenovirus HKU1 genome consists of 31,735 nucleotides. Comparative genome analysis showed that the Psittacine adenovirus HKU1 genome contains 23 open reading frames (ORFs) with sequence similarity to known adenoviral genes, and six additional ORFs at the 3' end of the genome. Similar to Duck adenovirus A, the novel adenovirus lacks LH1, LH2 and LH3, which distinguishes it from other viruses in the Atadenovirus genus. Notably, fiber-2 protein, which is present in Aviadenovirus but not Atadenovirus, is also present in Psittacine adenovirus HKU1. Psittacine adenovirus HKU1 had pairwise amino acid sequence identities of 50.3-54.0% for the DNA polymerase, 64.6-70.7% for the penton protein, and 66.1-74.0% for the hexon protein with other Atadenovirus. The C. psittaci bacterial load was positively correlated with adenovirus viral load in the lung. Immunostaining for fiber protein expression was positive in lung and liver tissue cells of affected parrots, confirming active viral replication. No other viruses were found. This is the first documentation of an adenovirus-C. psittaci co-infection in an avian species that was associated with a human outbreak of psittacosis. Viral-bacterial co-infection often increases disease severity in both humans and animals. The role of viral-bacterial co-infection in animal-to-human transmission of infectious agents has not received sufficient attention and should be emphasized in the investigation of disease outbreaks in human and animals.
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Wallensten A, Fredlund H, Runehagen A. Multiple human-to-human transmission from a severe case of psittacosis, Sweden, January-February 2013. ACTA ACUST UNITED AC 2014; 19. [PMID: 25358043 DOI: 10.2807/1560-7917.es2014.19.42.20937] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Proven transmission of Chlamydia psittaci between humans has been described on only one occasion previously. We describe an outbreak which occurred in Sweden in early 2013, where the epidemiological and serological investigation suggests that one patient, severely ill with psittacosis after exposure to wild bird droppings, transmitted the disease to ten others: Two family members, one hospital roommate and seven hospital caregivers. Three cases also provided respiratory samples that could be analysed by PCR. All the obtained C. psittaci sequences were indistinguishable and clustered within genotype A. The finding has implications for the management of severely ill patients with atypical pneumonia, because these patients may be more contagious than was previously thought. In order to prevent nosocomial person-to-person transmission of C. psittaci, stricter hygiene measures may need to be applied.
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