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Huang W, Wang F, Cai Q, Xu H, Hong D, Wu H, Zhou L, Hu L, Lu Y. Epidemiological and clinical characteristics of psittacosis among cases with complicated or atypical pulmonary infection using metagenomic next-generation sequencing: a multi-center observational study in China. Ann Clin Microbiol Antimicrob 2023; 22:80. [PMID: 37679777 PMCID: PMC10486088 DOI: 10.1186/s12941-023-00631-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/29/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND Chlamydia psittaci (C. psittaci) causes parrot fever in humans. Development of metagenomic next-generation sequencing (mNGS) enables the identification of C. psittaci. METHODS This study aimed to determine the epidemiological and clinical characteristics of parrot fever cases in China. A multi-center observational study was conducted in 44 tertiary and secondary hospitals across 14 provinces and municipalities between April 2019 and October 2021. RESULTS A total of 4545 patients with complicated or atypical pulmonary infection were included in the study, among which the prevalence of C. psittaci was determined to be 2.1% using mNGS. The prevalence of C. psittaci was further determined across demographic groups and types of specimens. It was significantly higher in patients with senior age (2.6% in those > 50 years), winter-spring (3.6%; particularly in December, January, and February), and southwestern (3.4%) and central and southern China (2.7%) (each P < 0.001). Moreover, the prevalence was the highest in bronchoalveolar lavage fluid (BALF) (2.9%), compared with sputum (1.1%) and peripheral blood specimens (0.9%). Additionally, co-infection of principal microorganisms was compared. Certain microorganisms were more likely to co-infect in parrot fever cases, such as Candida albicans in BALF (26.7%) and peripheral blood (6.3%), compared with non-parrot fever cases (19.7% and 1.3%); however, they did not significantly differ (each P > 0.05). CONCLUSION Parrot fever remains low in patients with complicated or atypical pulmonary infection. It is likely to occur in winter-spring and southwestern region in China. BALF may be the optimal specimen in the application of mNGS. Co-infection of multiple microorganisms should be further considered.
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Affiliation(s)
- Weifeng Huang
- Department of Intensive Care Medicine, The Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Fengge Wang
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
| | - Qingqing Cai
- Genoxor Medical Science and Technology Inc, Shanghai, China
| | - Huiliang Xu
- Department of Respiratory, Nanxiang Hospital of Jiading district, Shanghai, China
| | - Dengwei Hong
- Genoxor Medical Science and Technology Inc, Shanghai, China
| | - Han Wu
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety, Fudan University School of Public Health, Shanghai, China
| | - Lu Zhou
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety, Fudan University School of Public Health, Shanghai, China
| | - Linjie Hu
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety, Fudan University School of Public Health, Shanghai, China
| | - Yihan Lu
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety, Fudan University School of Public Health, Shanghai, China
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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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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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Salisch H, Von Malottki K, Ryll M, Hinz KH. Chlamydial infections of poultry and human health. WORLD POULTRY SCI J 2019. [DOI: 10.1079/wps19960021] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- H. Salisch
- Clinic for Poultry, Hannover School of Veterinary Medicine, Bünteweg 17, 30559 Hannover, Germany
| | - Kirstin Von Malottki
- Clinic for Poultry, Hannover School of Veterinary Medicine, Bünteweg 17, 30559 Hannover, Germany
| | - M. Ryll
- Clinic for Poultry, Hannover School of Veterinary Medicine, Bünteweg 17, 30559 Hannover, Germany
| | - K.-H. Hinz
- Clinic for Poultry, Hannover School of Veterinary Medicine, Bünteweg 17, 30559 Hannover, Germany
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Branley JM, Weston KM, England J, Dwyer DE, Sorrell TC. Clinical features of endemic community-acquired psittacosis. New Microbes New Infect 2014; 2:7-12. [PMID: 25356332 PMCID: PMC4184616 DOI: 10.1002/2052-2975.29] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 09/26/2013] [Accepted: 11/22/2013] [Indexed: 11/14/2022] Open
Abstract
Following a large outbreak of community-acquired psittacosis in 2002 in residents of the Blue Mountains, New South Wales, Australia, we reviewed new cases in this area over a 7-year period from 2003 to 2009. Using the 2010 criteria from the Centers for Disease Control National Notifiable Diseases Surveillance System, 85 patients with possible psittacosis were identified, of which 48 were identified as definite or probable infection. Clinical features of these cases are summarized. In addition to Chlamydia-specific serology, specimens, where available, underwent nucleic acid testing for chlamydial DNA using real-time PCR. Chlamydophila psittaci DNA was detected in samples from 23 patients. Four of 18 specimens were culture positive. This is the first description of endemic psittacosis, and is characterized in this location by community-acquired psittacosis resulting from inadvertent exposure to birds. The disease is likely to be under-diagnosed, and may often be mistaken for gastroenteritis or meningitis given the frequency of non-respiratory symptoms, particularly without a history of contact with birds. Clinical characteristics of endemic and outbreak-associated cases were similar. The nature of exposure, risk factors and reasons for the occurrence of outbreaks of psittacosis require further investigation.
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Affiliation(s)
- J M Branley
- Nepean Hospital Penrith, New South Wales, 2751, Australia ; University of Sydney New South Wales, 2006, Australia ; Blue Mountains Anzac Memorial Hospital Katoomba, New South Wales, 2780, Australia
| | - K M Weston
- Centre for Population Health, Nepean and Blue Mountains Local Health District Penrith, New South Wales, 2751, Australia ; Graduate School of Medicine, University of Wollongong New South Wales, 2522, Australia
| | - J England
- Blue Mountains Anzac Memorial Hospital Katoomba, New South Wales, 2780, Australia
| | - D E Dwyer
- Institute for Clinical Pathology and Medical Research, Westmead Hospital Westmead, New South Wales, 2145, Australia ; Sydney Emerging Infections and Biosecurity Institute, University of Sydney New South Wales, 2006, Australia
| | - T C Sorrell
- Sydney Emerging Infections and Biosecurity Institute, University of Sydney New South Wales, 2006, Australia ; Centre for Infectious Diseases and Microbiology and Westmead Millennium Institute Westmead, New South Wales, 2145, Australia
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Variable association between Chlamydophila psittaci infection and ocular adnexal lymphomas: methodological biases or true geographical variations? Anticancer Drugs 2008; 19:761-5. [DOI: 10.1097/cad.0b013e32830b58c4] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Bourke SJ, Carrington D, Frew CE, McSharry CP, Boyd G. A comparison of the seroepidemiology of chlamydial infection in pigeon fanciers and farmers in the U.K. J Infect 1992; 25 Suppl 1:91-8. [PMID: 1522344 DOI: 10.1016/0163-4453(92)92192-l] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A detailed comparative seroepidemiological study of antibody responses was performed in 271 pigeon fanciers and 100 farmers. Overall 73% of pigeon fanciers had IgG antibodies at a titre greater than or equal to 16 to Chlamydia pneumoniae, 39% to Chlamydia psittaci, and 6.6% to Chlamydia trachomatis. The prevalence of chlamydial antibodies was significantly lower in the farmers at 47% for C. pneumoniae, 6% for C. psittaci, and 2% for C. trachomatis. Both populations were exposed to complex microbiological and antigenic environments: 50.5% of the pigeon fanciers had antibodies to pigeon antigens, 34% to egg membrane, and 0.73% to yolk sac antigen, and 59% of the farmers had antibodies to Micropolyspora faeni, but the high prevalence of chlamydial antibodies could not be attributed to interaction with these antigens. There was considerable overlap of chlamydial antibody responses in the pigeon fanciers but not in the farmers: 36% of the pigeon fanciers had antibodies to C. pneumoniae alone, 5% to C. psittaci alone, and 31% to both agents, whereas only 3% of farmers had antibodies to both C. pneumoniae and C. psittaci. The high prevalence of antibodies to C. psittaci in the pigeon fanciers is compatible with the known avian reservoir for this infection. The particularly high prevalence of antibodies to C. pneumoniae suggests that complex interactions may be occurring in a population exposed to two chlamydial organisms, whereby infection with one species may provoke an anamnestic response against other chlamydial organisms with which the subject has previously been infected.
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Affiliation(s)
- S J Bourke
- Department of Respiratory Medicine, Freeman Hospital, Newcastle upon Tyne, UK
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Abstract
The records of the Public Health Laboratory at Leeds were searched and cases in which a four-fold rise of antibodies to Chlamydia psittaci had occurred were reviewed. Clinical and epidemiological features of these cases are presented. The importance of birds as a potential source of infection is emphasised.
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Affiliation(s)
- B A Crosse
- Department of Infectious Diseases, Seacroft Hospital, Leeds, U.K
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