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Lu R, Luo J, Lin F, Han D, Chen G, Li W, Li S, Liu B, Li H, Song C, Cui Y, Zeng Y, Li Y, Pan P. Comparison of clinical, laboratory and radiological characteristics between COVID-19 and Chlamydia psittaci pneumonia: a multicenter retrospective study. Sci Rep 2024; 14:23790. [PMID: 39394412 PMCID: PMC11470005 DOI: 10.1038/s41598-024-74708-7] [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: 12/07/2023] [Accepted: 09/27/2024] [Indexed: 10/13/2024] Open
Abstract
Chlamydia psittaci pneumonia (CPP) exhibits similar characteristics as of COVID-19 with respect to clustering outbreaks and onset symptoms. This study is aimed at exploring the different clinical manifestations of both pneumonias to establish a simple nomogram to distinguish them. This multicenter, retrospective, case-control study compared two independent cohorts of patients with CPP or COVID-19. The risk factors of CPP were analyzed using multivariate logistic regression, which was used to establish the nomogram. Both patients with CPP and COVID-19 exhibited similar clinical symptoms. As compared to patients with COVID-19, a higher proportion of patients with CPP had nervous system symptoms. Patients with CPP had higher inflammatory indicators, creatine kinase, and lower lymphocyte and albumin. They also had lower proportions of ground-glass opacity and bilateral lung involvement than COVID-19 patients. Furthermore, patients with CPP had higher 30 day mortality as well as higher rates of severe pneumonia, septic shock, and ICU admission. Multivariate logistic regression showed that nervous system symptoms, lymphocytes, creatine kinase, bilateral lung lesions, and ground-glass opacity were risk factors for CPP. Incorporating these five factors, the nomogram achieved good concordance index of 0.989 in differentiating CPP from COVID-19, and had well-fitted calibration curves. Despite similar clinical characteristics, nervous system symptoms, lymphocyte, creatine kinase, lesions in bilateral lungs, and ground-glass opacity may help in differentiating the pneumonias. These were combined into a clinically useful nomogram for rapid and early identification of CPP to avoid misdiagnosis and help in the decision-making process.
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Affiliation(s)
- 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, 410008, 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
| | - Jiefeng Luo
- Department of Gynecology and Obstetrics, Xiangya Hospital Central South University, Changsha, 410008, China
- International Collaborative Research Center for Medical Metabolomics, Xiangya Hospital Central South University, Changsha, 410008, 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, 410008, 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
| | - Duoduo Han
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, 410008, 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, 410008, 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, 410008, 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
| | - Yanhui Cui
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, 410008, 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
| | - Yanjun Zeng
- Department of Geriatric Medicine, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - 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, 410008, 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, 410008, 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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Ko JCK, Choi YWY, Poon ESK, Wyre N, Go JLL, Poon LLM, Sin SYW. Prevalence and genotypes of Chlamydia psittaci in pet birds of Hong Kong. PLoS One 2024; 19:e0306528. [PMID: 39241026 PMCID: PMC11379223 DOI: 10.1371/journal.pone.0306528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 06/19/2024] [Indexed: 09/08/2024] Open
Abstract
Psittacosis, or parrot fever, is a zoonotic disease caused by Chlamydia species associated with birds. One of the causative agents of the disease is Chlamydia psittaci, which is commonly carried by psittacine and other bird species, can be highly pathogenic and virulent to humans. In Hong Kong, a city with high population density, psittacosis is a notifiable disease with over 60% of cases in the last decade resulting in hospitalization. However, the sources of transmission of C. psittaci and its prevalence in pet birds in Hong Kong are currently unknown. To evaluate the risks of psittacosis transmission through pet birds, we tested the presence of C. psittaci and determined its genotypes in samples obtained from 516 captive birds from households, pet shops, and a veterinary hospital in Hong Kong. Results revealed that five samples (0.97%), collected from budgerigars and cockatiels, were C. psittaci-positive, while four (80%) of them were obtained from pet shops. Our phylogenetic analysis revealed that all identified strains belonged to Genotype A and showed high similarity to other sequences of this genotype obtained from various geographical locations and host species, including mammals. Our findings provide evidence for the presence of Chlamydia psittaci and shed light on its sources in captive birds in Hong Kong. They highlight the potential zoonotic risks associated with this pathogen, which can affect both humans and wild birds.
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Affiliation(s)
- Jackie Cheuk Kei Ko
- School of Biological Sciences, The University of Hong Kong, Pok Fu Lam Road, Hong Kong, China
| | - Yannes Wai Yan Choi
- School of Biological Sciences, The University of Hong Kong, Pok Fu Lam Road, Hong Kong, China
| | - Emily Shui Kei Poon
- School of Biological Sciences, The University of Hong Kong, Pok Fu Lam Road, Hong Kong, China
| | - Nicole Wyre
- Zodiac Pet & Exotic Hospital, Shop 101A to 103A, 1/F, Victoria Centre, 15 Watson Road, Fortress Hill, Hong Kong, China
| | - Jennifer Le Lin Go
- Centre for Comparative Medicine Research, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong, China
| | - Leo Lit Man Poon
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Simon Yung Wa Sin
- School of Biological Sciences, The University of Hong Kong, Pok Fu Lam Road, Hong Kong, China
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Häcker G. Chlamydia in pigs: intriguing bacteria associated with sub-clinical carriage and clinical disease, and with zoonotic potential. Front Cell Dev Biol 2024; 12:1301892. [PMID: 39206090 PMCID: PMC11349706 DOI: 10.3389/fcell.2024.1301892] [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: 09/25/2023] [Accepted: 06/17/2024] [Indexed: 09/04/2024] Open
Abstract
Chlamydiae are bacteria that are intriguing and important at the same time. The genus Chlamydia encompasses many species of obligate intracellular organisms: they can multiply only inside the cells of their host organism. Many, perhaps most animals have their own specifically adapted chlamydial species. In humans, the clinically most relevant species is Chlamydia trachomatis, which has particular importance as an agent of sexually transmitted disease. Pigs are the natural host of Chlamydia suis but may also carry Chlamydia abortus and Chlamydia pecorum. C. abortus and possibly C. suis have anthropozoonotic potential, which makes them interesting to human medicine, but all three species bring a substantial burden of disease to pigs. The recent availability of genomic sequence comparisons suggests adaptation of chlamydial species to their respective hosts. In cell biological terms, many aspects of all the species seem similar but non-identical: the bacteria mostly replicate within epithelial cells; they are taken up by the host cell in an endosome that they customize to generate a cytosolic vacuole; they have to evade cellular defences and have to organize nutrient transport to the vacuole; finally, they have to organize their release to be able to infect the next cell or the next host. What appears to be very difficult and challenging to achieve, is in fact a greatly successful style of parasitism. I will here attempt to cover some of the aspects of the infection biology of Chlamydia, from cell biology to immune defence, epidemiology and possibilities of prevention. I will discuss the pig as a host species and the species known to infect pigs but will in particular draw on the more detailed knowledge that we have on species that infect especially humans.
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Affiliation(s)
- Georg Häcker
- Institute of Medical Microbiology and Hygiene, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- BIOSS Centre for Biological Signalling Studies, University of Freiburg, Freiburg, Germany
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Riccio MB, García JP, Chiapparrone ML, Cantón J, Cacciato C, Origlia JA, Cadario ME, Diab SS, Uzal FA. Outbreak of Chlamydia psittaci Infection in a Commercial Psittacine Breeding Aviary in Argentina. Animals (Basel) 2024; 14:1959. [PMID: 38998071 PMCID: PMC11240451 DOI: 10.3390/ani14131959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 06/27/2024] [Accepted: 06/28/2024] [Indexed: 07/14/2024] Open
Abstract
Chlamydiosis, caused by Chlamydia psittaci is a bacterial infection found in at least 465 species of birds worldwide. It is highly contagious among birds and can spread to humans. In birds, the disease can manifest itself in acute, subacute, and chronic forms with signs including anorexia, diarrhea, lethargy, weight loss, or, occasionally, mucopurulent or serous oculonasal discharge. This article describes an outbreak of chlamydiosis that occurred in a commercial psittacine breeding aviary in 2021 in Buenos Aires province, Argentina. In total, 16 juvenile blue-fronted parrots, more than 60 blue-fronted parrot chicks, and 2 adult macaws died during the outbreak. In all cases, clinical signs were weight loss, diarrhea, yellowish green excrement, and respiratory distress. The necropsy of four juvenile blue-fronted parrots, two blue-fronted parrot chicks, and two adult macaws revealed cachexia, hepatomegaly, splenomegaly, splenic petechial hemorrhages, ascites, pulmonary edema, and hydropericardium. Histologically, multifocal lymphoplasmacytic and heterophilic airsaculitis, multifocal lymphoplasmacytic and necrotizing hepatitis with intracytoplasmic elementary bodies, multifocal necro-heterophilic hepatitis, multifocal lymphoplasmacytic nephritis, and diffuse heterophilic pneumonia were found. A presumptive diagnosis was established based on gross and microscopic lesions, and it was confirmed using immunohistochemistry and polymerase chain reactions. The sequencing and phylogenetic analysis of the ompA gene revealed genotype A and B of Chlamydia psittaci.
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Affiliation(s)
- María Belén Riccio
- Servicio de Diagnóstico Veterinario FCV Tandil, Facultad de Ciencias Veterinarias, Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil B7000GHG, Argentina;
| | - Jorge Pablo García
- Servicio de Diagnóstico Veterinario FCV Tandil, Facultad de Ciencias Veterinarias, Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil B7000GHG, Argentina;
| | - María Laura Chiapparrone
- Laboratorio de Microbiología Clínica y Experimental, Centro de Investigación Veterinaria de Tandil (CIVETAN) (UNCPBA-CICPBA-CONICET), Facultad de Ciencias Veterinarias, Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil B7000GHG, Argentina; (M.L.C.); (J.C.); (C.C.)
| | - Juliana Cantón
- Laboratorio de Microbiología Clínica y Experimental, Centro de Investigación Veterinaria de Tandil (CIVETAN) (UNCPBA-CICPBA-CONICET), Facultad de Ciencias Veterinarias, Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil B7000GHG, Argentina; (M.L.C.); (J.C.); (C.C.)
| | - Claudio Cacciato
- Laboratorio de Microbiología Clínica y Experimental, Centro de Investigación Veterinaria de Tandil (CIVETAN) (UNCPBA-CICPBA-CONICET), Facultad de Ciencias Veterinarias, Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil B7000GHG, Argentina; (M.L.C.); (J.C.); (C.C.)
| | - Javier Anibal Origlia
- Cátedra de Patología de Aves y Pilíferos, Facultad de Ciencias Veterinarias, Universidad Nacional de La Plata, La Plata B1900BVB, Argentina;
| | - María Estela Cadario
- INEI-ANLIS «Dr. Carlos G. Malbrán», Ciudad Autónoma de Buenos Aires, Buenos Aires B1282AFF, Argentina;
| | - Santiago Sain Diab
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA 24061, USA;
| | - Francisco Alejandro Uzal
- California Animal Health and Food Safety Laboratory, School of Veterinary Medicine, University of California Davis, San Bernardino, CA 92408, USA;
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Ospina-Pinto MC, Alves BF, Soares HS, Jesus Pena HF, Raso TF. Chlamydia gallinacea in Brazilian backyard chicken farms. Braz J Microbiol 2024; 55:2005-2011. [PMID: 38573540 PMCID: PMC11153411 DOI: 10.1007/s42770-024-01319-9] [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: 11/23/2023] [Accepted: 03/26/2024] [Indexed: 04/05/2024] Open
Abstract
Avian chlamydiosis is a bacterial infectious disease of birds, considered until recently caused only by Chlamydia psittaci, that now includes the newly described species C. buteonis, C. avium, and C. gallinacea, associated with several avian hosts. Since its recognition as a species in 2014 and having chickens as one of its main hosts, C. gallinacea has already been described in backyard poultry on all continents. The present study aimed to survey by molecular techniques the presence and species of Chlamydia spp. in backyard chickens from three states of the southern region of Brazil (Paraná-PR, Santa Catarina-SC, and Rio Grande do Sul-RS). DNA extracted from cloacal swab samples were tested by polymerase chain reaction (PCR) for different species of Chlamydia, namely Chlamydiaceae (23 S rRNA gene), C. psittaci (ompA gene), C. avium (enoA gene) and C. gallinacea (gidA and enoA genes). The 16 S rRNA gene was used for sequencing and phylogenetic analysis. A total of 582 backyard chicken samples were collected and grouped in 238 pools, from 134 properties in 59 municipalities. Chlamydiaceae was detected in 25.2% (60/238) of the samples, in 38.8% (52/134) of the properties and in 66.1% (39/59) of the municipalities. None of the samples yielded positive PCR results for C. psittaci or C. avium. For C. gallinacea, the overall percentage was 16.3% (39/238) according to the results of gidA and enoA genes. Sequence analysis confirmed that the samples corresponded to C. gallinacea. This is the first report of C. gallinacea in Brazil.
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Affiliation(s)
- Maria Catalina Ospina-Pinto
- Laboratório de Ecopatologia de Aves, Departamento de Patologia, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, Av. Prof. Dr. Orlando Marques de Paiva, 87, São Paulo, SP, 05508-270, Brasil
| | - Bruna Farias Alves
- Laboratório de Doenças Parasitárias, Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, Av. Prof. Dr. Orlando Marques de Paiva, 87, São Paulo, SP, 05508-270, Brasil
| | - Herbert Sousa Soares
- Laboratório de Doenças Parasitárias, Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, Av. Prof. Dr. Orlando Marques de Paiva, 87, São Paulo, SP, 05508-270, Brasil
| | - Hilda Fátima Jesus Pena
- Laboratório de Doenças Parasitárias, Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, Av. Prof. Dr. Orlando Marques de Paiva, 87, São Paulo, SP, 05508-270, Brasil
| | - Tânia Freitas Raso
- Laboratório de Ecopatologia de Aves, Departamento de Patologia, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, Av. Prof. Dr. Orlando Marques de Paiva, 87, São Paulo, SP, 05508-270, Brasil.
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Chatterjee R, Setty SRG, Chakravortty D. SNAREs: a double-edged sword for intravacuolar bacterial pathogens within host cells. Trends Microbiol 2024; 32:477-493. [PMID: 38040624 DOI: 10.1016/j.tim.2023.11.002] [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: 08/05/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 12/03/2023]
Abstract
In the tug-of-war between host and pathogen, both evolve to combat each other's defence arsenals. Intracellular phagosomal bacteria have developed strategies to modify the vacuolar niche to suit their requirements best. Conversely, the host tries to target the pathogen-containing vacuoles towards the degradative pathways. The host cells use a robust system through intracellular trafficking to maintain homeostasis inside the cellular milieu. In parallel, intracellular bacterial pathogens have coevolved with the host to harbour strategies to manipulate cellular pathways, organelles, and cargoes, facilitating the conversion of the phagosome into a modified pathogen-containing vacuole (PCV). Key molecular regulators of intracellular traffic, such as changes in the organelle (phospholipid) composition, recruitment of small GTPases and associated effectors, soluble N-ethylmaleimide-sensitive factor-activating protein receptors (SNAREs), etc., are hijacked to evade lysosomal degradation. Legionella, Salmonella, Coxiella, Chlamydia, Mycobacterium, and Brucella are examples of pathogens which diverge from the endocytic pathway by using effector-mediated mechanisms to overcome the challenges and establish their intracellular niches. These pathogens extensively utilise and modulate the end processes of secretory pathways, particularly SNAREs, in repurposing the PCV into specialised compartments resembling the host organelles within the secretory network; at the same time, they avoid being degraded by the host's cellular mechanisms. Here, we discuss the recent research advances on the host-pathogen interaction/crosstalk that involves host SNAREs, conserved cellular processes, and the ongoing host-pathogen defence mechanisms in the molecular arms race against each other. The current knowledge of SNAREs, and intravacuolar bacterial pathogen interactions, enables us to understand host cellular innate immune pathways, maintenance of homeostasis, and potential therapeutic strategies to combat ever-growing antimicrobial resistance.
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Affiliation(s)
- Ritika Chatterjee
- Department of Microbiology and Cell Biology, Division of Biological Sciences, Indian Institute of Science, Bangalore, Karnataka, India
| | - Subba Rao Gangi Setty
- Department of Microbiology and Cell Biology, Division of Biological Sciences, Indian Institute of Science, Bangalore, Karnataka, India.
| | - Dipshikha Chakravortty
- Department of Microbiology and Cell Biology, Division of Biological Sciences, Indian Institute of Science, Bangalore, Karnataka, India; Adjunct Faculty, Indian Institute of Science Research and Education, Thiruvananthapuram, Kerala, India.
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Vorimore F, Aaziz R, Al Qaysi L, Wernery U, Borel N, Sachse K, Laroucau K. Detection of a novel genotype of Chlamydia buteonis in falcons from the Emirates. Vet Microbiol 2024; 291:110027. [PMID: 38430716 DOI: 10.1016/j.vetmic.2024.110027] [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: 11/21/2023] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 03/05/2024]
Abstract
Chlamydiaceae are a family of obligate intracellular bacterial pathogens that affect both humans and animals. Recently, a new species named Chlamydia (C.) buteonis was isolated from hawks. In this study, we aimed to investigate the prevalence of Chlamydiaceae in 60 falcons that underwent a routine health check at a specialized clinic in Dubai, United Arab Emirates. Using real-time PCR, we analyzed cloacal and tracheal swabs from these birds and found that 39 of them tested positive for Chlamydiaceae. Subsequent real-time PCR assays specific for C. psittaci, C. abortus, C. avium, and C. gallinacea yielded negative results, while testing positive for C. buteonis. Analysis of ompA and MLST sequences indicated a highly conserved group of strains within this set of samples, but with sequences distinct from the C. buteonis RSHA reference strains and other C. buteonis strains isolated from hawks in the United States. Two strains were further isolated by cell culture and sequenced using whole-genome sequencing, confirming the clustering of these falcon strains within the C. buteonis species, but in a separate clade from the previously identified hawk strains. We also developed a SNP-based PCR-HRM assay to distinguish between these different genotypes. Overall, our findings suggest a high prevalence of C. buteonis in falcons in Dubai and highlight the importance of monitoring this pathogen in birds of prey.
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Affiliation(s)
- F Vorimore
- Anses, Animal Health Laboratory, Bacterial Zoonoses Unit, Maisons-Alfort, France; Anses, Identhypath, Maisons-Alfort, France
| | - R Aaziz
- Anses, Identhypath, Maisons-Alfort, France
| | - L Al Qaysi
- Lehbab Clinic, Dubai, United Arab Emirates
| | | | - N Borel
- Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - K Sachse
- RNA Bioinformatics and High-Throughput Analysis, Friedrich Schiller University, Jena, Germany
| | - K Laroucau
- Anses, Animal Health Laboratory, Bacterial Zoonoses Unit, Maisons-Alfort, France.
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Yuan L, Chen Q, Zhu XY, Lai LM, Zhao R, Liu Y. Evaluation of clinical characteristics and risk factors associated with Chlamydia psittaci infection based on metagenomic next-generation sequencing. BMC Microbiol 2024; 24:86. [PMID: 38481150 PMCID: PMC10935969 DOI: 10.1186/s12866-024-03236-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 02/26/2024] [Indexed: 03/17/2024] Open
Abstract
INTRODUCTION Psittacosis is a zoonosis caused by Chlamydia psittaci, the clinical manifestations of Psittacosis range from mild illness to fulminant severe pneumonia with multiple organ failure. This study aimed to evaluate the clinical characteristics of Chlamydia psittaci infection diagnosed based on metagenomic next-generation sequencing(mNGS), as well as the risk factors affecting the progress of Chlamydia psittaci infection, in order to improve the effect of therapeutics. METHODS We retrospectively analyzed the clinical data of patients infected with chlamydia psittaci in the First Affiliated Hospital of Nanchang University from January 2021 to December 2021. The patient's past medical history, clinical manifestations, laboratory examinations, chest CT results, treatment status, and prognosis data were collected. we also investigated both the pathogenic profile characteristics and the lower respiratory tract microbiota of patients with Chlamydia psittaci pneumonia using mNGS. RESULTS All cases of Chlamydia psittaci in our research have been confirmed by mNGS. Among 46 cases of Chlamydia psittaci pneumonia, Poultry exposure was reported in 35 cases. In severe cases of Chlamydia psittaci pneumonia, Neutrophils, Procalcitonin (PCT), Lactate Dehydrogenase (LDH), Hydroxybutyrate Dehydrogenase (HBDH), Creatine Kinase Isoenzymes-B (CK-MB) and D-Dimer levels were remarkably higher than that of non-severe cases, except for lymphocytes (all P < 0.05). Chest CT scans showed Bilateral (77.8%), multiple lobar lungs (85.2%), pleural effusions (44.4%) involvement in those suffering from severe Chlamydia psittaci pneumonia, whereas its incidence was 0%, 21.1% and 10.5% in non-severe patients, respectively (P < 0.05). Multivariate analysis revealed that higher lymphocyte concentrations (OR 0.836, 95% CI 0.714-0.962, P = 0.041) were the only protective factor for survival. mNGS results indicated that 41.3% of patients (19/46) had suspected coinfections with a coinfection rate of 84.2% (16/19) in the severe group, much higher than that in the non severe group (p < 0.05). No significantly different profiles of lower respiratory tract microbiota diversity were found between non severe group and severe group. CONCLUSION A history of poultry exposure in patients can serve as an important basis for diagnosing Chlamydia psittaci pneumonia, and patients with severe Chlamydia psittaci pneumonia are more likely to develop elevated inflammatory biomarkers as well as elevated cardiac markers. Higher lymphocyte concentrations are protective factors associated with severe C. psittaci pneumonia. The higher proportion of patients with coinfections in our study supports the use of mNGS for comprehensive early detection of respiratory infections in patients with C. psittaci pneumonia.
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Affiliation(s)
- Lei Yuan
- Department of Clinical laboratory, The First Affiliated Hospital of Nanchang University of Nanchang University, Nanchang University, No.17, YongWaiZhengStreet, Nanchang, 330006, China
| | - Qiang Chen
- Department of Clinical laboratory, The First Affiliated Hospital of Nanchang University of Nanchang University, Nanchang University, No.17, YongWaiZhengStreet, Nanchang, 330006, China
| | - Xin Yu Zhu
- Department of Clinical laboratory, The First Affiliated Hospital of Nanchang University of Nanchang University, Nanchang University, No.17, YongWaiZhengStreet, Nanchang, 330006, China
| | - Lan Min Lai
- Department of Clinical laboratory, The First Affiliated Hospital of Nanchang University of Nanchang University, Nanchang University, No.17, YongWaiZhengStreet, Nanchang, 330006, China
| | - Rui Zhao
- Department of Clinical laboratory, The First Affiliated Hospital of Nanchang University of Nanchang University, Nanchang University, No.17, YongWaiZhengStreet, Nanchang, 330006, China.
| | - Yang Liu
- Department of Clinical laboratory, The First Affiliated Hospital of Nanchang University of Nanchang University, Nanchang University, No.17, YongWaiZhengStreet, Nanchang, 330006, China.
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Liu K, Wu L, Chen G, Zeng D, Zhong Q, Luo L, Song B, Ying X, Ni F, Yu L, Xu L, Lin X, Chen X, Zou X, Xiao J, Hu Y. Clinical Characteristics of Chlamydia psittaci Infection Diagnosed by Metagenomic Next-Generation Sequencing: A Retrospective Multi-Center Study in Fujian, China. Infect Drug Resist 2024; 17:697-708. [PMID: 38405056 PMCID: PMC10894596 DOI: 10.2147/idr.s443953] [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: 10/10/2023] [Accepted: 01/31/2024] [Indexed: 02/27/2024] Open
Abstract
Objective This study aimed to describe and compare the epidemiological, demographic, clinical, laboratory and radiological characteristics as well as the complications, treatments, and outcomes of these patients. Methods We retrospectively investigated clinical data of patients with C. psittaci infection (psittacosis) in eight Grade IIIA hospitals of Fujian. Metagenomic next-generation sequencing (mNGS) was used identify C. psittaci in clinical samples of all included patients. Results A total of 74 patients (39 severe/35 non-severe) was diagnosed with psittacosis, 25 (33.8%) of whom had history of poultry exposure. Common symptoms included high fever (98% [37/74]), fatigue (52.7% [39/74]), and dyspnea (51.4% [38/74]). Common manifestations in imaging included consolidation (89.2%), pleural effusion (77.0%), and air bronchogram (66.2%). Common complications included acute respiratory distress syndrome (55.4% [41/74]), type I respiratory failure (52.7% [39/74]), acute liver injury (41.9% [31/74]), and secondary infection (27.0% [20/74]). The in-hospital mortality rate was 8.11% (6/74). Conclusion C. psittaci infection is represents an underestimated cause of CAP. For SCAP patients with poultry and bird contact history, specimens were encouraged to be sended for mNGS test in time. C. psittaci infection can lead to severe, multiple system involvement, and several complications. mNGS facilitate timely diagnosis of C. psittaci infection.
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Affiliation(s)
- Kaixiong Liu
- Department of Respiratory and Critical Care medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, People’s Republic of China
- Institute of Respiratory Disease, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Luling Wu
- Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Gongping Chen
- Department of Respiratory and Critical Care medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, People’s Republic of China
- Institute of Respiratory Disease, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Dunhuan Zeng
- Department of Respiratory and Critical Care medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, People’s Republic of China
- Institute of Respiratory Disease, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Qiwei Zhong
- Department of Respiratory and Critical Care Medicine, Minnan Hospital, the First Affiliated Hospital of Fujian Medical University, Quau zhou, People’s Republic of China
| | - Li Luo
- Department of Respiratory and Critical Care medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, People’s Republic of China
| | - Bin Song
- Department of Respiratory and Critical Care Medicine, Mindong Hospital Affiliated to Fujian Medical University, Ningde, People’s Republic of China
| | - Xiuhong Ying
- Department of Respiratory and Critical Care medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, People’s Republic of China
| | - Fayu Ni
- Department of Respiratory, Fuqing General Hospital Affiliated to Fujian Medical University, Fuzhou, People’s Republic of China
| | - Lifang Yu
- Department of Respiratory, Fuqing General Hospital Affiliated to Fujian Medical University, Fuzhou, People’s Republic of China
| | - Liyu Xu
- Department of Respiratory and Critical Care Medicine, Fuzhou First Hospital of Fujian Medical University, Fuzhou, People’s Republic of China
| | - Xin Lin
- Department of Respiratory and Critical Care Medicine, Fuzhou First Hospital of Fujian Medical University, Fuzhou, People’s Republic of China
| | - Xiaoyan Chen
- Department of Emergency Medicine, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, People’s Republic of China
| | - Xin Zou
- Department of Respiratory and Critical Care Medicine, LongYan First Hospital Affiliated to Fujian Medical University, Longyan, People’s Republic of China
| | - Jianhong Xiao
- Department of Respiratory and Critical Care Medicine, Mindong Hospital Affiliated to Fujian Medical University, Ningde, People’s Republic of China
| | - Yuekai Hu
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
- Department of Infectious Diseases, First Affiliated Hospital of Fujian Medical University, Fuzhou, People’s Republic of China
- Department of Infectious Diseases, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China
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Miyauchi T, Hirata Y, Fukuda S. Postmortem diagnosis of gestational psittacosis: A case report. Acute Med Surg 2024; 11:e932. [PMID: 38370878 PMCID: PMC10873515 DOI: 10.1002/ams2.932] [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: 11/02/2023] [Revised: 01/31/2024] [Accepted: 02/07/2024] [Indexed: 02/20/2024] Open
Abstract
Background Gestational psittacosis is one of the causes of unanticipated maternal death but has been difficult to diagnose early in clinical practice. Case Presentation A 28-year-old woman who was 7 months pregnant experienced flu-like symptoms, which deteriorated. She was brought to our hospital in shock, and the fetus was nonviable. The patient was diagnosed with pneumonia and septic shock and administered meropenem. Despite aggressive resuscitation, she died 7 h after symptom onset. After obtaining consent from the patient's family, the autopsy was done to identify the cause of death. Microscopically, there was intervillous neutrophil accumulation in the placenta. Genetic analysis detected the Chlamydia psittaci gene in several organs, including placenta. Conclusion Gestational psittacosis should be considered for a pregnant woman with flu-like symptoms. Moreover, unanticipated death of a pregnant woman might warrant a detailed autopsy to reveal the cause of death.
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Affiliation(s)
- Takashi Miyauchi
- Emergency DepartmentIwakuni Clinical CenterIwakuniYamaguchiJapan
| | - Yutaro Hirata
- Emergency DepartmentIwakuni Clinical CenterIwakuniYamaguchiJapan
| | - Shinya Fukuda
- Emergency DepartmentIwakuni Clinical CenterIwakuniYamaguchiJapan
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Dembek ZF, Mothershead JL, Owens AN, Chekol T, Wu A. Psittacosis: An Underappreciated and Often Undiagnosed Disease. Pathogens 2023; 12:1165. [PMID: 37764973 PMCID: PMC10536718 DOI: 10.3390/pathogens12091165] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/02/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
The bacterial agent Chlamydia psittaci, and the resulting disease of psittacosis, is a little-known and underappreciated infectious disease by healthcare practitioners and in public health in general. C. psittaci infections can cause significant psittacosis outbreaks, with person-to-person transmission documented in the last decade. In this publication, we review the pathogen and its disease, as well as examine the potential for genetic manipulation in this organism to create a more deadly pathogen. Recent disease surveys indicate that currently, the highest incidences of human disease exist in Australia, Germany and the UK. We recommend the universal public health reporting of C. psittaci and psittacosis disease and increasing the promotion of public health awareness.
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Affiliation(s)
- Zygmunt F. Dembek
- Battelle Memorial Institute, Support to DTRA Technical Reachback, Columbus, OH 43201, USA; (Z.F.D.); (T.C.)
| | - Jerry L. Mothershead
- Applied Research Associates (ARA), Support to DTRA Technical Reachback, Albuquerque, NM 87110, USA;
| | - Akeisha N. Owens
- Defense Threat Reduction Agency (DTRA), Fort Belvoir, VA 22060, USA;
| | - Tesema Chekol
- Battelle Memorial Institute, Support to DTRA Technical Reachback, Columbus, OH 43201, USA; (Z.F.D.); (T.C.)
| | - Aiguo Wu
- Defense Threat Reduction Agency (DTRA), Fort Belvoir, VA 22060, USA;
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12
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Wu Y, Xu X, Liu Y, Jiang X, Wu H, Yang J, He L. Case Report: Clinical analysis of a cluster outbreak of chlamydia psittaci pneumonia. Front Cell Infect Microbiol 2023; 13:1214297. [PMID: 37637462 PMCID: PMC10448816 DOI: 10.3389/fcimb.2023.1214297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 07/17/2023] [Indexed: 08/29/2023] Open
Abstract
Objective To explore the clinical characteristics and prognosis of clustered cases of psittacosis pneumonia. Method We retrospectively analyzed the clinical data of a cluster outbreak of psittacosis pneumonia. The analysis included epidemiological data, clinical symptoms, laboratory results, and prognosis. The diagnosis was made using mNGS and nested PCR technology. Result Of the four cases, two had direct contact with diseased poultry while the other two did not. All cases presented with more than 39.5 °C fever and chills. Additionally, significant increases in C-reactive protein, ferritin, creatine kinase, and lactate dehydrogenase were observed in all cases, while absolute lymphocyte count decreased. Case 2 also had increased calcitonin levels. Acute respiratory failure occurred during the treatment of case 1 and case 2, leading to tracheal intubation and ventilator-assisted ventilation. Unfortunately, case 2 passed away due to sepsis and multiple organ dysfunction, while the other cases had a positive prognosis. Conclusion mNGS facilitated the early diagnosis of psittacosis pneumonia. It is important to note that there is still a substantial risk of human-to-human transmission in psittacosis pneumonia. Absolute lymphocyte count and calcitonin levels can predict the severity and prognosis of the disease.
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Affiliation(s)
- Yinxia Wu
- Department of Infectious Diseases, Lishui Municipal Central Hospital, Lishui, Zhejiang, China
| | - Xuemei Xu
- Department of Infectious Diseases, Lishui Municipal Central Hospital, Lishui, Zhejiang, China
| | - Yun Liu
- Department of Infectious Diseases, Lishui Municipal Central Hospital, Lishui, Zhejiang, China
| | - Xiangwei Jiang
- Department of Infectious Diseases, Lishui Municipal Central Hospital, Lishui, Zhejiang, China
| | - Hongjing Wu
- Department of Infectious Diseases, Lishui Municipal Central Hospital, Lishui, Zhejiang, China
| | - Jie Yang
- Department of Infectious Diseases, Lishui Municipal Central Hospital, Lishui, Zhejiang, China
| | - Limei He
- Department of Nephrology Diseases, Lishui Municipal Central Hospital, Lishui, Zhejiang, China
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13
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Cao J, Xie X, Lei Y, Li S, Song X, Lei Y, An Q, Zhang B. Epidemiological and clinical characteristics of a family cluster of psittacosis: A case report. IDCases 2023; 33:e01845. [PMID: 37492645 PMCID: PMC10365937 DOI: 10.1016/j.idcr.2023.e01845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/05/2023] [Accepted: 07/05/2023] [Indexed: 07/27/2023] Open
Abstract
Psittacosis accounts for 1-2 % of community-acquired pneumonia. In recent years, reports of psittacosis are increasing. Most reported cases of psittacosis are sporadic. Here, we report a familial cluster of five patients infected with Chlamydophila in a northwest Chinese region and share our diagnosis and treatment experience. The epidemiological characteristics, clinical features, laboratory examinations of family cluster psittacosis were collected and analyzed. We closely followed up all the family members and analyzed their clinical outcome. Five cases of family clustered pneumonia were mainly characterized by fever, cough and fatigue. mNGS rapidly identified the infecting agent as Chlamydophila in case 1 followed by RT-PCR analysis. A newly purchased pet parrot, which had diarrhea, was probably the primary source of infection. The main change of inflammation index in five patients was the decrease of lymphocyte counts. Chest CT showed peripheral or subpleural involvement of patchy high-density shadows with bronchial ventilation signs and blurred edges, mostly unilateral lesions. Five cases were completely cured with moxifloxacin and azithromycin. Our findings suggest that a familial cluster of Chlamydophila infection maybe caused by contact with sick pet parrot or human to human transmission in one close family. For this community-acquired pneumonia, epidemiological characteristics and use of mNGS is very important for improving accuracy in the early diagnosis.
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Affiliation(s)
- Jing Cao
- Department of Pulmonary Medicine, Air Force No. 986 Hospital, Air Force Medical University, Xi'an, China
| | - Xiaoyan Xie
- Department of Pulmonary Medicine, Air Force No. 986 Hospital, Air Force Medical University, Xi'an, China
| | - Yan Lei
- Department of Pulmonary Medicine, Air Force No. 986 Hospital, Air Force Medical University, Xi'an, China
| | - Shuangshuang Li
- Department of Pulmonary Medicine, Air Force No. 986 Hospital, Air Force Medical University, Xi'an, China
| | - Xuan Song
- Department of Pulmonary Medicine, Air Force No. 986 Hospital, Air Force Medical University, Xi'an, China
| | - Yingfeng Lei
- Department of Medical Microbiology and Parasitology, Air Force Medical University, Xi'an, China
| | - Qunxing An
- Department of Transfusion Medicine, The First Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Binghua Zhang
- Department of Pulmonary Medicine, Air Force No. 986 Hospital, Air Force Medical University, Xi'an, China
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14
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Lu H, Yuan J, Wu Z, Wang L, Wu S, Chen Q, Zhang Z, Chen Z, Zou X, Hu Q, Feng T, Lu J, Ji L, Qiu S, Xu S, Jiang M, Li Y, Peng B, Bai Q, Cai R, Geng Y, Shi X. Distribution of drug-resistant genes in alveolar lavage fluid from patients with psittacosis and traceability analysis of causative organisms. Front Microbiol 2023; 14:1182604. [PMID: 37425996 PMCID: PMC10327639 DOI: 10.3389/fmicb.2023.1182604] [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: 03/09/2023] [Accepted: 06/01/2023] [Indexed: 07/11/2023] Open
Abstract
Background Chlamydia psittaci is a small bacterium often found in birds, including poultry, and domesticated mammals, which causes psittacosis (or parrot fever) in humans. Different strains of C. psittaci respond variably to antibiotics, suggesting a possible risk of antibiotic resistance. In general, different genotypes of C. psittaci have relatively stable hosts and different pathogenicity. Methods Macrogenomic sequencing was performed using nucleic acids extracted from psittacosis patients' alveolar lavage fluid samples and analyzed for genetic variability and antibiotic resistance genes. Nucleic acid amplification sequences specific to the core coding region of the C. psittaci ompA gene were used, and a phylogenetic tree was constructed with C. psittaci genotypic sequences from other sources, including Chinese published sources. The C. psittaci found in each patient were genotyped by comparing ompA gene sequences. In addition, to better illustrate the relationship between genotype and host of C. psittaci, 60 bird fecal samples were collected from bird-selling stores for screening and C. psittaci typing. Results Macrogenomic sequence alignment revealed the presence of resistance genes in varying abundance in samples from all three patients, including C. psittaci resistance gene sequences from two patients that matched those previously published on NCBI. Based on ompA genotyping, two patients were infected with C. psittaci genotype A and one patient was infected with genotype B. All five C. psittaci-positive samples obtained from bird-selling stores were genotype A. Both genotypes are reported to be infectious to humans. The host origin of the samples and the previously reported main sources of each genotype suggested that all but one of the C. psittaci genotype A in this study were derived from parrots, while genotype B was probably derived from chickens. Conclusion The presence of bacterial resistance genes in psittacosis patients may affect the efficacy of clinical antibiotic therapy. Focusing on the developmental progression of bacterial resistance genes and differences in the therapeutic efficacy may facilitate effective treatment of clinical bacterial infections. Pathogenicity genotypes (e.g., genotype A and genotype B) are not limited to one animal host, suggesting that monitoring the development and changes of C. psittaci may help prevent transmission to humans.
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Affiliation(s)
- Huiqun Lu
- Department of Public Health Laboratory Sciences, School of Public Health, University of South China, Hengyang, China
| | - Jing Yuan
- Shenzhen Third People’s Hospital, Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - Zeming Wu
- Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian), Shenzhen, China
| | | | - Shuang Wu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Qiongcheng Chen
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Zhen Zhang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Zhigao Chen
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Xuan Zou
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Qinghua Hu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Tiejian Feng
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Jianhua Lu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Liyin Ji
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Shuxiang Qiu
- Department of Public Health Laboratory Sciences, School of Public Health, University of South China, Hengyang, China
| | - Shiqin Xu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Min Jiang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Yinghui Li
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Bo Peng
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Qinqin Bai
- Department of Public Health Laboratory Sciences, School of Public Health, University of South China, Hengyang, China
| | - Rui Cai
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Yijie Geng
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Xiaolu Shi
- Department of Public Health Laboratory Sciences, School of Public Health, University of South China, Hengyang, China
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
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15
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Huang W, Hu S, Zhu Y, Liu S, Zhou X, Fang Y, Lu Y, Wang R. Metagenomic surveillance and comparative genomic analysis of Chlamydia psittaci in patients with pneumonia. Front Microbiol 2023; 14:1157888. [PMID: 37323913 PMCID: PMC10265514 DOI: 10.3389/fmicb.2023.1157888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/12/2023] [Indexed: 06/17/2023] Open
Abstract
Chlamydia psittaci, a strictly intracellular bacterium, is an underestimated etiologic agent leading to infections in a broad range of animals and mild illness or pneumonia in humans. In this study, the metagenomes of bronchoalveolar lavage fluids from the patients with pneumonia were sequenced and highly abundant C. psittaci was found. The target-enriched metagenomic reads were recruited to reconstruct draft genomes with more than 99% completeness. Two C. psittaci strains from novel sequence types were detected and these were closely related to the animal-borne isolates derived from the lineages of ST43 and ST28, indicating the zoonotic transmissions of C. psittaci would benefit its prevalence worldwide. Comparative genomic analysis combined with public isolate genomes revealed that the pan-genome of C. psittaci possessed a more stable gene repertoire than those of other extracellular bacteria, with ~90% of the genes per genome being conserved core genes. Furthermore, the evidence for significantly positive selection was identified in 20 virulence-associated gene products, particularly bacterial membrane-embedded proteins and type three secretion machines, which may play important roles in the pathogen-host interactions. This survey uncovered novel strains of C. psittaci causing pneumonia and the evolutionary analysis characterized prominent gene candidates involved in bacterial adaptation to immune pressures. The metagenomic approach is of significance to the surveillance of difficult-to-culture intracellular pathogens and the research into molecular epidemiology and evolutionary biology of C. psittaci.
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Affiliation(s)
- Weifeng Huang
- Department of Intensive Care Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuqin Hu
- Department of Critical Care Medicine, Shanghai General Hospital of Nanjing Medical University, Shanghai, China
| | - Yongzhe Zhu
- Department of Microbiology, Navy Medical University, Shanghai, China
| | - Shijia Liu
- Department of Pulmonary Disease, PLA 905 Hospital, Shanghai, China
| | - Xingya Zhou
- Genoxor Medical Science and Technology Inc., Shanghai, China
| | - Yuan Fang
- Genoxor Medical Science and Technology Inc., Shanghai, China
| | - Yihan Lu
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China
- Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, China
| | - Ruilan Wang
- Department of Critical Care Medicine, Shanghai General Hospital of Nanjing Medical University, Shanghai, China
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Sachse K, Hölzer M, Vorimore F, Barf LM, Sachse C, Laroucau K, Marz M, Lamkiewicz K. Genomic analysis of 61 Chlamydia psittaci strains reveals extensive divergence associated with host preference. BMC Genomics 2023; 24:288. [PMID: 37248517 PMCID: PMC10226258 DOI: 10.1186/s12864-023-09370-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 05/09/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND Chlamydia (C.) psittaci, the causative agent of avian chlamydiosis and human psittacosis, is a genetically heterogeneous species. Its broad host range includes parrots and many other birds, but occasionally also humans (via zoonotic transmission), ruminants, horses, swine and rodents. To assess whether there are genetic markers associated with host tropism we comparatively analyzed whole-genome sequences of 61 C. psittaci strains, 47 of which carrying a 7.6-kbp plasmid. RESULTS Following clean-up, reassembly and polishing of poorly assembled genomes from public databases, phylogenetic analyses using C. psittaci whole-genome sequence alignment revealed four major clades within this species. Clade 1 represents the most recent lineage comprising 40/61 strains and contains 9/10 of the psittacine strains, including type strain 6BC, and 10/13 of human isolates. Strains from different non-psittacine hosts clustered in Clades 2- 4. We found that clade membership correlates with typing schemes based on SNP types, ompA genotypes, multilocus sequence types as well as plasticity zone (PZ) structure and host preference. Genome analysis also revealed that i) sequence variation in the major outer membrane porin MOMP can result in 3D structural changes of immunogenic domains, ii) past host change of Clade 3 and 4 strains could be associated with loss of MAC/perforin in the PZ, rather than the large cytotoxin, iii) the distinct phylogeny of atypical strains (Clades 3 and 4) is also reflected in their repertoire of inclusion proteins (Inc family) and polymorphic membrane proteins (Pmps). CONCLUSIONS Our study identified a number of genomic features that can be correlated with the phylogeny and host preference of C. psittaci strains. Our data show that intra-species genomic divergence is associated with past host change and includes deletions in the plasticity zone, structural variations in immunogenic domains and distinct repertoires of virulence factors.
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Affiliation(s)
- Konrad Sachse
- RNA Bioinformatics and High-Throughput Analysis, Friedrich Schiller University Jena, 07743, Jena, Germany.
| | - Martin Hölzer
- Methodology and Research Infrastructure, Bioinformatics, Robert Koch Institute, 13353, Berlin, Germany
| | - Fabien Vorimore
- Laboratory for Animal Health, Identypath, ANSES Maisons-Alfort, Paris-Est University, 94706, Paris, France
| | - Lisa-Marie Barf
- RNA Bioinformatics and High-Throughput Analysis, Friedrich Schiller University Jena, 07743, Jena, Germany
| | - Carsten Sachse
- Ernst-Ruska Centre 3 / Structural Biology, Forschungszentrum Jülich, Wilhelm-Johnen-Straße, 52425, Jülich, Germany
- Institute for Biological Information Processing 6 / Structural Cellular Biology, Forschungszentrum Jülich, Wilhelm-Johnen-Straße, 52425, Jülich, Germany
- Department of Biology, Heinrich Heine University, Universitätsstr. 1, 40225, Düsseldorf, Germany
| | - Karine Laroucau
- Laboratory for Animal Health, Bacterial Zoonosis Unit, ANSES Maisons-Alfort, Paris-Est University, 94706, Paris, France
| | - Manja Marz
- RNA Bioinformatics and High-Throughput Analysis, Friedrich Schiller University Jena, 07743, Jena, Germany
| | - Kevin Lamkiewicz
- RNA Bioinformatics and High-Throughput Analysis, Friedrich Schiller University Jena, 07743, Jena, Germany
- JRG Analytical MicroBioinformatics, Friedrich Schiller University Jena, 07743, Jena, Germany
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Zhu Z, Wang X, Zhao J, Xie Z, Yang C, Li L, Liu Y. Clinical Characteristics of Six Patients with Chlamydia psittaci Infection Diagnosed by Metagenomic Next-Generation Sequencing: A Case Series. Infect Drug Resist 2023; 16:869-878. [PMID: 36820082 PMCID: PMC9938668 DOI: 10.2147/idr.s393195] [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: 11/03/2022] [Accepted: 01/07/2023] [Indexed: 02/15/2023] Open
Abstract
The incidence of psittacosis infection has gradually increased in recent years. Metagenomic next-generation sequencing (mNGS) can be used to comprehensively identify the total DNA and RNA content of the microbiome, as well as identify both known and unexpected pathogens within 24 hours. We diagnosed and treated six patients with psittacosis infection using mNGS, two of whom developed severe disease and most of whom presented with pulmonary symptoms. One of the young female patients also presented with irregular vaginal bleeding and myocarditis. Patients with underlying gastric disorders first showed gastrointestinal symptoms, which is a rare manifestation in patients with psittacosis. Older patients with underlying disease usually showed more severe symptoms. However, rare complications can also occur in immunocompetent young people and develop into severe disease. All patients showed significant congestion at bronchial lumen lesions, which may be associated with a severe inflammatory response to mucosal Chlamydia psittaci (C. psittaci) infection. Overall, mNGS is a rapid and effective tool for the clinical diagnosis of psittacosis caused by C. psittaci, and early diagnosis and treatment can prevent psittacosis from developing into a serious illness.
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Affiliation(s)
- Zhenghua Zhu
- Department of Respiration, The Second People’s Hospital of Kunming, Kunming, People’s Republic of China
| | - Xiang Wang
- Department of Respiration, The Second People’s Hospital of Kunming, Kunming, People’s Republic of China
| | - Jinhong Zhao
- Department of Respiration, The Second People’s Hospital of Kunming, Kunming, People’s Republic of China
| | - Zuozhou Xie
- Department of Respiration, The Second People’s Hospital of Kunming, Kunming, People’s Republic of China
| | - Chen Yang
- Department of Respiration, The Second People’s Hospital of Kunming, Kunming, People’s Republic of China
| | - Lingyi Li
- Department of Medical, Hangzhou Matridx Biotechnology Co., Ltd, Hangzhou, People’s Republic of China,Correspondence: Lingyi Li, Department of Medical, Hangzhou Matridx Biotechnology Co., Ltd, No. 2073 Jinchang Road, Yuhang District, Hangzhou, Zhejiang Province, 311100, People’s Republic of China, Tel +8613888173009, Email
| | - Yi Liu
- Department of Respiration, The Second People’s Hospital of Kunming, Kunming, People’s Republic of China,Yi Liu, Department of Respiration, the Second People’s Hospital of Kunming, No. 871 Longquan Road, Panlong District, Kunming City, Yunnan Province, 650051, People’s Republic of China, Tel +8613648898773, Email
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Liu S, Cui Z, Carr MJ, Meng L, Shi W, Zhang Z. Chlamydia psittaci should be a notifiable infectious disease everywhere. THE LANCET. MICROBE 2023; 4:e62-e63. [PMID: 36372075 DOI: 10.1016/s2666-5247(22)00306-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/07/2022] [Accepted: 10/19/2022] [Indexed: 11/12/2022]
Affiliation(s)
- Shaoqiong Liu
- School of Clinical and Basic Medical Sciences, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, China
| | - Ziqi Cui
- Department of Respiratory and Critical Care Medicine, 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
| | - Ling Meng
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Shandong First Medical University, Taian, China
| | - Weifeng Shi
- School of Public Health, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, China; Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhenjie Zhang
- School of Clinical and Basic Medical Sciences, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, China.
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19
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Wang Z, Chen C, Lu H, Wang L, Gao L, Zhang J, Zhu C, Du F, Cui L, Tan Y. Case report: Clinical characteristics of two cases of pneumonia caused with different strains of Chlamydia psittaci. Front Cell Infect Microbiol 2023; 13:1086454. [PMID: 36798086 PMCID: PMC9927004 DOI: 10.3389/fcimb.2023.1086454] [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: 11/01/2022] [Accepted: 01/19/2023] [Indexed: 02/04/2023] Open
Abstract
Background With the development of metagenomic sequencing technologies, more and more cases of pneumonia caused with Chlamydia psittaci (C. psittaci) have been reported. However, it remains unknown about the characteristics of patients with pneumonia caused by different strains of C. psittaci. Here, we shared the clinical characteristics of two cases of pneumonia caused with C. psittaci strains SZ18-2 and SZ15 which were rarely identified in humans. Case presentation Case 1: A 69-year-old male farmer who fed ducks presented to hospital for cough, diarrhea and lethargy with the temperature of 39.8°C. Case 2: A 48-year-old male worker who slaughtered ducks was transferred to hospital for high fever, cough, myalgia, diarrhea and loss of appetite. Both patients did not take any protective measures (wearing face masks or gloves) while processing ducks. C. psittaci pneumonia was diagnosed by metagenomic next-generation sequencing and polymerase chain reaction. After treatment with doxycycline and azithromycin individually, they recovered well and discharged from hospital. Through OmpA sequencing, two different strains of SZ18-2 and SZ15 were identified in case 1 and case 2, respectively. Conclusions Patients infected with different strains of C. psittaci may own different clinical manifestations. C. psittaci infection should be suspected when pneumonia appears, accompanied by digestive symptoms and multiple organ dysfunction, especially under the exposure of specific birds.
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Affiliation(s)
- Zheng Wang
- Department of Respiratory and Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Chen Chen
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Hu Lu
- Department of Emergency, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Li Wang
- Department of Respiratory and Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Lin Gao
- Department of Respiratory and Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Jing Zhang
- Department of Respiratory and Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Chi Zhu
- State Key Laboratory of Translational Medicine and Innovative Drug Development, Jiangsu Simcere Diagnostics Co., Ltd., Nanjing, China
| | - Furong Du
- State Key Laboratory of Translational Medicine and Innovative Drug Development, Jiangsu Simcere Diagnostics Co., Ltd., Nanjing, China
| | - Lunbiao Cui
- NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China,*Correspondence: Yan Tan, ; Lunbiao Cui,
| | - Yan Tan
- Department of Respiratory and Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China,*Correspondence: Yan Tan, ; Lunbiao Cui,
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20
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Fang C, Xu L, Tan J, Tan H, Lin J, Zhao Z. Case Report: Chlamydia psittaci pneumonia complicated by Guillain-Barré syndrome detected using metagenomic next-generation sequencing. Front Cell Infect Microbiol 2023; 12:1070760. [PMID: 36755852 PMCID: PMC9901563 DOI: 10.3389/fcimb.2022.1070760] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 12/30/2022] [Indexed: 01/24/2023] Open
Abstract
Psittacosis and Guillain-Barré syndrome are both rare clinical diseases with low incidence, and their combination has rarely been reported. Here, we report a case of Chlamydia psittaci pneumonia combined with Guillain-Barré syndrome. The patient initially presented with high fever, difficulty breathing, and fatigue. Chest computerised tomography indicated large consolidation opacities in both lungs. Metagenomic next-generation sequencing clearly identified the pathogen as C. psittaci. The patient's fever subsided after targeted antibiotic treatment, but difficulty breathing and fatigue worsened, and the patient developed symmetric limb numbness and weakness. Lumbar puncture, electrophysiological examination, and clinical characteristics were suggestive of Guillain-Barré syndrome, and the symptoms improved after treatment with human immunoglobulin. The results of this study suggest that metagenomic next-generation sequencing is useful for the rapid diagnosis of pulmonary infectious agents. Psittacosis is closely associated with the development of Guillain-Barré syndrome; however, more cases are needed to support this conclusion, and early targeted antibiotic treatment, immunotherapy, and basic supportive treatment are essential for improving outcomes.
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Affiliation(s)
- Changquan Fang
- Department of Pulmonary and Critical Care Medicine, Huizhou Central People’s Hospital, Huizhou, Guangdong, China
| | - Limin Xu
- Department of Geriatrics, Huizhou First People’s Hospital, Huizhou, Guangdong, China
| | - Jiarong Tan
- Department of Pulmonary and Critical Care Medicine, Huizhou Central People’s Hospital, Huizhou, Guangdong, China
| | - Hongyi Tan
- Department of Pulmonary and Critical Care Medicine, Huizhou Central People’s Hospital, Huizhou, Guangdong, China
| | - Junhong Lin
- Department of Pulmonary and Critical Care Medicine, Huizhou Central People’s Hospital, Huizhou, Guangdong, China,*Correspondence: Junhong Lin, ; Ziwen Zhao,
| | - Ziwen Zhao
- Department of Pulmonary and Critical Care Medicine, Guangzhou First People’s Hospital Affiliated to South China University of Technology, Guangzhou, Guangdong, China,*Correspondence: Junhong Lin, ; Ziwen Zhao,
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21
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Cui Z, Meng L. Psittacosis Pneumonia: Diagnosis, Treatment and Interhuman Transmission. Int J Gen Med 2023; 16:1-6. [PMID: 36628298 PMCID: PMC9826634 DOI: 10.2147/ijgm.s396074] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 12/22/2022] [Indexed: 01/12/2023] Open
Abstract
Psittacosis pneumonia is a zoonosis caused by Chlamydia psittacosis infection, mainly resulting from contact with aerosols of birds or poultry's urine, feces, and excrement. The clinical manifestations range from general symptoms of infection to severe acute respiratory syndrome and systemic diseases, currently diagnosed using metagenomic next-generation sequencing (mNGS) to improve diagnostic accuracy. To date, most reports have only discussed human exposure to poultry disease. However, the latest studies have shown that human-to-human transmission of Chlamydia psittaci occurs not only between infected patients and their close contacts but also between secondary contacts. After looking back on relevant literature at home and abroad in the past ten years, this paper reviews the diagnosis, diagnosis and treatment, and progress in epidemiological research of Psittacosis pneumonia.
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Affiliation(s)
- ZiQi Cui
- Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, 271000, People’s Republic of China
| | - Ling Meng
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, 271000, People’s Republic of China,Correspondence: Ling Meng, Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, No. 366 Taishan Street, Taian, 271000, People’s Republic of China, Tel +86-18505386929, Email
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22
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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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23
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Three Cases of Atypical Pneumonia with Chlamydia psittaci: The Role of Laboratory Vigilance in the Diagnosis of Psittacosis. Pathogens 2022; 12:pathogens12010065. [PMID: 36678414 PMCID: PMC9861199 DOI: 10.3390/pathogens12010065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/20/2022] [Accepted: 12/26/2022] [Indexed: 01/03/2023] Open
Abstract
Chlamydia psittaci is an established zoonotic agent causing respiratory disease in humans. An infection often remains asymptomatic but can also result in flu-like illness, pneumonia or even multi-organ failure. This paper describes three patients, hospitalised at AZ Sint-Lucas Hospital, with atypical pneumonia who were diagnosed with C. psittaci after an in-depth anamnesis and laboratory investigation in the midst of the COVID pandemic. All three infections were confirmed with PCR and serology, whereas viable bacteria were only present for one patient. Genotyping revealed the presence of genotype B for patient 1 and 2 whereas ompA genotyping was unsuccessful for patient 3. This case report demonstrates the importance of a thorough patient history as close contact with birds is one of the main risk factors to contract the pathogen. Once exposure to birds has been confirmed, a diagnosis by a combination of PCR and serology is essential in order to initiate a treatment with the proper antibiotics. As psittacosis is still an underestimated and underdiagnosed disease, communication between laboratory, clinicians and bird fanciers is encouraged.
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24
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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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25
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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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26
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Hou C, Jin Y, Wu H, Li P, Liu L, Zheng K, Wang C. Alternative strategies for Chlamydia treatment: Promising non-antibiotic approaches. Front Microbiol 2022; 13:987662. [PMID: 36504792 PMCID: PMC9727249 DOI: 10.3389/fmicb.2022.987662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 11/04/2022] [Indexed: 11/24/2022] Open
Abstract
Chlamydia is an obligate intracellular bacterium where most species are pathogenic and infectious, causing various infectious diseases and complications in humans and animals. Antibiotics are often recommended for the clinical treatment of chlamydial infections. However, extensive research has shown that antibiotics may not be sufficient to eliminate or inhibit infection entirely and have some potential risks, including antibiotic resistance. The impact of chlamydial infection and antibiotic misuse should not be underestimated in public health. This study explores the possibility of new therapeutic techniques, including a review of recent studies on preventing and suppressing chlamydial infection by non-antibiotic compounds.
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Affiliation(s)
- Chen Hou
- School of Basic Medicine, Hengyang Medical College, Institute of Pathogenic Biology, University of South China, Hengyang, China
| | - Yingqi Jin
- School of Basic Medicine, Hengyang Medical College, Institute of Pathogenic Biology, University of South China, Hengyang, China
| | - Hua Wu
- Department of Clinical Laboratory, Affiliated Hengyang Hospital of Southern Medical University, Hengyang Central Hospital, Hengyang, China
| | - Pengyi Li
- School of Basic Medicine, Hengyang Medical College, Institute of Pathogenic Biology, University of South China, Hengyang, China
| | - Longyun Liu
- School of Basic Medicine, Hengyang Medical College, Institute of Pathogenic Biology, University of South China, Hengyang, China
| | - Kang Zheng
- Department of Clinical Laboratory, Affiliated Hengyang Hospital of Southern Medical University, Hengyang Central Hospital, Hengyang, China,*Correspondence: Kang Zheng
| | - Chuan Wang
- School of Basic Medicine, Hengyang Medical College, Institute of Pathogenic Biology, University of South China, Hengyang, China,Chuan Wang
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27
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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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28
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Chen M, Zhang M, Shi M, Hu X. Diagnosis and Analysis of Clinical Characteristics of Chlamydia psittaci Pneumonia. Vector Borne Zoonotic Dis 2022; 22:499-504. [PMID: 36190520 DOI: 10.1089/vbz.2022.0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: We assessed the clinical characteristics of three patients with Chlamydia psittaci-associated pneumonia. Methods: Clinical data for three patients with C. psittaci-associated pneumonia admitted to our hospital from June 2020 to December 2020 were retrospectively analyzed, and the diagnosis, clinical features, and treatment of the disease are summarized. Results: Fever, headache, and fatigue were the main symptoms in all three patients, whereas local respiratory symptoms such as cough and expectoration were not obvious. Not all patients had a definite contact history with poultry and birds. Chest computed tomography (CT) showed inflammatory exudation, consolidation, and bronchial inflation signs on one side of the lungs, which progressed rapidly. Treatment with beta-amides did not result in positive clinical responses. Combined with clinical manifestations, the disease was confirmed by detection of C. psittaci nucleic acid sequences in alveolar lavage fluid and blood by metagenomic second-generation sequencing technology. Fever and malaise were rapidly relieved after the administration of moxifloxacin-based regimens and levels of infectious blood markers decreased; and the consolidation shadow on chest CT was gradually absorbed. Conclusion: Early application of metagenomic second-generation sequencing in patients with community-acquired pneumonia due to rare and complex pathogens that cannot be diagnosed by conventional tests and for whom empirical anti-infective therapy is ineffective is important for definitive diagnosis and selection of appropriate antibacterial drugs.
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Affiliation(s)
- Ming Chen
- Department of Respiratory and Critical Care Medicine, Tongde Hospital of Zhejiang Province, Zhejiang, China
| | - Miao Zhang
- Department of Respiratory and Critical Care Medicine, Tongde Hospital of Zhejiang Province, Zhejiang, China
| | - Miao Shi
- Department of Respiratory and Critical Care Medicine, Tongde Hospital of Zhejiang Province, Zhejiang, China
| | - Xueqin Hu
- Basic Academic Department of Orthopaedic Institute, The first Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang, China.,Institute of Orthopaedics and Traumatology, Zhejiang Chinese Medical University, Zhejiang, China
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29
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Khadka S, Timilsina B, Pangeni RP, Regmi PR, Thapa AS. Importance of clinical history in the diagnosis of psittacosis: A case report. Ann Med Surg (Lond) 2022; 82:104695. [PMID: 36268359 PMCID: PMC9577640 DOI: 10.1016/j.amsu.2022.104695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/05/2022] [Accepted: 09/09/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- Sulochana Khadka
- Nepalese Army Institute of Health Sciences, College of Medicine, Kathmandu, Nepal
- Corresponding author.
| | - Bibek Timilsina
- Nepalese Army Institute of Health Sciences, College of Medicine, Kathmandu, Nepal
| | | | | | - Anupam Singh Thapa
- Nepalese Army Institute of Health Sciences, College of Medicine, Kathmandu, Nepal
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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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Li H, Hao B, Wang Y, Yu D, Chen Z, Du D, Xiong J, Li K, Zhang H, Liu X, Liu K, Xiao F, Cheng X, Huang L. Metagenomic next-generation sequencing for the diagnosis of Chlamydia psittaci pneumonia. THE CLINICAL RESPIRATORY JOURNAL 2022; 16:513-521. [PMID: 35724965 PMCID: PMC9329019 DOI: 10.1111/crj.13519] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/11/2022] [Accepted: 06/13/2022] [Indexed: 11/26/2022]
Abstract
The aim of this study was to investigate the clinical characteristics of Chlamydia psittaci pneumonia and evaluate the diagnostic value of Metagenomic Next-Generation Sequencing (mNGS). A total of 44 patients diagnosed with Chlamydia psittaci pneumonia using mNGS were retrospectively analysed. The demographic and clinical features, laboratory data, imaging findings and clinical outcomes were collected. Results showed that 65.91% of the patients had a history of exposure to poultry or birds. All patients presented with fever. Apart from systemic and respiratory symptoms, some patients also presented with digestive and neurological symptoms. Respiratory failure was common among patients. The key laboratory tests were normal white blood cell counts, slightly elevated PCT, changes in levels of cardiac enzymes, liver enzymes and hyponatremia. Chest imaging revealed that most of the lesions contained patchy exudation or lobar consolidation of one lobe, especially in the lower lobe. Consolidation of both lungs was seen in critically ill patients. Although quinolones were effective in most patients, tetracyclines should be the first choice of treatment. The overall prognosis was good; however, patients who developed severe pneumonia had poor prognosis. The incidence of chlamydia psittaci pneumonia may be underestimated due to the nonspecific clinical manifestations and lack of confirmatory testing methods. The use of mNGS has increased the number of patients diagnosed with chlamydia psittaci pneumonia. mNGS is an effective diagnostic method for chlamydia psittaci pneumonia.
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Affiliation(s)
- Hu Li
- Department of Imaging, Yueyang Central Hospital, Yueyang, Hunan, China
| | - Binwei Hao
- Department of Pulmonary and Critical Care Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China.,Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yongxue Wang
- Department of Pulmonary and Critical Care Medicine, Yueyang Central Hospital, Yueyang, Hunan, China
| | - Dinghong Yu
- Department of Pulmonary and Critical Care Medicine, Yueyang Central Hospital, Yueyang, Hunan, China
| | - Zhonghua Chen
- Department of Pulmonary and Critical Care Medicine, Yueyang Central Hospital, Yueyang, Hunan, China
| | - Duanlin Du
- Department of Pulmonary and Critical Care Medicine, Yueyang Central Hospital, Yueyang, Hunan, China
| | - Jian Xiong
- Department of Pulmonary and Critical Care Medicine, Yueyang Central Hospital, Yueyang, Hunan, China
| | - Kang Li
- Department of Pulmonary and Critical Care Medicine, Yueyang Central Hospital, Yueyang, Hunan, China
| | - Hengping Zhang
- Department of Pulmonary and Critical Care Medicine, Yueyang Central Hospital, Yueyang, Hunan, China
| | - Xu Liu
- Department of Pulmonary and Critical Care Medicine, Yueyang Central Hospital, Yueyang, Hunan, China
| | - Kai Liu
- Department of Pulmonary and Critical Care Medicine, Yueyang Central Hospital, Yueyang, Hunan, China
| | - Fanrong Xiao
- Department of Pulmonary and Critical Care Medicine, Yueyang Central Hospital, Yueyang, Hunan, China
| | - Xiaosan Cheng
- Department of Pulmonary and Critical Care Medicine, Yueyang Central Hospital, Yueyang, Hunan, China
| | - Lingmei Huang
- Department of Pulmonary and Critical Care Medicine, Yueyang Central Hospital, Yueyang, Hunan, China
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Zhang Z, Zhou H, Cao H, Ji J, Zhang R, Li W, Guo H, Chen L, Ma C, Cui M, Wang J, Chen H, Ding G, Yan C, Dong L, Holmes EC, Meng L, Hou P, Shi W. Human-to-human transmission of Chlamydia psittaci in China, 2020: an epidemiological and aetiological investigation. THE LANCET. MICROBE 2022; 3:e512-e520. [PMID: 35617977 DOI: 10.1016/s2666-5247(22)00064-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 12/19/2021] [Accepted: 03/09/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Chlamydia psittaci can infect a wide range of avian species, occasionally causing psittacosis (also known as parrot fever) in humans. Most human psittacosis cases are associated with close contact with pet birds or poultry. In December, 2020, an outbreak of severe community-acquired pneumonia of unknown aetiology was reported in a hospital in Shandong province, China, and some of the patients' close contacts had respiratory symptoms. Our aims were to determine the causative agent of this epidemic and whether there had been human-to-human transmission. METHODS For this epidemiological and aetiological investigation study, we enrolled patients who had community-acquired pneumonia confirmed by chest CT at two local hospitals in Shandong Province in China. We collected sputum, bronchoalveolar lavage fluid, and nasopharyngeal swab samples from participants and detected pathogens by surveying for 22 target respiratory microbes using a commercial assay, followed by metagenomic next-generation sequencing, specific nested PCR, and qPCR tests. We excluded individuals who were C psittaci-negative on both tests. We recruited close contacts of the C psittaci-positive patients, and tested nasopharyngeal swabs from the close contacts and samples from ducks from the processing plant where these patients worked. We then integrated the epidemiological, clinical, and laboratory data to reveal the potential chain of transmission of C psittaci that characterised this outbreak. FINDINGS Between Dec 4 and 29, 2020, we used metagenomic next-generation sequencing and different PCR-based approaches to test 12 inpatients with community-acquired pneumonia, of whom six (50%) were workers at a duck-meat processing plant and two (17%) were unemployed people, who were positive for C psittaci and enrolled in this study. We contacted 61 close contacts of the six patients who worked at the duck-meat processing plant, of whom 61 (100%) were enrolled and tested, and we determined that the community-acquired pneumonia outbreak was caused by C psittaci. Within the outbreak cluster, 17 (77%) of 22 participants had confirmed C psittaci infections and five (23%) of 22 participants were asymptomatic C psittaci carriers. The outbreak had begun with avian-to-human transmission, and was followed by secondary and tertiary human-to-human transmission, which included transmission by several asymptomatic carriers and by health-care workers. In addition, some of the participants with confirmed C psittaci infection had no identified source of infection, which suggested cryptic bacterial transmission. INTERPRETATION Our study data might represent the first documented report of human-to-human transmission of C psittaci in China. Therefore, C psittaci has the potential to evolve human-to-human transmission via various routes, should be considered an elevated biosecurity and emergent risk, and be included as part of the routine diagnosis globally, especially for high-risk populations. FUNDING Academic Promotion Programme of Shandong First Medical University, National Science and Technology Major Project, ARC Australian Laureate Fellowship.
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Affiliation(s)
- Zhenjie Zhang
- Key Laboratory of Aetiology and Epidemiology of Emerging Infectious Diseases in Universities of Shandong, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai'an, China
| | - Hong Zhou
- Key Laboratory of Aetiology and Epidemiology of Emerging Infectious Diseases in Universities of Shandong, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai'an, China
| | - Huae Cao
- Department of Infectious Disease, Xintai Third People's Hospital, Tai'an, China
| | - Jingkai Ji
- Key Laboratory of Aetiology and Epidemiology of Emerging Infectious Diseases in Universities of Shandong, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai'an, China
| | - Rongqiang Zhang
- Clinical Laboratory, The Department of Clinical Laboratory, The Centre for Disease Control and Prevention of Tai'an, Tai'an, China
| | - Wenxin Li
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Shandong First Medical University, Tai'an, China
| | - Hongfeng Guo
- Department of Obstetrics and Gynecology, Xintai Third People's Hospital, Tai'an, China
| | - Long Chen
- Department of Infectious Disease, Xintai Third People's Hospital, Tai'an, China
| | - Chuanmin Ma
- Key Laboratory of Aetiology and Epidemiology of Emerging Infectious Diseases in Universities of Shandong, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai'an, China
| | - Mingxue Cui
- Key Laboratory of Aetiology and Epidemiology of Emerging Infectious Diseases in Universities of Shandong, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai'an, China
| | - Jing Wang
- Key Laboratory of Aetiology and Epidemiology of Emerging Infectious Diseases in Universities of Shandong, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai'an, China
| | - Hao Chen
- School of Life Sciences, Qufu Normal University, Ji'ning, China
| | - Guoyong Ding
- School of Public Health, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai'an, China
| | - Chengxin Yan
- Department of Medical Imaging, The Second Affiliated Hospital of Shandong First Medical University, Tai'an, China
| | - Liang Dong
- Shandong Institute of Respiratory Diseases, The First Affiliated Hospital of Shandong First Medical University, Ji'nan, China
| | - Edward C Holmes
- Sydney Institute for Infectious Diseases, School of Life and Environmental Sciences and School of Medical Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Ling Meng
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Shandong First Medical University, Tai'an, China
| | - Peiqiang Hou
- Clinical Laboratory, The Department of Clinical Laboratory, The Centre for Disease Control and Prevention of Tai'an, Tai'an, China
| | - Weifeng Shi
- Key Laboratory of Aetiology and Epidemiology of Emerging Infectious Diseases in Universities of Shandong, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai'an, China; School of Public Health, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai'an, China.
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Yang M, Yang DH, Yang H, Ding SZ, Liu CH, Yin HM, Liu D, Chen P, Luo H. Clinical Characteristics of Chlamydia psittaci Pneumonia Infection in Central South China. Infect Dis Ther 2022; 11:1631-1647. [PMID: 35723864 PMCID: PMC9207437 DOI: 10.1007/s40121-022-00662-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/23/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Chlamydia psittaci pneumonia has been a global public health hotspot in recent years. Although some scattered cases of C. psittaci pneumonia have been reported, there is a lack of large case studies worldwide. Methods In this multicenter, observational study, we recruited all consecutive patients with confirmed C. psittaci pneumonia from October 4, 2018, to October 23, 2020, in nine tertiary general hospitals in Central-South China. Epidemiologic and clinical data from patients’ electronic medical records were collected and analyzed. Results One hundred and sixteen patients with C. psittaci pneumonia were included in the study. The mean age was 59.7 years. Fever (96.6%) and cough (65.5%) were the most common clinical symptoms. Most patients presented with an increase in the proportion of neutrophils, neutrophil to lymphocyte ratio, LDH, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) and a significant decrease in lymphocytes. The main CT lung findings were consolidation (81%) and pleural effusion (35.3%), and bilateral lung consolidation was mainly found in severe patients. Chlamydia psittaci DNA was detected in BALF (bronchoalveolar lavage fluid) or blood samples by metagenomic next-generation sequencing (mNGS) in all patients. Use of quinolone was associated with shorter length of hospital stay and fever duration after antibiotic use. Multivariate logistic regression analysis indicated that respiratory support was associated with both severe pneumonia and in-hospital death. Conclusions The clinical phenotype of C. psittaci pneumonia is complex and variable. mNGS is helpful in the diagnosis and treatment of C. psittaci pneumonia, and early treatment with quinolone may benefit patients. Supplementary Information The online version contains supplementary material available at 10.1007/s40121-022-00662-4.
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Affiliation(s)
- Min Yang
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
- Research Unit of Respiratory Disease, Central South University, Changsha, 410011, Hunan, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, 410011, Hunan, China
| | - Dan-Hui Yang
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
- Research Unit of Respiratory Disease, Central South University, Changsha, 410011, Hunan, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, 410011, Hunan, China
| | - Huan Yang
- Department of Respiratory Medicine, Hunan Provincial People's Hospital (the First Affiliated Hospital of Normal University), Changsha, 410011, Hunan, China
| | - Shui-Zi Ding
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
- Research Unit of Respiratory Disease, Central South University, Changsha, 410011, Hunan, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, 410011, Hunan, China
| | - Cai-Hong Liu
- Department of Respiratory Medicine, The Third Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Hui-Ming Yin
- Department of Respiratory Medicine, The First Affiliated Hospital of Hunan Medical College (Huaihua Third People's Hospital), Huaihua, 418001, Hunan, China
| | - Dan Liu
- Department of Respiratory Medicine, Changsha Hospital of Traditional Chinese Medicine (Changsha Eighth Hospital), Changsha, 410100, China
| | - Ping Chen
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
- Research Unit of Respiratory Disease, Central South University, Changsha, 410011, Hunan, China.
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, 410011, Hunan, China.
| | - Hong Luo
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
- Research Unit of Respiratory Disease, Central South University, Changsha, 410011, Hunan, China.
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, 410011, Hunan, China.
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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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Li Q, Chen S, Yan Z, Fang H, Wang Z, He C. A Novel Intranasal Vaccine With PmpGs + MOMP Induces Robust Protections Both in Respiratory Tract and Genital System Post Chlamydia psittaci Infection. Front Vet Sci 2022; 9:855447. [PMID: 35529835 PMCID: PMC9072866 DOI: 10.3389/fvets.2022.855447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 02/14/2022] [Indexed: 11/13/2022] Open
Abstract
Chlamydia psittaci (C. psittaci) is a crucial zoonotic pathogen that causes severe respiratory and reproductive system disease in humans and animals. In our pioneer study, polymorphic membrane protein G (PmpG) mediated attachment to host cells as the adhesions and induced immunity against C. psittaci infection. We hypothesize that multiple PmpG antigens adjuvanted with Vibrio cholerae ghost (VCG) and chitosan gel might trigger full protection via the intranasal route (i.n). In the present study, 40 SPF chickens were randomly divided into four groups, including the PmpGs + MOMP group (i.n), major outer membrane protein (MOMP) group (i.n), PmpGs (Pmp17G + Pmp20G + Pmp21G) group (i.n), and control groups (VCG + chitosan gel) (i.n). Post twice immunizations, the PmpGs + MOMP group yielded highly level-specific IgG, IgA antibodies, and lymphocyte proliferation. As for cytokines, IFN-γ expression was upregulated significantly, while IL-10 concentration was downregulated in the PmpGs + MOMP group compared with other groups. Post challenge, exudate inflammations in air sacs, bacterial loads in lungs, and bacterial shedding in throat swabs were reduced significantly in the PmpGs + MOMP group. In the second experiment, 100 breeder ducks were divided into the PmpGs + MOMP group (i.n), the commercial MOMP group (via intramuscular injection, i.m), the inactivated EBs group (i.n), and the control group (i.n), 25 ducks per group. Post challenge, the reduced egg production recovered soon in the inactivated EBs group and the PmpGs + MOMP group. Moreover, the aforementioned two groups induced higher robust IgG antibodies, lymphocyte proliferation, and IFN-γ secretions than the commercial MOMP vaccine did. Postmortem, lower bacterial loads of spleens were determined in the PmpGs + MOMP group and the inactivated EBs group. However, bacterial clearance of follicular membranes and shedding from the vaginal tract were not significant differences among the three tested groups. Furthermore, the PmpGs + MOMP group induced lower inflammations in the follicles and oviducts. Based on the above evidence, the combination of PmpGs and MOMP adjuvanted with chitosan gel and VCG via intranasal route could induce full protection both in the respiratory system and genital tract post C. psittaci infection. More importantly, the combination antigens are superior to the inactivated EBs antigen due to no contamination to the environment and less genital inflammation. The combination of PmpGs + MOMP adjuvanted with VCG and chitosan gel might be a promising novel vaccine by blocking C. psittaci infection from animals to human beings.
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Affiliation(s)
- Qiang Li
- College of Life Science and Engineering, Foshan University, Foshan, China
- Key Lab of Animal Epidemiology and Zoonoses of Ministry of Agriculture and Rural Affairs, College of Veterinary Medicine, China Agricultural University, Beijing, China
| | - Siyu Chen
- Key Lab of Animal Epidemiology and Zoonoses of Ministry of Agriculture and Rural Affairs, College of Veterinary Medicine, China Agricultural University, Beijing, China
| | - Zhuanqiang Yan
- Wen's Group Academy, Wen's Foodstuffs Group Co., Ltd., Yunfu, China
| | - Huanxin Fang
- Wen's Group Academy, Wen's Foodstuffs Group Co., Ltd., Yunfu, China
| | - Zhanxin Wang
- Wen's Group Academy, Wen's Foodstuffs Group Co., Ltd., Yunfu, China
- *Correspondence: Zhanxin Wang
| | - Cheng He
- College of Life Science and Engineering, Foshan University, Foshan, China
- Key Lab of Animal Epidemiology and Zoonoses of Ministry of Agriculture and Rural Affairs, College of Veterinary Medicine, China Agricultural University, Beijing, China
- Cheng He
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Solorzano-Morales A, Dolz G. Molecular characterization of Chlamydia species in commercial and backyard poultry farms in Costa Rica. Epidemiol Infect 2022; 150:1-18. [PMID: 35197138 PMCID: PMC8950988 DOI: 10.1017/s0950268821002715] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 12/08/2021] [Accepted: 12/12/2021] [Indexed: 11/05/2022] Open
Abstract
Outbreaks caused by Chlamydia psittaci and other chlamydial species have recently been reported in poultry farms worldwide, causing considerable economic losses. The objective of this study was to determine the presence of chlamydial species in these birds in Costa Rica. One hundred and fifty pools of lung tissue samples from industrial poultry with respiratory problems and 112 pools of tracheal swabs from asymptomatic backyard poultry were analysed by real-time quantitative polymerase chain reaction (qPCR), end-point PCR and sequencing. A total of 16.8% (44/262) samples were positive for Chlamydia spp., most of them detected in asymptomatic backyard poultry (28.6%, 32/112) and fewer in industrial poultry (8%, 12/150). Of these positive samples, 45.5% (20/44) were determined to be C. psittaci . For the first time C. psittaci genotype A is reported in poultry in Latin America. In addition, the presence of Chlamydia gallinacea in backyard poultry and of Chlamydia muridarum in industrial and backyard poultry is reported for the first time in Central America. In 40.9% (18/44) of the positive samples, it was not possible to identify the infecting chlamydial species. These findings reveal a zoonotic risk, particularly for poultry farm and slaughterhouse workers having direct contact with these birds.
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Affiliation(s)
- Antony Solorzano-Morales
- Universidad Nacional, Escuela de Medicina Veterinaria, Laboratorio de Investigación en Medicina Poblacional, P.O. Box 86-3000, Heredia, Costa Rica.
| | - Gaby Dolz
- Universidad Nacional, Escuela de Medicina Veterinaria, Laboratorio de Investigación en Medicina Poblacional, P.O. Box 86-3000, Heredia, Costa Rica.
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Marchino M, Rizzo F, Barzanti P, Sparasci OA, Bottino P, Vicari N, Rigamonti S, Braghin S, Aaziz R, Vorimore F, Ru G, Laroucau K, Mandola ML. Chlamydia Species and Related Risk Factors in Poultry in North-Western Italy: Possible Bird-to-Human Transmission for C. gallinacea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042174. [PMID: 35206361 PMCID: PMC8872282 DOI: 10.3390/ijerph19042174] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/08/2022] [Accepted: 02/11/2022] [Indexed: 11/16/2022]
Abstract
Chlamydiaceae are obligatory intracellular bacteria causing acute and chronic diseases in animals and humans worldwide, with recently discovered species with a still unclear pathogenic potential (i.e., C. gallinacea). In Italy, Chlamydiaceae infections are underestimated both in animals and humans. To estimate the prevalence of Chlamydiaceae species in poultry and occupationally exposed workers on farm, a cross-sectional study was carried out in north-western Italy. A total of 2063 samples from 83 commercial and 31 backyard poultry farms were analysed using real-time PCRs for Chlamydiaceae screening and species typing. Chlamydiaceae were detected in 23 farms, with a herd prevalence of 20.2% (95%CI: 13.2-28.7), higher in backyard farms (38.7%; 95%CI: 21.8-57.8) compared to commercial ones (13.3%; 95%CI: 6.8-22.5). C. gallinacea was found in 18 chicken farms, both commercial and backyard, and C. psittaci only in 3 backyard farms. Exposure to wild birds and factors related to biosecurity resulted the main risk factors associated with Chlamydia positivity. Out of the 113 sputum samples collected from farmers, 16 tested positive to Chlamydiaceae, with a prevalence of 14.2% (95%CI: 8, 3-22). To the best of our knowledge, for the first time at international level, C. gallinacea was detected in humans with farmer positivity associated with farm infectious status, suggesting a bird-to-human transmission.
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Affiliation(s)
- Monica Marchino
- Experimental Zooprophylactic Institute of Piedmont, Liguria and Aosta Valley (IZSPLV), Via Bologna 148, 10154 Turin, Italy; (F.R.); (P.B.); (O.A.S.); (G.R.)
- Correspondence: (M.M.); (M.L.M.)
| | - Francesca Rizzo
- Experimental Zooprophylactic Institute of Piedmont, Liguria and Aosta Valley (IZSPLV), Via Bologna 148, 10154 Turin, Italy; (F.R.); (P.B.); (O.A.S.); (G.R.)
| | - Paola Barzanti
- Experimental Zooprophylactic Institute of Piedmont, Liguria and Aosta Valley (IZSPLV), Via Bologna 148, 10154 Turin, Italy; (F.R.); (P.B.); (O.A.S.); (G.R.)
| | - Oriana Anna Sparasci
- Experimental Zooprophylactic Institute of Piedmont, Liguria and Aosta Valley (IZSPLV), Via Bologna 148, 10154 Turin, Italy; (F.R.); (P.B.); (O.A.S.); (G.R.)
| | - Paolo Bottino
- S.C. Microbiology and Virology Unit, Azienda Ospedaliero Universitaria “Città della Salute e della Scienza di Torino”, 10126 Turin, Italy;
| | - Nadia Vicari
- National Reference Laboratory for Chlamydioses, Experimental Zooprophylactic Institute of Lombardia and Emilia Romagna (IZSLER), 27100 Pavia, Italy; (N.V.); (S.R.)
| | - Sara Rigamonti
- National Reference Laboratory for Chlamydioses, Experimental Zooprophylactic Institute of Lombardia and Emilia Romagna (IZSLER), 27100 Pavia, Italy; (N.V.); (S.R.)
| | - Silvia Braghin
- S.C. Sanità Animale, Dipartimento Di Prevenzione, ASL CN1, Via Carlo Boggio 12, 12100 Cuneo, Italy;
| | - Rachid Aaziz
- Laboratory for Animal Health, Bacterial Zoonosis Unit, ANSES Maisons-Alfort, Paris-Est University, 94706 Paris, France; (R.A.); (F.V.); (K.L.)
| | - Fabien Vorimore
- Laboratory for Animal Health, Bacterial Zoonosis Unit, ANSES Maisons-Alfort, Paris-Est University, 94706 Paris, France; (R.A.); (F.V.); (K.L.)
| | - Giuseppe Ru
- Experimental Zooprophylactic Institute of Piedmont, Liguria and Aosta Valley (IZSPLV), Via Bologna 148, 10154 Turin, Italy; (F.R.); (P.B.); (O.A.S.); (G.R.)
| | - Karine Laroucau
- Laboratory for Animal Health, Bacterial Zoonosis Unit, ANSES Maisons-Alfort, Paris-Est University, 94706 Paris, France; (R.A.); (F.V.); (K.L.)
| | - Maria Lucia Mandola
- Experimental Zooprophylactic Institute of Piedmont, Liguria and Aosta Valley (IZSPLV), Via Bologna 148, 10154 Turin, Italy; (F.R.); (P.B.); (O.A.S.); (G.R.)
- Correspondence: (M.M.); (M.L.M.)
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Ruiz-Laiton A, Molano-Ayala N, García-Castiblanco S, Puentes-Orozco AM, Falla AC, Camargo M, Roa L, Rodríguez-López A, Patarroyo MA, Avendaño C. The prevalence of Chlamydia psittaci in confiscated Psittacidae in Colombia. Prev Vet Med 2022; 200:105591. [DOI: 10.1016/j.prevetmed.2022.105591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/07/2021] [Accepted: 01/29/2022] [Indexed: 11/16/2022]
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Suminda GGD, Bhandari S, Won Y, Goutam U, Kanth Pulicherla K, Son YO, Ghosh M. High-throughput sequencing technologies in the detection of livestock pathogens, diagnosis, and zoonotic surveillance. Comput Struct Biotechnol J 2022; 20:5378-5392. [PMID: 36212529 PMCID: PMC9526013 DOI: 10.1016/j.csbj.2022.09.028] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 12/03/2022] Open
Abstract
Increasing globalization, agricultural intensification, urbanization, and climatic changes have resulted in a significant recent increase in emerging infectious zoonotic diseases. Zoonotic diseases are becoming more common, so innovative, effective, and integrative research is required to better understand their transmission, ecological implications, and dynamics at wildlife-human interfaces. High-throughput sequencing (HTS) methodologies have enormous potential for unraveling these contingencies and improving our understanding, but they are only now beginning to be realized in livestock research. This study investigates the current state of use of sequencing technologies in the detection of livestock pathogens such as bovine, dogs (Canis lupus familiaris), sheep (Ovis aries), pigs (Sus scrofa), horses (Equus caballus), chicken (Gallus gallus domesticus), and ducks (Anatidae) as well as how it can improve the monitoring and detection of zoonotic infections. We also described several high-throughput sequencing approaches for improved detection of known, unknown, and emerging infectious agents, resulting in better infectious disease diagnosis, as well as surveillance of zoonotic infectious diseases. In the coming years, the continued advancement of sequencing technologies will improve livestock research and hasten the development of various new genomic and technological studies on farm animals.
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Stalder S, Marti H, Borel N, Vogler BR, Pesch T, Prähauser B, Wencel P, Laroucau K, Albini S. Falcons From the United Arab Emirates Infected With Chlamydia psittaci/ C abortus Intermediates Specified as Chlamydia buteonis by Polymerase Chain Reaction. J Avian Med Surg 2021; 35:333-340. [PMID: 34677032 DOI: 10.1647/20-00050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Chlamydiaceae are obligate intracellular bacteria with a broad host range. Several studies have found chlamydial species that are genetically intermediate between Chlamydia psittaci and Chlamydia abortus in various avian species. One of these intermediate Chlamydia species, found in a red-shouldered hawk (Buteo lineatus), was recently classified as a new species Chlamydia buteonis. This newly described Chlamydia species has, so far, only been reported in hawks exhibiting clinical signs of conjunctivitis, dyspnea, and diarrhea. In the present study, fecal samples of 5 gyrfalcons (Falco rusticolus), 3 gyr/peregrine falcon hybrids (Falco rusticolus × Falco peregrinus), and 15 falcons of unknown species presented to falcon clinics on the Arabian Peninsula were shipped to the Vetsuisse Faculty, University of Zurich (Zurich, Switzerland), for examination for the presence of Chlamydiaceae. A step-wise diagnostic approach was performed to identify the chlamydial species involved. Chlamydiaceae were detected in 21/23 falcons by a family-specific real-time quantitative PCR (qPCR). Further identification with a 23S ribosomal RNA-based microarray assay and 16S conventional PCR and sequencing yielded inconclusive results, indicating the presence of an intermediate Chlamydia species. Because none of the falcons tested positive for Chlamydia psittaci by specific qPCR, all 23 samples were subjected to a Chlamydia buteonis-specific qPCR, which was positive in 16/23 samples. Detailed information regarding clinical history was available for 8 falcons admitted to a falcon clinic in Dubai, United Arab Emirates. Six of those birds that were presented to the clinic because of loss of performance and poor general condition, including vomiting and diarrhea, were positive for C buteonis. In 2 birds without clinical disease signs admitted for a routine health examination, 1 was positive for C buteonis, and 1 was negative. It is yet unknown whether Chlamydia buteonis causes disease in birds, but the findings in this study indicate that Chlamydia buteonis may be an infectious pathogen in falcon species.
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Affiliation(s)
- Sandro Stalder
- National Reference Center for Poultry and Rabbit Diseases (NRGK), Institute for Food Safety and Hygiene, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland,
| | - Hanna Marti
- Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
| | - Nicole Borel
- Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
| | - Barbara Renate Vogler
- National Reference Center for Poultry and Rabbit Diseases (NRGK), Institute for Food Safety and Hygiene, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
| | - Theresa Pesch
- Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
| | - Barbara Prähauser
- Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
| | - Peter Wencel
- Al Aseefa Falcon Hospital, Nad Al Sheba, Dubai, United Arab Emirates
| | - Karine Laroucau
- Bacterial Zoonoses Unit, Animal Health Laboratory, University Paris-Est, Anses, 94706 Maisons-Alfort Cedex, France
| | - Sarah Albini
- National Reference Center for Poultry and Rabbit Diseases (NRGK), Institute for Food Safety and Hygiene, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
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Seibert BA, Keel MK, Kelly TR, Nilsen RA, Ciembor P, Pesti D, Gregory CR, Ritchie BW, Hawkins MG. Chlamydia buteonis in birds of prey presented to California wildlife rehabilitation facilities. PLoS One 2021; 16:e0258500. [PMID: 34644359 PMCID: PMC8513822 DOI: 10.1371/journal.pone.0258500] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 09/28/2021] [Indexed: 11/18/2022] Open
Abstract
Chlamydial infections, caused by a group of obligate, intracellular, gram-negative bacteria, have health implications for animals and humans. Due to their highly infectious nature and zoonotic potential, staff at wildlife rehabilitation centers should be educated on the clinical manifestations, prevalence, and risk factors associated with Chlamydia spp. infections in raptors. The objectives of this study were to document the prevalence of chlamydial DNA shedding and anti-chlamydial antibodies in raptors admitted to five wildlife rehabilitation centers in California over a one-year period. Chlamydial prevalence was estimated in raptors for each center and potential risk factors associated with infection were evaluated, including location, species, season, and age class. Plasma samples and conjunctiva/choana/cloaca swabs were collected for serology and qPCR from a subset of 263 birds of prey, representing 18 species. Serologic assays identified both anti-C. buteonis IgM and anti-chlamydial IgY antibodies. Chlamydial DNA and anti-chlamydial antibodies were detected in 4.18% (11/263) and 3.14% (6/191) of patients, respectively. Chamydial DNA was identified in raptors from the families Accipitridae and Strigidae while anti-C.buteonis IgM was identified in birds identified in Accipitridae, Falconidae, Strigidae, and Cathartidae. Two of the chlamydial DNA positive birds (one Swainson’s hawk (Buteo swainsoni) and one red-tailed hawk (Buteo jamaicensis)) were necropsied, and tissues were collected for culture. Sequencing of the cultured elementary bodies revealed a chlamydial DNA sequence with 99.97% average nucleotide identity to the recently described Chlamydia buteonis. Spatial clusters of seropositive raptors and raptors positive for chlamydial DNA were detected in northern California. Infections were most prevalent during the winter season. Furthermore, while the proportion of raptors testing positive for chlamydial DNA was similar across age classes, seroprevalence was highest in adults. This study questions the current knowledge on C. buteonis host range and highlights the importance of further studies to evaluate the diversity and epidemiology of Chlamydia spp. infecting raptor populations.
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Affiliation(s)
- Brittany A. Seibert
- Department of Avian Science, University of California, Davis, California, United States of America
| | - Michael K. Keel
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, California, United States of America
| | - Terra R. Kelly
- Karen C. Drayer Wildlife Health Center, School of Veterinary Medicine, University of California, Davis, California, United States of America
| | - Roger A. Nilsen
- Infectious Disease Laboratory, University of Georgia, Athens, Georgia, United States of America
| | - Paula Ciembor
- Infectious Disease Laboratory, University of Georgia, Athens, Georgia, United States of America
| | - Denise Pesti
- Infectious Disease Laboratory, University of Georgia, Athens, Georgia, United States of America
| | - Christopher R. Gregory
- Infectious Disease Laboratory, University of Georgia, Athens, Georgia, United States of America
| | - Branson W. Ritchie
- Infectious Disease Laboratory, University of Georgia, Athens, Georgia, United States of America
| | - Michelle G. Hawkins
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California, United States of America
- * E-mail:
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Sahu R, Vishnuraj MR, Srinivas C, Dadimi B, Megha GK, Pollumahanti N, Malik SS, Vaithiyanathan S, Rawool DB, Barbuddhe SB. Development and comparative evaluation of droplet digital PCR and quantitative PCR for the detection and quantification of Chlamydia psittaci. J Microbiol Methods 2021; 190:106318. [PMID: 34592374 DOI: 10.1016/j.mimet.2021.106318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/28/2021] [Accepted: 08/29/2021] [Indexed: 10/20/2022]
Abstract
Chlamydia psittaci is a zoonotic pathogen mainly transmitted by psittacine birds and poultry. The low shedding rate of the pathogen in the apparently healthy birds and human clinical cases may result in false-negative results. In the present study, a droplet digital PCR (ddPCR) assay was developed and compared with optimized quantitative PCR (qPCR) for the detection of C. psittaci from the clinical samples. The ddPCR assay was found to be comparatively more sensitive than the qPCR, wherein the limit of detection (LOD) of ddPCR was upto 2.4 copies of the DNA template, whereas, the qPCR could detect upto 38 copies of the DNA template in the reaction mixture. Overall, the developed ddPCR assay was found to be robust, specific, and could reliably quantify up to 17.8 copies of the DNA template. Finally, the applicability of the developed ddPCR assay was tested by screening the field samples (n = 124), comprising lung tissues from dead poultry and feral birds; pooled faecal samples from the free-living birds, commercial and backyard poultry farms; pharyngeal and cloacal swabs collected from the duck farms. Of these, a total of seven samples were found to be positive by the ddPCR, whereas, three samples could be detected as positive using the qPCR. The developed ddPCR could serve as a reliable screening tool, particularly in those clinical samples wherein the shedding of C. psittaci is substantially very low.
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Affiliation(s)
- Radhakrishna Sahu
- ICAR-National Research Centre on Meat, Chengicherla, Hyderabad 500092, India; Department of Veterinary Public Health, ICAR- Indian Veterinary Research Institute, Izatnagar 243122, India
| | - M R Vishnuraj
- ICAR-National Research Centre on Meat, Chengicherla, Hyderabad 500092, India
| | - Ch Srinivas
- ICAR-National Research Centre on Meat, Chengicherla, Hyderabad 500092, India
| | - Bhargavi Dadimi
- Department of Veterinary Public Health, ICAR- Indian Veterinary Research Institute, Izatnagar 243122, India
| | - G K Megha
- Department of Veterinary Public Health, ICAR- Indian Veterinary Research Institute, Izatnagar 243122, India
| | | | - Satyaveer S Malik
- Department of Veterinary Public Health, ICAR- Indian Veterinary Research Institute, Izatnagar 243122, India
| | - S Vaithiyanathan
- ICAR-National Research Centre on Meat, Chengicherla, Hyderabad 500092, India
| | - Deepak B Rawool
- ICAR-National Research Centre on Meat, Chengicherla, Hyderabad 500092, India
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Taheri F, Ownagh A, Mardani K. Phylogenetic and molecular analysis based on genes 16S-rRNA, OMPA and POMP to identify Chlamydia abortus infection occurrence at the milk samples of goats and sheep in west Azerbaijan of Iran. IRANIAN JOURNAL OF MICROBIOLOGY 2021; 13:480-487. [PMID: 34557276 PMCID: PMC8421589 DOI: 10.18502/ijm.v13i4.6972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background and Objectives: Enzootic abortion in sheep and goats, also called ovine enzootic abortion (OEA) or enzootic abortion of ewes (EAE), is caused by Chlamydia abortus. The disease has a major economic impact as it represents the most important cause of lamb loss in sheep in parts of Europe, North America and Africa. This serious and potentially life-threatening zoonosis can also affect pregnant women after contact with lambing ewes, leading to severe febrile illness in pregnancy and loss of the foetus. Materials and Methods: The present study was conducted to the Phylogenetic and Molecular Analysis based on Genes 16S-rRNA, OmpA and POMP of C. abortus in milk samples collected from sheep and goats in West Azerbaijan province, Iran. During 2018, a total number of 360 milk samples were collected from sheep (n = 180) and goats (n = 180) of different regions of the province. All milk samples were subjected to DNA extraction and examined by PCR. Results: Among 360 milk samples collected from sheep and goats, 31 (8.611%; 95% CI=6.13–11.96) were positive for Chlamydia spp. The helicase, 16S-rRNA and ompA genes were examined and resulted in 8, 31, 31 of positive samples respectively. The accession numbers have been deposited in GenBank (NCBI) (MT367602 and MT367603). Conclusion: Phylogenetic analysis based on the gene of helicase showed that most of the isolates shared similarity > 99.97%.
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Affiliation(s)
- Fariba Taheri
- Department of Microbiology, School of Veterinary Medicine, Urmia University, Urmia, West Azerbaijan, Iran
| | - Abdulghaffar Ownagh
- Department of Microbiology, School of Veterinary Medicine, Urmia University, Urmia, West Azerbaijan, Iran
| | - Karim Mardani
- Department of Food Hygiene and Quality Control, School of Veterinary Medicine, Urmia University, Urmia, West Azerbaijan, Iran
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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: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 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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Veletzky L, Huebl L, Schulze Zur Wiesch J, Schmiedel S. Psittacosis in a traveller. J Travel Med 2021; 28:6225389. [PMID: 33851712 DOI: 10.1093/jtm/taab062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/30/2021] [Accepted: 04/12/2021] [Indexed: 01/01/2023]
Abstract
A 48-year-old male was admitted with severe community-acquired pneumonia after a family visit to turkey. Upon specific questioning he reported having close contact to a tame budgerigar. Sputum PCR for Chlamydia psittaci turned positive. After treatment adaptation to doxycycline he quickly improved. Detailed anamnesis is paramount for establishing correct diagnosis.
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Affiliation(s)
- Luzia Veletzky
- Department for Tropical Medicine, Bernhard-Nocht-Institute for Tropical Medicine & I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany
| | - Lena Huebl
- Department for Tropical Medicine, Bernhard-Nocht-Institute for Tropical Medicine & I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julian Schulze Zur Wiesch
- German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany.,Division of Infectious Diseases, I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Schmiedel
- German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany.,Division of Infectious Diseases, I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Ravichandran K, Anbazhagan S, Karthik K, Angappan M, Dhayananth B. A comprehensive review on avian chlamydiosis: a neglected zoonotic disease. Trop Anim Health Prod 2021; 53:414. [PMID: 34312716 PMCID: PMC8313243 DOI: 10.1007/s11250-021-02859-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 07/09/2021] [Indexed: 01/12/2023]
Abstract
Avian chlamydiosis is one of the important neglected diseases with critical zoonotic potential. Chlamydia psittaci, the causative agent, affects most categories of birds, livestock, companion animals, and humans. It has many obscured characters and epidemiological dimensions, which makes it unique among other bacterial agents. Recent reports on transmission from equine to humans alarmed the public health authorities, and it necessitates the importance of routine screening of this infectious disease. High prevalence of spill-over infection in equines was associated with reproductive losses. Newer avian chlamydial species are being reported in the recent years. It is a potential biological warfare agent and the disease is an occupational hazard mainly to custom officers handling exotic birds. Prevalence of the disease in wild birds, pet birds, and poultry causes economic losses to the poultry industry and the pet bird trade. Interestingly, there are speculations on the ‘legal’ and ‘illegal’ bird trade that may be the global source of some of the most virulent strains of this pathogen. The mortality rate generally ranges from 5 to 40% in untreated cases, but it can sometimes be higher in co-infection. The intracellular lifestyle of this pathogen makes the diagnosis more complicated and there is also lack of accurate diagnostics. Resistance to antibiotics is reported only in some pathogens of the Chlamydiaceae family, but routine screening may assess the actual situation in all pathogens. Due to the diverse nature of the pathogen, the organism necessitates the One Health partnerships to have complete understanding. The present review focuses on the zoonotic aspects of avian chlamydiosis with its new insights into the pathogenesis, transmission, treatment, prevention, and control strategies. The review also briefs on the basic understandings and complex epidemiology of avian chlamydiosis, highlighting the need for research on emerging one health perspectives.
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Affiliation(s)
- Karthikeyan Ravichandran
- Division of Public Health and Epidemiology, ICAR-Indian Veterinary Research Institute, Izatnagar, India.
| | - Subbaiyan Anbazhagan
- Division of Bacteriology and Mycology, ICAR-Indian Veterinary Research Institute, Izatnagar, India
| | - Kumaragurubaran Karthik
- Central University Laboratory, Tamil Nadu Veterinary and Animal Sciences University, Chennai, India
| | - Madesh Angappan
- Division of Public Health and Epidemiology, ICAR-Indian Veterinary Research Institute, Izatnagar, India
| | - Balusamy Dhayananth
- Division of Public Health and Epidemiology, ICAR-Indian Veterinary Research Institute, Izatnagar, India
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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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Li N, Li S, Tan W, Wang H, Xu H, Wang D. Metagenomic next-generation sequencing in the family outbreak of psittacosis: the first reported family outbreak of psittacosis in China under COVID-19. Emerg Microbes Infect 2021; 10:1418-1428. [PMID: 34176434 PMCID: PMC8284143 DOI: 10.1080/22221751.2021.1948358] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Chlamydia psittaci infection in humans, also known as psittacosis, is usually believed to be an uncommon disease which mainly presents as community-acquired pneumonia (CAP). It is usually sporadic, but outbreaks of infection may occasionally occur. In outbreaks, diagnosis and investigations were usually hampered by the non-specificity of laboratory testing methods to identify C. psittaci. In this study, we use metagenomic next-generation sequencing (mNGS) in the diagnosis of a family outbreak of psittacosis under COVID-19. Three members of an extended family of 6 persons developed psittacosis with pneumonia and hepatic involvement with common symptoms of fever and weakness. Two newly purchased pet parrots, which had died successively, were probably the primary source of infection. Imagings show lung consolidations and infiltrates, which are difficult to be differentiated from CAP caused by other common pathogens. mNGS rapidly identified the infecting agent as C. psittaci within 48 h. The results of this work suggest that there are not characteristic clinical manifestations and imagings of psittacosis pneumonia which can differentiate from CAP caused by other pathogens. The use of mNGS can improve accuracy and reduce the delay in the diagnosis of psittacosis especially during the outbreak, which can shorten the course of the disease control. Family outbreak under COVID-19 may be related to the familial aggregation due to the epidemic. To our knowledge, this is the first reported family outbreak of psittacosis in China, and the first reported psittacosis outbreak identified by the method of mNGS in the world.
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Affiliation(s)
- Na Li
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Shengjin Li
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Wanmei Tan
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Hanghang Wang
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Huan Xu
- Vision Medicals Center for Infection Diseases, Guangzhou, People's Republic of China
| | - Daoxing Wang
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
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Wang K, Liu X, Liu H, Li P, Lin Y, Yin D, Yang L, Li J, Li S, Jia L, Bai C, Jiang Y, Li P, Song H. Metagenomic diagnosis of severe psittacosis using multiple sequencing platforms. BMC Genomics 2021; 22:406. [PMID: 34078288 PMCID: PMC8173916 DOI: 10.1186/s12864-021-07725-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 05/19/2021] [Indexed: 12/25/2022] Open
Abstract
Background Chlamydia psittaci is an avian pathogen that can cause lethal human infections. Diagnosis of C. psittaci pneumonia is often delayed due to nonspecific clinical presentations and limited laboratory diagnostic techniques. Results The MinION platform established the diagnosis in the shortest time, while BGISEQ-500 generated additional in-depth sequence data that included the rapid characterization of antibiotic susceptibility. Cytopathy appeared only in cell cultures of BALF. BALF yielded a higher bacterial load than sputum or blood, and may be the most suitable clinical specimen for the genomic diagnosis of severe pneumonia. Conclusions This study indicated that the benefits of metagenomic sequencing include rapid etiologic diagnosis of unknown infections and the provision of additional relevant information regarding antibiotic susceptibility. The continued optimization and standardization of sampling and metagenomic analysis promise to enhance the clinical utility of genomic diagnosis. Supplementary Information The online version contains supplementary material available at 10.1186/s12864-021-07725-9.
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Affiliation(s)
- Kaiying Wang
- Academy of Military Medical Sciences, Academy of Military Sciences, 20 Dongda Street, Fengtai District, 100071, Beijing, China.,Chinese PLA Center for Disease Control and Prevention, 20 Dongda Street, Fengtai District, 100071, Beijing, China
| | - Xiong Liu
- Chinese PLA Center for Disease Control and Prevention, 20 Dongda Street, Fengtai District, 100071, Beijing, China
| | - Huiying Liu
- Department of Respiratory and Critical Care Medicine, the Fifth Medical Center of PLA General Hospital, Beijing, China
| | - Peihan Li
- Academy of Military Medical Sciences, Academy of Military Sciences, 20 Dongda Street, Fengtai District, 100071, Beijing, China.,Chinese PLA Center for Disease Control and Prevention, 20 Dongda Street, Fengtai District, 100071, Beijing, China
| | - Yanfeng Lin
- Academy of Military Medical Sciences, Academy of Military Sciences, 20 Dongda Street, Fengtai District, 100071, Beijing, China.,Chinese PLA Center for Disease Control and Prevention, 20 Dongda Street, Fengtai District, 100071, Beijing, China
| | - Dongdong Yin
- Anhui Province Key Laboratory of Veterinary Pathobiology and Disease Control College of Animal Science and Technology, Anhui Agricultural University, Hefei, China
| | - Lang Yang
- Chinese PLA Center for Disease Control and Prevention, 20 Dongda Street, Fengtai District, 100071, Beijing, China
| | - Jinhui Li
- Chinese PLA Center for Disease Control and Prevention, 20 Dongda Street, Fengtai District, 100071, Beijing, China
| | - Shenlong Li
- Chinese PLA Center for Disease Control and Prevention, 20 Dongda Street, Fengtai District, 100071, Beijing, China
| | - Leili Jia
- Chinese PLA Center for Disease Control and Prevention, 20 Dongda Street, Fengtai District, 100071, Beijing, China
| | - Changqing Bai
- Department of Respiratory and Critical Care Medicine, the Fifth Medical Center of PLA General Hospital, Beijing, China
| | - Yongqiang Jiang
- Academy of Military Medical Sciences, Academy of Military Sciences, 20 Dongda Street, Fengtai District, 100071, Beijing, China.
| | - Peng Li
- Chinese PLA Center for Disease Control and Prevention, 20 Dongda Street, Fengtai District, 100071, Beijing, China.
| | - Hongbin Song
- Chinese PLA Center for Disease Control and Prevention, 20 Dongda Street, Fengtai District, 100071, Beijing, China.
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Australia's notifiable disease status, 2016: Annual report of the National Notifiable Diseases Surveillance System. ACTA ACUST UNITED AC 2021; 45. [PMID: 34074234 DOI: 10.33321/cdi.2021.45.28] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Abstract In 2016, a total of 67 diseases and conditions were nationally notifiable in Australia. The states and territories reported 330,387 notifications of communicable diseases to the National Notifiable Diseases Surveillance System. Notifications have remained stable between 2015 and 2016. In 2016, the most frequently notified diseases were vaccine preventable diseases (139,687 notifications, 42% of total notifications); sexually transmissible infections (112,714 notifications, 34% of total notifications); and gastrointestinal diseases (49,885 notifications, 15% of total notifications). Additionally, there were 18,595 notifications of bloodborne diseases; 6,760 notifications of vectorborne diseases; 2,020 notifications of other bacterial infections; 725 notifications of zoonoses and one notification of a quarantinable disease.
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Affiliation(s)
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- Australian Government Department of Health
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