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Hu X, Jiang L, Liu X, Chang H, Dong H, Yan J, Zhou X, Kong M. The diagnostic value of bronchoalveolar lavage fluid metagenomic next-generation sequencing in critically ill patients with respiratory tract infections. Microbiol Spectr 2024:e0045824. [PMID: 38916357 DOI: 10.1128/spectrum.00458-24] [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: 03/09/2024] [Accepted: 05/18/2024] [Indexed: 06/26/2024] Open
Abstract
Metagenomic next-generation sequencing (mNGS) is an unbiased and rapid method for detecting pathogens. This study enrolled 145 suspected severe pneumonia patients who were admitted to the Affiliated Hospital of Jining Medical University. This study primarily aimed to determine the diagnostic performance of mNGS and conventional microbiological tests (CMTs) using bronchoalveolar lavage fluid samples for detecting pathogens. Our findings indicated that mNGS performed significantly higher sensitivity (97.54% vs 28.68%, P < 0.001), coincidence (90.34% vs 35.17%, P < 0.001), and negative predictive value (80.00% vs 13.21%, P < 0.001) but performed lower specificity than CMTs (52.17% vs 87.5%, P < 0.001). Streptococcus pneumoniae as the most common bacterial pathogen had the largest proportion (22.90%, 30/131) in this study. In addition to bacteria, fungi, and virus, mNGS can detect a variety of atypical pathogens such as Mycobacterium tuberculosis and non-tuberculous. Mixed infections were common in patients with severe pneumonia, and bacterial-fungal-viral-atypical pathogens were the most complicated infection. After adjustments of antibiotics based on mNGS and CMTs, the clinical manifestation improved in 139 (95.86%, 139/145) patients. Our data demonstrated that mNGS had significant advantage in diagnosing respiratory tract infections, especially atypical pathogens and fungal infections. Pathogens were detected timely and comprehensively, contributing to the adjustments of antibiotic treatments timely and accurately, improving patient prognosis and decreasing mortality potentially.IMPORTANCEMetagenomic next-generation sequencing using bronchoalveolar lavage fluid can provide more comprehensive and accurate pathogens for respiratory tract infections, especially when considering the previous usage of empirical antibiotics before admission or complicated clinical presentation. This technology is expected to play an important role in the precise application of antimicrobial drugs in the future.
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Affiliation(s)
- Xiaohang Hu
- Medical Laboratory Science, Affiliated Hospital of Jining Medical University, Jining Medical University, Shandong Jining, China
| | - Liqing Jiang
- Medical Laboratory Science, Affiliated Hospital of Jining Medical University, Jining Medical University, Shandong Jining, China
| | - Xiaowei Liu
- Department of Intensive Care Unit, Affiliated Hospital of Jining Medical University,Jining Medical University, Shandong Jining, China
| | - Hong Chang
- Medical Laboratory Science, Affiliated Hospital of Jining Medical University, Jining Medical University, Shandong Jining, China
| | - Haixin Dong
- Medical Laboratory Science, Affiliated Hospital of Jining Medical University, Jining Medical University, Shandong Jining, China
| | - Jinyan Yan
- Medical Laboratory Science, Affiliated Hospital of Jining Medical University, Jining Medical University, Shandong Jining, China
| | - Xiaoya Zhou
- Medical Laboratory of Jining Medical University, Lin He's Academician Workstation of New Medicine and Clinical Translation in Jining Medical University, Jining Medical University, Shandong Jining, China
| | - Min Kong
- Medical Laboratory of Jining Medical University, Lin He's Academician Workstation of New Medicine and Clinical Translation in Jining Medical University, Jining Medical University, Shandong Jining, China
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Liu M, Zhang H, Li L, Mao J, Li R, Yin J, Wu X. The etiological diagnostic value of metagenomic next-generation sequencing in suspected community-acquired pneumonia. BMC Infect Dis 2024; 24:626. [PMID: 38914949 PMCID: PMC11194883 DOI: 10.1186/s12879-024-09507-6] [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: 03/01/2024] [Accepted: 06/13/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND The emergence of metagenomic next-generation sequencing (mNGS) may provide a promising tool for early and comprehensive identification of the causative pathogen in community-acquired pneumonia (CAP). In this study, we aim to further evaluate the etiological diagnostic value of mNGS in suspected CAP. METHODS A total of 555 bronchoalveolar lavage fluid (BALF) samples were collected for pathogen detection by mNGS from 541 patients with suspected CAP. The clinical value was assessed based on infection diagnosis and treatment guidance. The diagnostic performance for pathogen identification by mNGS and sputum culture and for tuberculosis (TB) by mNGS and X-pert MTB/RIF were compared. To evaluate the potential for treatment guidance, we analyzed the treatment regimen of patients with suspected CAP, including imaging changes of lung after empirical antibacterial therapy, intensified regimen, antifungal treatment, and a 1-year follow up for patients with unconfirmed diagnosis and non-improvement imaging after anti-infective treatment and patients with high suspicion of TB or NTM infection who were transferred to the Wuhan Pulmonary Hospital for further diagnosis and even anti-mycobacterium therapy. RESULTS Of the 516 BALF samples that were analyzed by both mNGS and sputum culture, the positivity rate of mNGS was significantly higher than that of sputum culture (79.1% vs. 11.4%, P = 0.001). A total of 48 samples from patients with confirmed TB were analyzed by both mNGS and X-pert MTB/RIF, and the sensitivity of mNGS for the diagnosis of active TB was significantly lower than that of X-pert MTB/RIF (64.6% vs. 85.4%, P = 0.031). Of the 106 pathogen-negative cases, 48 were ultimately considered non-infectious diseases, with a negative predictive value of 45.3%. Of the 381 pathogen-positive cases, 311 were eventually diagnosed as CAP, with a positive predictive value of 81.6%. A total of 487 patients were included in the evaluation of the therapeutic effect, and 67.1% improved with initial empirical antibiotic treatment. Of the 163 patients in which bacteria were detected, 77.9% improved with antibacterial therapy; of the 85 patients in which fungi were detected, 12.9% achieved remission after antifungal therapy. CONCLUSIONS Overall, mNGS had unique advantages in the detection of suspected CAP pathogens. However, mNGS was not superior to X-pert MTB/RIF for the diagnosis of TB. In addition, mNGS was not necessary as a routine test for all patients admitted with suspected CAP. Furthermore, when fungi are detected by mNGS, antifungal therapy should be cautious.
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Affiliation(s)
- Mengling Liu
- Department of Pulmonary and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Haiyue Zhang
- Department of Pulmonary and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Liangyu Li
- Department of Pulmonary and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Jieyu Mao
- Department of Pulmonary and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Ruiyun Li
- Department of Pulmonary and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Jing Yin
- Department of Pulmonary and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Xiaojun Wu
- Department of Pulmonary and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
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Zhang R, Fu H, Luo C, Huang Z, Pei R, Di Y, Zhu C, Peng J, Hu H, Chen S, Chen J, Chen L, Xu M, Yang X, Yang R. Chlamydia psittaci detected at a live poultry wholesale market in central China. BMC Infect Dis 2024; 24:585. [PMID: 38867171 PMCID: PMC11170795 DOI: 10.1186/s12879-024-09478-8] [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: 01/20/2024] [Accepted: 06/05/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND We investigated the presence of Chlamydia psittaci in poultry and the environment in live poultry wholesale markets in Changsha during 2021-2022 and conducted a phylogenetic analysis to understand its distribution in this market. METHODS In total, 483 samples were analyzed using real-time polymerase chain reaction and 17 C. psittaci-positive samples using high-throughput sequencing, BLAST similarity, and phylogenetic analysis. RESULTS Twenty-two out of 483 poultry and environmental samples were positive for C. psittaci (overall positivity rate: 4.55%) with no difference in positivity rates over 12 months. Chlamydia psittaci was detected at 11 sampling points (overall positivity rate: 27.5%), including chicken, duck, and pigeon/chicken/duck/goose shops, with pigeon shops having the highest positivity rate (46.67%). The highest positivity rates were found in sewage (12.5%), poultry fecal (7.43%), cage swab (6.59%), avian pharyngeal/cloacal swab (3.33%), and air (2.29%) samples. The ompA sequences were identified in two strains of C. psittaci, which were determined to bear genotype B using phylogenetic analysis. Thus, during monitoring, C. psittaci genotype B was detected in the poultry and environmental samples from the poultry wholesale market in Changsha. CONCLUSIONS To address the potential zoonotic threat, C. psittaci monitoring programs in live poultry markets should be enhanced.
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Affiliation(s)
- Rusheng Zhang
- Changsha Center for Disease Prevention and Control, Changsha, Hunan, 410007, China
| | - Huiyuan Fu
- Changsha Center for Disease Prevention and Control, Changsha, Hunan, 410007, China
| | - Can Luo
- Changsha Center for Disease Prevention and Control, Changsha, Hunan, 410007, China
| | - Zheng Huang
- Changsha Center for Disease Prevention and Control, Changsha, Hunan, 410007, China
| | - Ruiqing Pei
- Changsha Center for Disease Prevention and Control, Changsha, Hunan, 410007, China
| | - Yu Di
- Changsha Center for Disease Prevention and Control, Changsha, Hunan, 410007, China
| | - Caiying Zhu
- Changsha Center for Disease Prevention and Control, Changsha, Hunan, 410007, China
| | - Jiayi Peng
- Public Health College, University of South China, Hengyang, Hunan, 421001, China
| | - Huiqi Hu
- Public Health College, University of South China, Hengyang, Hunan, 421001, China
| | - Shan Chen
- Changsha Center for Disease Prevention and Control, Changsha, Hunan, 410007, China
| | - Jingfang Chen
- Changsha Center for Disease Prevention and Control, Changsha, Hunan, 410007, China
| | - Lamei Chen
- Changsha Kaifu Disease Prevention and Control Center, Changsha, Hunan, 410007, China
| | - Mingzhong Xu
- Changsha Center for Disease Prevention and Control, Changsha, Hunan, 410007, China
| | - Xuewen Yang
- Changsha Center for Disease Prevention and Control, Changsha, Hunan, 410007, China
| | - Rengui Yang
- Changsha Center for Disease Prevention and Control, Changsha, Hunan, 410007, China.
- Changsha Hospital of Traditional Chinese Medicine (Changsha Eighth Hospital), Changsha, Hunan, 410125, China.
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Quarton S, McGee K, Cumley N, Behruznia M, Jeff C, Belchamber K, Cox M, Thickett D, Scott A, Parekh D, McNally A, Sapey E. Towards personalised anti-microbial and immune approaches to infections in acute care. Can real-time genomic-informed diagnosis of pathogens, and immune-focused therapies improve outcomes for patients? An observational, experimental study protocol. PLoS One 2024; 19:e0298425. [PMID: 38551904 PMCID: PMC10980213 DOI: 10.1371/journal.pone.0298425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/24/2024] [Indexed: 04/01/2024] Open
Abstract
INTRODUCTION Infection causes a vast burden of disease, with significant mortality, morbidity and costs to health-care systems. However, identifying the pathogen causative infection can be challenging, resulting in high use of broad-spectrum antibiotics, much of which may be inappropriate. Novel metagenomic methods have potential to rapidly identify pathogens, however their clinical utility for many infections is currently unclear. Outcome from infection is also impacted by the effectiveness of immune responses, which can be impaired by age, co-morbidity and the infection itself. The aims of this study are twofold: To compare diversity of organisms identified and time-to-result using metagenomic methods versus traditional culture -based techniques, to explore the potential clinical role of metagenomic approaches to pathogen identification in a range of infections.To characterise the ex vivo function of immune cells from patients with acute infection, exploring host and pathogen-specific factors which may affect immune function and overall outcomes. METHODS This is a prospective observational study of patients with acute infection. Patients with symptoms suggestive of an acute infection will be recruited, and blood and bodily fluid relevant to the site of infection collected (for example, sputum and naso-oropharyngeal swabs for respiratory tract infections, or urine for a suspected urinary tract infection). Metagenomic analysis of samples will be compared to traditional microbiology, alongside the antimicrobials received. Blood and respiratory samples such as bronchoalveolar lavage will be used to isolate immune cells and interrogate immune cell function. Where possible, similar samples will be collected from matched participants without a suspected infection to determine the impact of infection on both microbiome and immune cell function.
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Affiliation(s)
- Samuel Quarton
- Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- Institute of Inflammation & Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Kirsty McGee
- Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- Institute of Inflammation & Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Nicola Cumley
- Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- Institute of Microbiology & Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Mahboobeh Behruznia
- Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- Institute of Microbiology & Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Charlotte Jeff
- Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Kylie Belchamber
- Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- Institute of Inflammation & Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Michael Cox
- Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- Institute of Microbiology & Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - David Thickett
- Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- Institute of Inflammation & Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Aaron Scott
- Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- Institute of Inflammation & Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Dhruv Parekh
- Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- Institute of Inflammation & Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Alan McNally
- Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- Institute of Microbiology & Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Elizabeth Sapey
- Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- Director of PIONEER: Health Data Research UK (HDRUK) Health Data Research Hub for Acute Care, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
- Patient Safety Research Collaborative, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
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Zhang A, Liang J, Lao X, Xia X, Liang J. Pneumonia Caused by Chlamydia psittaci and SARS-CoV-2 Coinfection Diagnosed Using Metagenomic Next-Generation Sequencing: A Case Report. Int Med Case Rep J 2024; 17:187-194. [PMID: 38529114 PMCID: PMC10962458 DOI: 10.2147/imcrj.s458131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 03/18/2024] [Indexed: 03/27/2024] Open
Abstract
We report a case of pneumonia caused by coinfection with Chlamydia psittaci and the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron XBB.1 variant, confirmed using metagenomic next-generation sequencing (mNGS) and quantitative polymerase chain reaction (qPCR). C. psittaci and SARS-CoV-2 were detected in bronchoalveolar lavage fluid using mNGS. Additionally, mNGS detected C. psittaci in blood and nasopharyngeal specimens and was more sensitive than qPCR. The patient recovered after treatment with moxifloxacin. This report highlights the use of coinfections of C. psittaci and SARS-CoV-2, as mNGS has already been recognized to be a diagnostic tool for identifying coinfections.
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Affiliation(s)
- Anbing Zhang
- Department of Respiratory and Critical Care Medicine, Zhongshan People’s Hospital, Zhongshan, Guangdong Province, People’s Republic of China
| | - Jinguang Liang
- Department of Respiratory and Critical Care Medicine, Zhongshan Huangpu People’s Hospital, Zhongshan, Guangdong Province, People’s Republic of China
| | - Xiaoli Lao
- Department of Respiratory and Critical Care Medicine, Zhongshan People’s Hospital, Zhongshan, Guangdong Province, People’s Republic of China
- Graduate School, Guangdong Medical University, Zhanjiang, Guangdong Province, People’s Republic of China
| | - Xiuqiong Xia
- Department of Respiratory and Critical Care Medicine, Zhongshan People’s Hospital, Zhongshan, Guangdong Province, People’s Republic of China
| | - Jianping Liang
- Department of Respiratory and Critical Care Medicine, Zhongshan People’s Hospital, Zhongshan, Guangdong Province, People’s Republic of China
- Graduate School, Guangdong Medical University, Zhanjiang, Guangdong Province, People’s Republic of China
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Wang J, Jia P, Zhang D, Zhao Y, Sui X, Jin Z, Song W. Diagnosis of a Familial Psittacosis Outbreak with Clinical Analysis and Metagenomic Next-Generation Sequencing Under COVID-19: A Case Series. Infect Drug Resist 2024; 17:1099-1105. [PMID: 38590553 PMCID: PMC10999973 DOI: 10.2147/idr.s440400] [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: 10/19/2023] [Accepted: 03/05/2024] [Indexed: 04/10/2024] Open
Abstract
Purpose To explore the clinical characteristics, diagnosis, and treatment of family outbreak of psittacosis and to improve the success rate of treatment. Patients and Methods The clinical characteristics, diagnosis, treatment, and outcome of family outbreak of psittacosis, which consists three patients, diagnosed by clinical analysis and metagenomic next-generation sequencing (mNGS) in our hospital were analyzed retrospectively. Results We report on three instances of clustered atypical pneumonia, which were caused by Chlamydia psittaci during the COVID-19 pandemic. All patients exhibited symptoms of fever and cough, while one patient also experienced gastrointestinal symptoms such as nausea, vomiting, and diarrhea. Laboratory tests indicated no significant increase in leukocytes and neutrophils, but a mild increase in C-reactive protein was observed in all three patients. Chest computed tomography (CT) scans revealed a consolidation shadow in a unilateral lung lobe in all three patients. Both patients were treated with empirical moxifloxacin, yielding unsatisfactory outcomes. mNGS was conducted on sputum samples from one adult patient, revealing the presence of Chlamydia psittaci. Additional doxycycline was prescribed immediately, and then the patients' temperatures were stabilized, and the lesion in chest CT was absorbed. The pediatric patient exhibited less severe symptoms compared to the adult patients and exhibited a favorable response to azithromycin administration. Conclusion This study reports a cluster of a family outbreak of atypical pneumonia caused by C. psittaci in China. The occurrence of a family outbreak during the COVID-19 pandemic may be attributed to familial aggregation resulting from the epidemic. The three cases reported in this study did not experience severe complications, which can be attributed to the prompt medical intervention and swift diagnosis. This finding implies the need to enhance patients' awareness and vigilance towards their health. Additionally, mNGS emerges as a valuable technique for accurately identifying pathogens causing pulmonary infections.
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Affiliation(s)
- Jiaru Wang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Peiyao Jia
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People’s Republic of China
| | - Dong Zhang
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People’s Republic of China
| | - Ying Zhao
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People’s Republic of China
- Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, People’s Republic of China
| | - Xin Sui
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Zhengyu Jin
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Wei Song
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
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Sreiri N, Ben Abdallah Y, Belfeki N, Klopfenstein T, Zayet S. Chlamydia psittaci-related pleuro-myocarditis. Braz J Infect Dis 2024; 28:103739. [PMID: 38679059 PMCID: PMC11099301 DOI: 10.1016/j.bjid.2024.103739] [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: 01/04/2024] [Accepted: 04/14/2024] [Indexed: 05/01/2024] Open
Abstract
Chlamydia psittaci ‒ related community-acquired pneumonia associated to acute myocarditis was diagnosed in a young man with no medical history, and a professional exposition to birds. The diagnosis was confirmed with positive specific polymerase chain reaction in bronchoalveolar lavage. The patient was treated with spiramycin for two weeks with anti-inflammatory treatment for myocarditis for three months. Clinical and biological improvement was rapidly observed followed by normalization of electrocardiogram and chest CT scan. No relapse was reported for over a two-year follow-up.
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Affiliation(s)
- Nour Sreiri
- Nord Franche-Comté Hospital, Infectious Diseases Department, Trévenans, France
| | | | - Nabil Belfeki
- Groupe Hospitalier Sud Ile de France, Internal Medicine and Clinical Immunology Department, Melun, France
| | | | - Souheil Zayet
- Nord Franche-Comté Hospital, Infectious Diseases Department, Trévenans, France.
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Wang J, Dong S, Fang M, Fan Z, Xu Y. Omadacycline for the Treatment of Severe Chlamydia psittaci Pneumonia Complicated with Guillain-Barre Syndrome. Infect Drug Resist 2024; 17:81-87. [PMID: 38223561 PMCID: PMC10787558 DOI: 10.2147/idr.s437100] [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: 09/28/2023] [Accepted: 12/29/2023] [Indexed: 01/16/2024] Open
Abstract
Background Chlamydia psittaci (C. psittaci) is a pathogen that is seldom implicated in community-acquired pneumonia and is rarely linked to severe pneumonia. Reports of severe C. psittaci pneumonia accompanied by Guillain-Barre syndrome (GBS) are scarce. Tetracyclines are the preferred therapeutic approach for psittacosis. Omadacycline, a novel tetracycline, demonstrates strong antibacterial efficacy against typical bacteria and atypical pathogens, including C. psittaci. However, its application in the treatment of psittacosis pneumonia remains constrained. Case Presentation A 77-year-old female patient was admitted to the hospital presenting with symptoms of fever, low back pain, and headache. The diagnosis of C. psittaci was established through the utilization of metagenomic next-generation sequencing (mNGS). Initial administration of moxifloxacin, meropenem, piperacillin-tazobactam, and doxycycline proved to be ineffective. Subsequent omadacycline leaded to the successful resolution of fever and dyspnea. However, after the endotracheal tube was removed, the patient experienced a rapid decline in symmetrical limb strength, leading to a diagnosis of GBS based on clinical manifestations, cerebrospinal fluid analysis, and electromyography. Following a 5-day course of immunoglobulin therapy and nutritional nerve treatment, the patient's condition ameliorated, culminating in an uncomplicated discharge. Conclusion This case provides evidence supporting the potential use of omadacycline as a therapeutic option for the treatment of severe C. psittaci pneumonia. The utilization of mNGS technology is of paramount importance in the prompt identification of uncommon pathogens, including C. psittaci. Nevertheless, the occurrence of GBS should be taken into consideration when C. psittaci pneumonia is accompanied by symmetrical limb weakness. These findings have important implications for the diagnosis, treatment, and management of patients with C. psittaci pneumonia.
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Affiliation(s)
- Juan Wang
- Department of Emergency, Affiliated Hangzhou First People`s Hospital, School of Medicine, Westlake University, Hangzhou, People’s Republic of China
| | - Shuangyong Dong
- Department of Emergency, Affiliated Hangzhou First People`s Hospital, School of Medicine, Westlake University, Hangzhou, People’s Republic of China
| | - Mengjuan Fang
- Department of Emergency, Affiliated Hangzhou First People`s Hospital, School of Medicine, Westlake University, Hangzhou, People’s Republic of China
| | - Zhiyan Fan
- Department of Emergency, Affiliated Hangzhou First People`s Hospital, School of Medicine, Westlake University, Hangzhou, People’s Republic of China
| | - Yuansheng Xu
- Department of Emergency, Affiliated Hangzhou First People`s Hospital, School of Medicine, Westlake University, Hangzhou, People’s Republic of China
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Zhang Y, Hu H, Xu Y, Chen Y, Liu B, Chen J, Nie W, Zhong S, Ma J, Liu C. Venous-arterial extracorporeal membrane oxygenation for psittacosis pneumonia complicated with cardiogenic shock: case report and literature review. BMC Cardiovasc Disord 2024; 24:6. [PMID: 38166547 PMCID: PMC10763678 DOI: 10.1186/s12872-023-03669-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 12/11/2023] [Indexed: 01/04/2024] Open
Abstract
INTRODUCTION Dilated cardiomyopathy (DCM) is characterized by the enlargement of the left ventricle or biventricular, accompanied by myocardial systolic dysfunction. Chlamydia psittacosis (CP) is a zoonotic pathogen, which can cause severe pneumonia, respiratory failure, and acute organ dysfunction. The deterioration of DCM caused by CP infection is extremely rare, and few cases of successful management were reported. CASE PRESENTATION We reported a 67-year-old male patient with DCM and chronic heart failure. Who was admitted to ICU with severe pneumonia, acute hypoxemic respiratory failure, acute decompensated heart failure, arrhythmia, and cardiogenic shock. Mechanical ventilation (MV) and venous-arterial extracorporeal membrane oxygenation (VA-ECMO) were established for respiratory and circulatory support. Broncho alveolar lavage fluid(BALF)was collected for culture and metagenomics next-generation sequencing (mNGS) test. Repeated mNGS tests indicated the high possibility of CP pneumonia, thereafter, moxifloxacin and doxycycline were prescribed. After targeted antibiotics and organ support treatment, pneumonia, respiratory and circulatory failure were gradually resolved, patient was successfully weaned from MV and VA-ECMO. Finally, the patient was recovered and discharged alive. CONCLUSIONS Severe respiratory and circulatory failure caused by CP infection in DCM patients is a rare life-threatening clinical condition. Early accurate diagnosis, targeted antibiotic therapy, coupled with extracorporeal life support posed positive impact on the patient's disease course and outcome.
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Affiliation(s)
- Yanting Zhang
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 430071, Wuhan, China
- Clinical Research Center of Hubei Critical Care Medicine, 430071, Wuhan, China
| | - Hongtao Hu
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 430071, Wuhan, China
- Clinical Research Center of Hubei Critical Care Medicine, 430071, Wuhan, China
| | - Ying Xu
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 430071, Wuhan, China
- Clinical Research Center of Hubei Critical Care Medicine, 430071, Wuhan, China
| | - Yi Chen
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 430071, Wuhan, China
- Clinical Research Center of Hubei Critical Care Medicine, 430071, Wuhan, China
| | - Biao Liu
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 430071, Wuhan, China
- Clinical Research Center of Hubei Critical Care Medicine, 430071, Wuhan, China
| | - Jun Chen
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 430071, Wuhan, China
- Clinical Research Center of Hubei Critical Care Medicine, 430071, Wuhan, China
| | - Wenfang Nie
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 430071, Wuhan, China
- Clinical Research Center of Hubei Critical Care Medicine, 430071, Wuhan, China
| | - Si Zhong
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 430071, Wuhan, China
- Clinical Research Center of Hubei Critical Care Medicine, 430071, Wuhan, China
| | - Jing Ma
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 430071, Wuhan, China
- Clinical Research Center of Hubei Critical Care Medicine, 430071, Wuhan, China
| | - Chang Liu
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 430071, Wuhan, China.
- Clinical Research Center of Hubei Critical Care Medicine, 430071, Wuhan, China.
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Jin W, Liang R, Tian X, Cheng Y, Kong X, He F, Zhang C, Wang G, Li S, Lu H, Sun S, Shen L. Clinical features of psittacosis in 46 Chinese patients. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2023; 41:545-548. [PMID: 36707280 DOI: 10.1016/j.eimce.2022.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 05/09/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Psittacosis is a relatively uncommon cause of community-acquired pneumonia, often leading to diagnostic difficulty. METHODS A retrospective study was conducted on the clinical features of psittacosis patients in China. Forty-six cases of Chlamydophila psittaci infection with atypical pneumonia of varying severity in the last two years were described retrospectively. RESULTS Fever, relative bradycardia, and other systemic upsets were the main clinical presentation. The most common radiographic abnormality was segmental or lobar shadowing or consolidation. The total white cell counts were usually normal or slightly increased. The concentration of creatine kinase, C reactive protein, and lactic dehydrogenase increased, while albumin decreased remarkably. These cases exhibited good recovery after being treated with tetracycline or quinolone antibiotics. CONCLUSION These features may help differentiate psittacosis from other traditional bacterial pneumonia. However, they do not provide a definitive diagnosis. Psittacosis diagnosis must perform the whole-genome sequencing for Chlamydophila psittaci in respiratory, blood, or sputum specimens. Increased awareness of psittacosis can shorten diagnostic delays and improve patient outcomes.
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Affiliation(s)
- Weizhong Jin
- Department of Respiratory Disease, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Rongzhang Liang
- Department of Pulmonary and Critical Care Medicine, The First Hospital of Longyan Affiliated to Fujian Medical University, Longyan, Fujian Province, China
| | - Xianjiang Tian
- Department of Infectious Disease, The First People's Hospital of Xiaoshan District, Hangzhou, Zhejiang Province, China
| | - Yuan Cheng
- Department of Infectious Diseases, Hunan University of Traditional Medicine Affiliated NingXiang people's Hospital, NingXiang, Hunan Province, China
| | - Xianglong Kong
- Department of Pulmonary Medicine, Changsha First Hospital, Changsha, Hunan Province, China
| | - Fei He
- Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, ZheJiang Province, China
| | - Chao Zhang
- Institute of Respiratory Disease, China Three Gorges University, Yichang Central People's Hospital, Yichang, Hubei Province, China
| | - Guoan Wang
- Department of Pulmonary and Critical Care Medicine, Ningbo Medical Center Li Huili Hospital, Ningbo, Zhejiang, China
| | - SenHua Li
- Department of Pulmonary Medicine, Hangzhou Ninth People's Hospital, Hangzhou, Zhejiang Province, China
| | - Huadong Lu
- Department of Respiratory and Critical Care, Huzhou Central Hospital, Huzhou, ZheJiang Province, China
| | - Siqing Sun
- Department of General Medicine, Nanjing Second Hospital, Nanjing, Jiangsu Province, China
| | - Ling Shen
- Department of Respiratory Disease, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
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Alsubaiyel AM, Bukhari SI. Computational exploration and design of a multi-epitopes vaccine construct against Chlamydia psittaci. J Biomol Struct Dyn 2023:1-17. [PMID: 37897717 DOI: 10.1080/07391102.2023.2268173] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 09/29/2023] [Indexed: 10/30/2023]
Abstract
Chlamydia psittaci is an intracellular pathogen and causes variety of deadly infections in humans. Antibiotics are effective against C. psittaci however high percentage of resistant strains have been reported in recent times. As there is no licensed vaccine, we used in-silico techniques to design a multi-epitopes vaccine against C. psittaci. Following a step-wise protocol, the proteome of available 26 strains was retrieved and filtered for subcellular localized proteins. Five proteins were selected (2 extracellular and 3 outer membrane) and were further analyzed for B-cell and T-cell epitopes prediction. Epitopes were further checked for antigenicity, solubility, stability, toxigenicity, allergenicity, and adhesive properties. Filtered epitopes were linked via linkers and the 3D structure of the designed vaccine construct was predicted. Binding of the designed vaccine with immune receptors: MHC-I, MHC-II, and TLR-4 was analyzed, which resulted in docking energy scores of -4.37 kcal/mol, -0.20 kcal/mol and -22.38 kcal/mol, respectively. Further, the docked complexes showed stable dynamics with a maximum value of vaccine-MHC-I complex (7.8 Å), vaccine-MHC-II complex (6.2 Å) and vaccine-TLR4 complex (5.2 Å). As per the results, the designed vaccine construct reported robust immune responses to protect the host against C. psittaci infections. In the study, the C. psittaci proteomes were considered in pan-genome analysis to extract core proteins. The pan-genome analysis was conducted using bacterial pan-genome analysis (BPGA) software. The core proteins were checked further for non-redundant proteins using a CD-Hit server. Surface localized proteins were investigated using PSORTb v 3.0. The surface proteins were BLASTp against Virulence Factor Data Base (VFDB) to predict virulent factors. Antigenicity prediction of the shortlisted proteins was further done using VAXIGEN v 2.0. The epitope mapping was done using the immune epitope database (IEDB). A multi-epitopes vaccine was built and a 3D structure was generated using 3Dprot online server. The docking analysis of the designed vaccine with immune receptors was carried out using PATCHDOCK. Molecular dynamics and post-simulation analyses were carried out using AMBER v20 to decipher the dynamics stability and intermolecular binding energies of the docked complexes.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Amal M Alsubaiyel
- Department of Pharmaceutics, College of Pharmacy, Qassim University, Buraydah, Saudi Arabia
| | - Sarah I Bukhari
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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12
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Zheng X, Wu C, Jiang B, Qin G, Zeng M. Clinical analysis of severe Chlamydia psittaci pneumonia: Case series study. Open Life Sci 2023; 18:20220698. [PMID: 37772263 PMCID: PMC10523279 DOI: 10.1515/biol-2022-0698] [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: 12/27/2022] [Revised: 06/25/2023] [Accepted: 07/30/2023] [Indexed: 09/30/2023] Open
Abstract
The clinical characteristics and diagnosis of ten cases with severe Chlamydia psittaci pneumonia were analyzed. Ten patients had high fever, cough, or diarrhea, and all had a history of contact with birds or poultry. The white blood cell count of the patients was normal or slightly increased. The percentage of neutrophils (N%) and C reactive protein of the patients were significantly increased. Chest computer tomography showed patchy consolidation of both lungs, with one-sided lung lobes prominent, and bronchial inflation signs. All the patients were admitted to the intensive care unit due to respiratory failure. Nine patients needed ventilator-assisted ventilation therapy, and one patient needed high-flow oxygen therapy. All patients had sepsis, and five patients developed septic shock. The patients were diagnosed with severe C. psittaci pneumonia by clinical manifestations and contact history. After timely adjustment of tetracycline-based treatment, eight patients recovered and were discharged, and two patients died of septic shock and respiratory failure. Patients with poultry contact should be cautious toward C. psittaci pneumonia. A better method for the detection of C. psittaci is metagenomic next-generation sequencing. Its examination can shorten the diagnosis time. In a later stage, large-sample research is needed to guide clinical diagnosis and treatment.
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Affiliation(s)
- Xi Zheng
- Department of Respiratory and Critical Care Medicine, Yongchuan Hospital Affiliated to Chongqing Medical University, 439 Xuanhua Road, Yongchuan District, Chongqing, 402160, China
| | - Chonghao Wu
- Department of Respiratory and Critical Care Medicine, Yongchuan Hospital Affiliated to Chongqing Medical University, 439 Xuanhua Road, Yongchuan District, Chongqing, 402160, China
| | - Bing Jiang
- Department of Respiratory and Critical Care Medicine, Yongchuan Hospital Affiliated to Chongqing Medical University, 439 Xuanhua Road, Yongchuan District, Chongqing, 402160, China
| | - Guangmei Qin
- Department of Respiratory and Critical Care Medicine, Yongchuan Hospital Affiliated to Chongqing Medical University, 439 Xuanhua Road, Yongchuan District, Chongqing, 402160, China
| | - Ming Zeng
- Department of Respiratory and Critical Care Medicine, Yongchuan Hospital Affiliated to Chongqing Medical University, 439 Xuanhua Road, Yongchuan District, Chongqing, 402160, China
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13
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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: 0] [Impact Index Per Article: 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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14
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Huang W, Wang F, Cai Q, Xu H, Hong D, Wu H, Zhou L, Hu L, Lu Y. Epidemiological and clinical characteristics of psittacosis among cases with complicated or atypical pulmonary infection using metagenomic next-generation sequencing: a multi-center observational study in China. Ann Clin Microbiol Antimicrob 2023; 22:80. [PMID: 37679777 PMCID: PMC10486088 DOI: 10.1186/s12941-023-00631-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/29/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND Chlamydia psittaci (C. psittaci) causes parrot fever in humans. Development of metagenomic next-generation sequencing (mNGS) enables the identification of C. psittaci. METHODS This study aimed to determine the epidemiological and clinical characteristics of parrot fever cases in China. A multi-center observational study was conducted in 44 tertiary and secondary hospitals across 14 provinces and municipalities between April 2019 and October 2021. RESULTS A total of 4545 patients with complicated or atypical pulmonary infection were included in the study, among which the prevalence of C. psittaci was determined to be 2.1% using mNGS. The prevalence of C. psittaci was further determined across demographic groups and types of specimens. It was significantly higher in patients with senior age (2.6% in those > 50 years), winter-spring (3.6%; particularly in December, January, and February), and southwestern (3.4%) and central and southern China (2.7%) (each P < 0.001). Moreover, the prevalence was the highest in bronchoalveolar lavage fluid (BALF) (2.9%), compared with sputum (1.1%) and peripheral blood specimens (0.9%). Additionally, co-infection of principal microorganisms was compared. Certain microorganisms were more likely to co-infect in parrot fever cases, such as Candida albicans in BALF (26.7%) and peripheral blood (6.3%), compared with non-parrot fever cases (19.7% and 1.3%); however, they did not significantly differ (each P > 0.05). CONCLUSION Parrot fever remains low in patients with complicated or atypical pulmonary infection. It is likely to occur in winter-spring and southwestern region in China. BALF may be the optimal specimen in the application of mNGS. Co-infection of multiple microorganisms should be further considered.
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Affiliation(s)
- Weifeng Huang
- Department of Intensive Care Medicine, The Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Fengge Wang
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
| | - Qingqing Cai
- Genoxor Medical Science and Technology Inc, Shanghai, China
| | - Huiliang Xu
- Department of Respiratory, Nanxiang Hospital of Jiading district, Shanghai, China
| | - Dengwei Hong
- Genoxor Medical Science and Technology Inc, Shanghai, China
| | - Han Wu
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety, Fudan University School of Public Health, Shanghai, China
| | - Lu Zhou
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety, Fudan University School of Public Health, Shanghai, China
| | - Linjie Hu
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety, Fudan University School of Public Health, Shanghai, China
| | - Yihan Lu
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety, Fudan University School of Public Health, Shanghai, China
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15
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Marchese S, Marchese G, Paviglianiti G, Lapi M, Ottoveggio G, Pipitone G, Corsello G. A pediatric case of Chlamydia psittaci caused severe Acute Respiratory Distress Syndrome (ARDS) in Italy. Ital J Pediatr 2023; 49:107. [PMID: 37649055 PMCID: PMC10468848 DOI: 10.1186/s13052-023-01497-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 07/11/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND This case of psittacosis in children, is the first described in literature, in Italy. This respiratory infection can be transmitted to humans from the inhalation of respiratory secretions, feces and plumage aerosol of infected birds (and other animals). Usually it can have an asymptomatic or paucisymptomatic course, and the onset is often flu-like, but in this case the child risked his life for a severe respiratory failure. This report is unique because in children psittacosis is rare, and always misdiagnosed, or could cause a delayed diagnosis because of lack of awareness among the paediatricians and physicians. Furthermore, psittacosis enters a differential diagnosis with SARS-COV2 infection because both diseases may determine dyspnea and atypical pneumonia, up to acute respiratory failure. CASE PRESENTATION This clinical case talks about a three-and-a-half-year-old male child affected by psittacosis (or ornithosis), with severe dyspnea and systemic symptoms who required oro-tracheal intubation for acute respiratory failure. The child had slept in a room at home, with some recently bought parrots affected by psittacosis. Initially the child was treated with empiric antibiotic therapy (i.v.ceftriaxone and teicoplanin), but after having isolated the DNA of the germ "Chlamydia psittaci" in both serological and through bronchoalveolar lavage (BAL), he was treated with targeted antibiotic therapy: tetracyclines (doxicillin). CONCLUSIONS Psittacosis is an extremely contagious disease, caused by an intracellular germ, called "Chlamydia psittaci", a Gram-negative bacterium, transmitted to humans in particular by infected birds, responsible for atypical pneumonia, with acute and chronic respiratory symptoms, sometimes with multi-organ failure and disseminated intravascular coagulation. Even if it is a rare respiratory disease among children, a good doctor must think about psittacosis as cause of respiratory symptoms (and not only flu or SARS-COV2), above all through a correct medical history, in order to provide a targeted antibiotic therapy. An interesting case of psittacosis in a child is being reported here, which has been treated successfully with doxycillin.
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Affiliation(s)
- Serena Marchese
- Emergency and Admission Medicine and Surgery, Childrens'Hospital, ISMEP-Arnas Civico-Benfratelli- Di Cristina, Palermo, Italy.
| | | | | | - Maria Lapi
- Anesthesia and Pediatric Resuscitation with Trauma Center, ISMEP-Arnas Civico-Benfratelli- Di Cristina, Palermo, Italy
| | - Gaetano Ottoveggio
- Anesthesia and Pediatric Resuscitation with Trauma Center, ISMEP-Arnas Civico-Benfratelli- Di Cristina, Palermo, Italy
| | - Giuseppe Pipitone
- Systemic and immune-suppressed associated infection Disease Unit, INMI Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Giovanni Corsello
- Unit of General Pediatrics, Childrens'Hospital, ISMEP-Arnas Civico-Benfratelli- Di Cristina, University of Palermo, Palermo, Italy
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Li Y, Pan B, Xiao W, Fang L, Zhang L, Jiang F, Jia J, Ma H. A Case of Psittacosis - Qingdao City, Shandong Province, China, May 2023. China CDC Wkly 2023; 5:637-638. [PMID: 37520447 PMCID: PMC10372412 DOI: 10.46234/ccdcw2023.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 06/29/2023] [Indexed: 08/01/2023] Open
Affiliation(s)
- Ying Li
- Chinese Field Epidemiology Training Program, Chinese Center for Disease Control and Prevention, Beijing, China
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Bei Pan
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao City, Shandong Province, China
| | - Wenzhe Xiao
- Jiaozhou Center for Disease Control and Prevention, Qingdao City, Shandong Province, China
| | - Lizhu Fang
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao City, Shandong Province, China
| | - Lijie Zhang
- Chinese Field Epidemiology Training Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Fachun Jiang
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao City, Shandong Province, China
| | - Jing Jia
- Chinese Field Epidemiology Training Program, Chinese Center for Disease Control and Prevention, Beijing, China
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao City, Shandong Province, China
| | - Huilai Ma
- Chinese Field Epidemiology Training Program, Chinese Center for Disease Control and Prevention, Beijing, China
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Cao J, Xie X, Lei Y, Li S, Song X, Lei Y, An Q, Zhang B. Epidemiological and clinical characteristics of a family cluster of psittacosis: A case report. IDCases 2023; 33:e01845. [PMID: 37492645 PMCID: PMC10365937 DOI: 10.1016/j.idcr.2023.e01845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/05/2023] [Accepted: 07/05/2023] [Indexed: 07/27/2023] Open
Abstract
Psittacosis accounts for 1-2 % of community-acquired pneumonia. In recent years, reports of psittacosis are increasing. Most reported cases of psittacosis are sporadic. Here, we report a familial cluster of five patients infected with Chlamydophila in a northwest Chinese region and share our diagnosis and treatment experience. The epidemiological characteristics, clinical features, laboratory examinations of family cluster psittacosis were collected and analyzed. We closely followed up all the family members and analyzed their clinical outcome. Five cases of family clustered pneumonia were mainly characterized by fever, cough and fatigue. mNGS rapidly identified the infecting agent as Chlamydophila in case 1 followed by RT-PCR analysis. A newly purchased pet parrot, which had diarrhea, was probably the primary source of infection. The main change of inflammation index in five patients was the decrease of lymphocyte counts. Chest CT showed peripheral or subpleural involvement of patchy high-density shadows with bronchial ventilation signs and blurred edges, mostly unilateral lesions. Five cases were completely cured with moxifloxacin and azithromycin. Our findings suggest that a familial cluster of Chlamydophila infection maybe caused by contact with sick pet parrot or human to human transmission in one close family. For this community-acquired pneumonia, epidemiological characteristics and use of mNGS is very important for improving accuracy in the early diagnosis.
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Affiliation(s)
- Jing Cao
- Department of Pulmonary Medicine, Air Force No. 986 Hospital, Air Force Medical University, Xi'an, China
| | - Xiaoyan Xie
- Department of Pulmonary Medicine, Air Force No. 986 Hospital, Air Force Medical University, Xi'an, China
| | - Yan Lei
- Department of Pulmonary Medicine, Air Force No. 986 Hospital, Air Force Medical University, Xi'an, China
| | - Shuangshuang Li
- Department of Pulmonary Medicine, Air Force No. 986 Hospital, Air Force Medical University, Xi'an, China
| | - Xuan Song
- Department of Pulmonary Medicine, Air Force No. 986 Hospital, Air Force Medical University, Xi'an, China
| | - Yingfeng Lei
- Department of Medical Microbiology and Parasitology, Air Force Medical University, Xi'an, China
| | - Qunxing An
- Department of Transfusion Medicine, The First Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Binghua Zhang
- Department of Pulmonary Medicine, Air Force No. 986 Hospital, Air Force Medical University, Xi'an, China
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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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19
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Yao W, Yang X, Shi J, Yang Z, Yao Y, Kou J, Liu S, Wang L, Wu Z, Shi G, Yan H, Song Y. Case Report: A case of Chlamydia psittaci infection in an HIV patient. Front Cell Infect Microbiol 2023; 13:1185803. [PMID: 37260699 PMCID: PMC10229061 DOI: 10.3389/fcimb.2023.1185803] [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: 03/14/2023] [Accepted: 05/03/2023] [Indexed: 06/02/2023] Open
Abstract
Chlamydia psittaci is the pathogen of psittacosis and infects a wide range of birds and even humans. Human infection occurs most commonly in those with a history of contact with birds or poultry. We describe a case of psittacosis in a human immunodeficiency virus infected patient in Zhejiang Province for the first time. C. psittaci infection was confirmed by nested polymerase chain reaction (PCR) and Real-Time PCR. Phylogenetic analysis revealed that the sequences from the patient's samples clustered with genotype A in the same branch. Our study highlights the possibility of diagnosing psittacosis in patients with a chronic disease such as HIV-infected patients, and should increase awareness and surveillance of psittacosis in China.
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Affiliation(s)
- Wenwu Yao
- Department of Microbiology and Department of Infectious Diseases, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Xuhui Yang
- Department of Health Monitoring, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Jinchuan Shi
- Affiliated Hangzhou Xixi Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhangnv Yang
- Department of Microbiology and Department of Infectious Diseases, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Ying Yao
- Department of Infectious Diseases, Disease Prevention Control Center of Shangcheng District, Hangzhou, China
| | - Jun Kou
- Department of Infectious Diseases, Disease Prevention Control Center of Shangcheng District, Hangzhou, China
| | - Shelan Liu
- Department of Microbiology and Department of Infectious Diseases, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Linbo Wang
- Department of Microbiology and Department of Infectious Diseases, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Zhuoyin Wu
- Department of Microbiology and Department of Infectious Diseases, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Guoxiang Shi
- Department of Microbiology and Department of Infectious Diseases, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Hao Yan
- Department of Microbiology and Department of Infectious Diseases, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Yajun Song
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
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He L, Yang H, Liu S, Liang W, Zhou Z, Long J, Wu J. Physiological analysis of severe chlamydia psittaci pneumonia and clinical diagnosis after doxycycline-based treatment. Front Physiol 2023; 14:1132724. [PMID: 36846335 PMCID: PMC9947341 DOI: 10.3389/fphys.2023.1132724] [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: 12/27/2022] [Accepted: 01/30/2023] [Indexed: 02/11/2023] Open
Abstract
Objective: To describe the clinical spectrum of severe Chlamydia psittaci pneumonia in order to understand the disease better. Methods: Retrospective analysis was made on 31 patients with severe Chlamydia psittaci pneumonia diagnosed in ICU by next-generation sequencing of metagenome Metagenomic next-generation sequencing(mNGS) from January 2019-November 2022, including clinical characteristics, laboratory examination results, imaging characteristics, treatment, and prognosis. Results: We included 31 patients with severe Chlamydia psittaci pneumonia, 15 of whom had a history of virus exposure. There were 12 cases with multiple bacterial infections, and the common symptoms included fever (31/31,100%), dyspnea (31/31, 100%), cough (22/31, 71.0%), and myalgia (20/31, 64.5%). Laboratory data showed that white blood cells were average or slightly increased, but the levels of C-reactive protein and neutrophils were high. CT findings of the lung were consolidation (19/31, 61.3%) and pleural effusion (11/31, 35.5%). Only one lobe was involved in 11 patients (35.5%). Before diagnosis, 22 patients (71.0%) did not have atypical pathogens in their antimicrobial regimen. After diagnosis, 19 patients (61.3%) received single drug treatment, of which doxycycline or moxifloxacin were the most commonly used drugs. Among 31 patients, three died, nine improved, and nineteen were cured. Conclusion: The clinical manifestations of severe Chlamydia psittaci pneumonia are non-specific. The application of mNGS can improve the diagnostic accuracy of Chlamydia psittaci pneumonia, reduce the unnecessary use of antibiotics, and shorten the course of the disease. Doxycycline-based treatment is effective for severe chlamydia psittaci pneumonia, but it is necessary to understand the secondary bacterial infection and other complications in the course of the disease.
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Affiliation(s)
- Lujuan He
- The Affiliated Changsha Central Hospital, Department of Respiratory and Critical Care Medicine, Hengyang Medical School, University of South China, Changsha, China
| | - Hongzhong Yang
- The Affiliated Changsha Central Hospital, Department of Respiratory and Critical Care Medicine, Hengyang Medical School, University of South China, Changsha, China
| | - Shenggang Liu
- The Affiliated Changsha Central Hospital, Department of Respiratory and Critical Care Medicine, Hengyang Medical School, University of South China, Changsha, China
| | - Weijun Liang
- The Affiliated Changsha Central Hospital, Department of Respiratory and Critical Care Medicine, Hengyang Medical School, University of South China, Changsha, China
| | - Zezhi Zhou
- The Affiliated Changsha Central Hospital, Department of Respiratory and Critical Care Medicine, Hengyang Medical School, University of South China, Changsha, China
| | - Jing Long
- The Affiliated Changsha Central Hospital, Department of Respiratory and Critical Care Medicine, Hengyang Medical School, University of South China, Changsha, China
| | - Jinyang Wu
- The Affiliated Changsha Central Hospital, Department of Internal Neurology, Hengyang Medical School, University of South China, Changsha, China,*Correspondence: Jinyang Wu,
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21
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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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22
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Li M, Wang B, Liu P, Wang H, Zhu J. Prostatitis as initial manifestation of Chlamydia psittaci pneumonia diagnosed by metagenome next-generation sequencing: A case report. Open Life Sci 2023; 18:20220596. [PMID: 37070075 PMCID: PMC10105550 DOI: 10.1515/biol-2022-0596] [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: 10/31/2022] [Revised: 03/03/2023] [Accepted: 03/15/2023] [Indexed: 04/19/2023] Open
Abstract
Chlamydia psittaci (C. psittaci) pneumonia is a zoonotic infectious disease caused by C. psittaci, which is often underdiagnosed. The application of metagenomic next-generation sequencing (mNGS) provides an unbiased method for the detection of unknown pathogens. A 46-year-old man received empirical treatment with piperacillin-tazobactam and moxifloxacin after an initial diagnosis of prostatitis and pneumonia. However, he experienced recurrent symptoms and a cough, and a chest computed tomography (CT) showed aggravated pulmonary inflammation. Upon further questioning, the patient recalled a history of contact with pigeons, and a bronchoscope alveolar lavage fluid analysis with mNGS suggested C. psittaci infection. Following treatment with doxycycline, the patient's symptoms were rapidly alleviated, and chest CT showed pulmonary lesions absorption. The patient was followed up for 1 month without any discomfort. This case highlights that initial manifestations of C. psittaci pneumonia may present with atypical symptoms such as prostatitis. Furthermore, mNGS can be a useful tool for the detection of rare or unknown pathogens such as C. psittaci.
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Affiliation(s)
- Mengjie Li
- Department of Respiratory and Critical Care Medicine, Cangzhou Fifth Hospital (People’s Hospital of Qingxian), Cangzhou062650, China
| | - Biao Wang
- Department of Respiratory and Critical Care Medicine, Cangzhou Fifth Hospital (People’s Hospital of Qingxian), Cangzhou062650, China
| | - Peng Liu
- Department of Respiratory and Critical Care Medicine, Cangzhou Fifth Hospital (People’s Hospital of Qingxian), Cangzhou062650, China
| | - Huan Wang
- Department of Respiratory and Critical Care Medicine, Cangzhou Fifth Hospital (People’s Hospital of Qingxian), Cangzhou062650, China
| | - Jian Zhu
- Department of Thoracic Cardiovascular Surgery, General Hospital of Central Theater Command of The People’s Liberation Army, No. 627 Wuluo Road, Wuchang District, Wuhan430070, China
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23
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Wang J, Zhu Y, Mo Q, Yang Y. Case Report: A Chlamydia psittaci pulmonary infection presenting with migratory infiltrates. Front Public Health 2022; 10:1028989. [PMID: 36600937 PMCID: PMC9806249 DOI: 10.3389/fpubh.2022.1028989] [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: 08/26/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022] Open
Abstract
Community-acquired pneumonia is a public health problem in all countries in the world, with a broad range of causative agents and Chlamydia psittaci infection tends to be overlooked. Pulmonary migratory infiltrates are commonly seen in eosinophilic pneumonia, cryptogenic organizing pneumonia, etc. However, the association of Chlamydia psittaci and pulmonary migratory infiltrates has been seldom described in literatures before. We reviewed a 64-year-old man referred to our hospital for treatment against Chlamydia psittaci pneumonia which was diagnosed by metagenomics next generation sequencing (mNGS). During the treatment period, chest imaging showed migratory infiltrates, which has been rarely described before.
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Affiliation(s)
- Jundi Wang
- Department of Rheumatology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yurou Zhu
- Department of Respiratory Diseases, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Qiongya Mo
- Department of Respiratory Diseases, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yanfei Yang
- Department of Respiratory Diseases, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China,*Correspondence: Yanfei Yang ✉
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24
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Xu L, Zhao Z, Mai H, Tan X, Du Y, Fang C. Clinical and chest computed tomography features associated with severe Chlamydia psittaci pneumonia diagnosed by metagenomic next-generation sequencing: A multicenter, retrospective, observational study. Medicine (Baltimore) 2022; 101:e32117. [PMID: 36550834 PMCID: PMC9771292 DOI: 10.1097/md.0000000000032117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Chlamydia psittaci pneumonia is a rare disease with varying clinical presentations. Here, we aimed to investigate the clinical and chest computed tomography (CT) features of severe psittacosis pneumonia. Clinical data of 35 patients diagnosed with psittacosis pneumonia were retrospectively analyzed using metagenomic next-generation sequencing. The patients were classified into severe (n = 20) and non-severe (n = 15) groups. The median age of patients was 54 years, and 27 patients (77.1%) had a definite history of bird contact. Severe patients had more underlying comorbidities and were more prone to dyspnea and consciousness disorders than non-severe patients. The neutrophil count and D-dimer, lactate dehydrogenase, interleukin (IL)-2, IL-6, and IL-10 levels were higher, whereas the lymphocyte, CD3 + T cell, and CD4 + T cell counts, CD4+/CD8 + T cell ratio, and albumin level were substantially lower in severe patients than in non-severe patients. Chest CT findings of severe patients revealed large areas of pulmonary consolidation, and ground-glass opacities were observed in some patients, with a higher risk of involving multiple lobes of the lungs and pleural effusion. One patient died of multiple organ failure, whereas the condition of the other 34 patients improved, and they were discharged from the hospital. Patients with severe psittacosis pneumonia often have underlying comorbidities and are prone to developing dyspnea, consciousness disorder, and lesions in both lungs. Serum D-dimer, IL-2, IL-6, and IL-10 levels and lymphocyte, CD3 + T cell, and CD4 + T cell counts are associated with disease severity.
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Affiliation(s)
- Limin Xu
- Department of Geriatrics, Huizhou First People’s Hospital, Huizhou, People’s Republic of China
| | - Ziwen Zhao
- Department of Pulmonary and Critical Care Medicine, Guangzhou First People’s Hospital Affiliated to South China University of Technology, Guangzhou, People’s Republic of China
| | - Hui Mai
- Department of Geriatrics, Huizhou First People’s Hospital, Huizhou, People’s Republic of China
| | - Xiaoying Tan
- Department of Geriatrics, Huizhou First People’s Hospital, Huizhou, People’s Republic of China
| | - Yubin Du
- Department of Geriatrics, Huizhou First People’s Hospital, Huizhou, People’s Republic of China
| | - Changquan Fang
- Department of Pulmonary and Critical Care Medicine, Huizhou Central People’s Hospital, Huizhou, People’s Republic of China
- *Correspondence: Changquan Fang, Department of Pulmonary and Critical Care Medicine, Huizhou Central People’s Hospital, Huizhou, People’s Republic of China (e-mail: )
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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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Liang Y, Dong T, Li M, Zhang P, Wei X, Chen H, Wang Y, Gao X. Clinical diagnosis and etiology of patients with Chlamydia psittaci pneumonia based on metagenomic next-generation sequencing. Front Cell Infect Microbiol 2022; 12:1006117. [PMID: 36310873 PMCID: PMC9606567 DOI: 10.3389/fcimb.2022.1006117] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 09/20/2022] [Indexed: 11/14/2022] Open
Abstract
The incidence of severe Chlamydia psittaci (C. psittaci) pneumonia and coinfections is increasing. Early detection of this condition is needed to prevent negative outcomes, along with detailed descriptions of its associated clinical characteristics. Our study contributes by undertaking etiological analysis of patients with C. psittaci pneumonia based on metagenomic next-generation sequencing (mNGS). A retrospective analysis of 30 patients with C. psittaci pneumonia was undertaken and confirmed by mNGS or polymerase chain reaction (PCR). Clinical manifestations of the severe and non-severe C. psittaci pneumonia groups were compared for clinical reference. Etiological analyses were also performed to comprehensively understand pathogeny and coinfection with other respiratory pathogens in C. psittaci patients. The absolute value of lymphocytes (LYM) in the severe group was lower than in the non-severe group. At the same time, neutrophil-to-lymphocyte ratio (NLR), procalcitonin (PCT), alanine aminotransferase (ALT), D-II polymer, brain natriuretic peptide (BNP), myoglobin (MYO), and cardiac troponin I (cTnI) were significantly higher (P < 0.05) in the severe group. mNGS has a broader pathogen spectrum and can more sensitively detect C. psittaci and other low-abundance pathogens with a higher positive detection rate (100%, 13/13 vs. 46%, 6/13, P <0.05) than conventional culture methods. mNGS detected the following dominant species associated with C. psittaci in patients: bacteria (53.2%, 39% gram-positive, 61% gram-negative), fungi (12.9%), and viruses (33.9%). A total of 73.3% (11/15) of patients had suspected coinfections, with a coinfection rate of 91.7% (11/12) in the severe group. No coinfection or death occurred in the non-severe group. Prognosis in the severe group was poor, with a mortality rate of 27.3% (3/11) for patients with coinfection. Eight of 11 patients with coinfections (72.7%) recovered. In conclusion, the clinical symptoms of severe C. psittaci pneumonia manifested as abnormal inflammatory indicators, impaired liver function, myocardial injury, coagulation, and relatively low immune responses. 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. Simultaneous early identification of coinfections would further improve the clinical treatment of these patients.
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Affiliation(s)
- Yueming Liang
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Department of Geriatric Respiratory Medicine, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China
| | - Tingyan Dong
- Integrated Diagnostic Centre for Infectious Diseases, Guangzhou Huayin Medical Laboratory Center, Guangzhou, China
- The School of Medicine, Nanjing University, Nanjing, China
| | - Minjing Li
- Department of Respiratory and Critical Care Medicine, The First People’s Hospital of Foshan, Foshan, China
| | - Peifang Zhang
- Department of Respiratory and Critical Care Medicine, The First People’s Hospital of Foshan, Foshan, China
| | - Xiaoqun Wei
- Department of Respiratory and Critical Care Medicine, The First People’s Hospital of Foshan, Foshan, China
| | - Haitao Chen
- Integrated Diagnostic Centre for Infectious Diseases, Guangzhou Huayin Medical Laboratory Center, Guangzhou, China
| | - Yongsi Wang
- Integrated Diagnostic Centre for Infectious Diseases, Guangzhou Huayin Medical Laboratory Center, Guangzhou, China
| | - Xinglin Gao
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Department of Geriatric Respiratory Medicine, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Geriatrics Institute, Guangzhou, China
- *Correspondence: Xinglin Gao,
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Improving Suspected Pulmonary Infection Diagnosis by Bronchoalveolar Lavage Fluid Metagenomic Next-Generation Sequencing: a Multicenter Retrospective Study. Microbiol Spectr 2022; 10:e0247321. [PMID: 35943274 PMCID: PMC9431624 DOI: 10.1128/spectrum.02473-21] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Metagenomic next-generation sequencing (mNGS) has been gradually applied to clinical practice due to its unbiased characteristics of pathogen detection. However, its diagnostic performance and clinical value in suspected pulmonary infection need to be evaluated. We systematically reviewed the clinical data of 246 patients with suspected pulmonary infection from 4 medical institutions between January 2019 and September 2021. The diagnostic performances of mNGS and conventional testing (CT) were systematically analyzed based on bronchoalveolar lavage fluid (BALF). The impacts of mNGS and CT on diagnosis modification and treatment adjustment were also assessed. The positive rates of mNGS and CT were 47.97% and 23.17%, respectively. The sensitivity of mNGS was significantly higher than that of CT (53.49% versus 23.26%, P < 0.01), especially for infections of Mycobacterium tuberculosis (67.86% versus 17.86%, P < 0.01), atypical pathogens (100.00% versus 7.14%, P < 0.01), viruses (92.31% versus 7.69%, P < 0.01), and fungi (78.57% versus 39.29%, P < 0.01). The specificity of mNGS was superior to that of CT, with no statistical difference (90.32% versus 77.42%, P = 0.167). The positive predictive value (PPV) and negative predictive value (NPV) of mNGS were 97.46% and 21.88%, respectively. Diagnosis modification and treatment adjustment were conducted in 32 (32/246, 13.01%) and 23 (23/246, 9.35%) cases, respectively, according to mNGS results only. mNGS significantly improved the diagnosis of suspected pulmonary infection, especially infections of M.tuberculosis, atypical pathogens, viruses, and fungi, and it demonstrated the pathogen distribution of pulmonary infections. It is expected to be a promising microbiological detection and diagnostic method in clinical practice. IMPORTANCE Pulmonary infection is a heterogeneous and complex infectious disease with high morbidity and mortality worldwide. In clinical practice, a considerable proportion of the etiology of pulmonary infection is unclear, microbiological diagnosis being challenging. Metagenomic next-generation sequencing detects all nucleic acids in a sample in an unbiased manner, revealing the microbial community environment and organisms and improving the microbiological detection and diagnosis of infectious diseases in clinical settings. This study is the first multicenter, large-scale retrospective study based entirely on BALF for pathogen detection by mNGS, and it demonstrated the superior performance of mNGS for microbiological detection and diagnosis of suspected pulmonary infection, especially in infections of Mycobacterium tuberculosis, atypical pathogens, viruses, and fungi. It also demonstrated the pathogen distribution of pulmonary infections in the real world, guiding targeted treatment and improving clinical management and prognoses.
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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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Jin W, Liang R, Tian X, Cheng Y, Kong X, He F, Zhang C, Wang G, Li S, Lu H, Sun S, Shen L. Clinical features of psittacosis in 46 Chinese patients. Enferm Infecc Microbiol Clin 2022. [DOI: 10.1016/j.eimc.2022.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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30
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Xie N, Zhou Y. Unresolving fever, headache, cough, and negative covid-19 PCR result. BMJ 2022; 377:e068645. [PMID: 35545266 DOI: 10.1136/bmj-2021-068645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Nina Xie
- Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
- National Clinical Research Centre for Geriatric Disorders, Changsha, Hunan 410078, China
| | - Yafang Zhou
- Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
- National Clinical Research Centre for Geriatric Disorders, Changsha, Hunan 410078, China
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31
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Yang F, Li J, Qi B, Zou L, Shi Z, Lei Y, Li J, Luo X, Zeng F, Lu S, Huang X, Liu R, Lan Y. Clinical Symptoms and Outcomes of Severe Pneumonia Caused by Chlamydia psittaci in Southwest China. Front Cell Infect Microbiol 2022; 11:727594. [PMID: 35071027 PMCID: PMC8770948 DOI: 10.3389/fcimb.2021.727594] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 12/13/2021] [Indexed: 11/23/2022] Open
Abstract
Here, we aimed to retrospectively analyze the clinical characteristics of 27 patients with severe pneumonia caused by Chlamydia psittaci between January 2019 and April 2021 in southwest China. To this end, we collected data on the exposure history, clinical symptoms, laboratory examination, imaging characteristics, evolution, etiology, treatment, and outcomes to suggest a better diagnosis and prevention system. Our results showed that a metagenomic next-generation sequencing test could provide early diagnosis. All patients were sensitive to quinolones and tetracyclines, and the recovery rate was relatively high. Overall, all patients were in critical condition with moderate to severe acute respiratory distress syndrome and shock. In conclusion, early diagnosis of pneumonia caused by C. psittaci depends on effective molecular testing, and most patients recover after treatment.
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Affiliation(s)
- Fuxun Yang
- Department of ICU, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Jiajia Li
- Department of ICU, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Bo Qi
- Department of Intensive Care Unit, 903 Hospital, Mianyang, China
| | - Longfei Zou
- Department of ICU, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Zongming Shi
- Department of ICU, Neijiang People's Hospital Southwest Medical University, Sichuan, China
| | - Yu Lei
- Department of ICU, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Jun Li
- Department of ICU, Shifang City People's Hospital Affiliated to North Sichuan Medical College, Shifang, China
| | - Xiaoxiu Luo
- Department of ICU, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Fan Zeng
- Department of ICU, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Sen Lu
- Department of ICU, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiaobo Huang
- Department of ICU, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Rongan Liu
- Department of ICU, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Yunping Lan
- Department of ICU, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
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32
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Luo C, Lin Y, Chen C, Liu Y, Sun X. Diagnosis of severe Chlamydia psittaci pneumonia by metagenomic next-generation sequencing: 2 case reports. Respir Med Case Rep 2022; 38:101709. [PMID: 35875605 PMCID: PMC9304875 DOI: 10.1016/j.rmcr.2022.101709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 06/10/2022] [Accepted: 07/13/2022] [Indexed: 11/30/2022] Open
Abstract
Psittacosis is a infectious disease caused by Chlamydia psittaci (C. psittaci), which presents as pneumonia in humans. The diagnosis of psittacosis is challenging, however, Metagenomic next-generation sequencing (MNGS) is very efficient. Herein we documented the clinical characteristics of two patients with severe C. psittaci pneumonia who were admitted to the Intensive Care Unit. C. psittaci nucleic acid sequences were detected by MNGS of bronchoalveolar lavage fluid from both patients. Doxycycline was administered and the treatment was effective. Implementation of MNGS is helpful for the early identification of pathogens, shortening the diagnosis and treatment time, and improving the prognosis of patients.
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Affiliation(s)
- Chunhua Luo
- Department of Intensive Care Unit, The Second Affiliated Hospital of Fujian Medical University, 950 Donghai Street, Fengze District, Quanzhou City, Fujian Province, China
| | - Yanping Lin
- Department of Intensive Care Unit, The Second Affiliated Hospital of Fujian Medical University, 950 Donghai Street, Fengze District, Quanzhou City, Fujian Province, China
- Respiratory Medicine Center of Fujian Province, 950 Donghai Street, Fengze District, Quanzhou City, Fujian Province, China
| | - Chengwen Chen
- Department of Intensive Care Unit, The Second Affiliated Hospital of Fujian Medical University, 950 Donghai Street, Fengze District, Quanzhou City, Fujian Province, China
| | - Yuqi Liu
- Department of Intensive Care Unit, The Second Affiliated Hospital of Fujian Medical University, 950 Donghai Street, Fengze District, Quanzhou City, Fujian Province, China
- Respiratory Medicine Center of Fujian Province, 950 Donghai Street, Fengze District, Quanzhou City, Fujian Province, China
| | - Xuri Sun
- Department of Intensive Care Unit, The Second Affiliated Hospital of Fujian Medical University, 950 Donghai Street, Fengze District, Quanzhou City, Fujian Province, China
- Respiratory Medicine Center of Fujian Province, 950 Donghai Street, Fengze District, Quanzhou City, Fujian Province, China
- Corresponding author. Department of Intensive Care Unit, The Second Affiliated Hospital of Fujian Medical University, 950 Donghai Street, Fengze District, Quanzhou City, Fujian Province, China.
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Chlamydia psittaci pneumonia complicated with organizing pneumonia: A case report and literature review. IDCases 2022; 30:e01584. [PMID: 36193103 PMCID: PMC9526182 DOI: 10.1016/j.idcr.2022.e01584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/25/2022] [Indexed: 11/26/2022] Open
Abstract
A patient with pneumonia had a fever for 2 weeks. After the initial anti-infection treatment failed, he was diagnosed with C. psittaci pneumonia complicated with organizing pneumonia, through next-generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF) and lung biopsy. He was treated with antibiotics and corticosteroids for 2 months. Chlamydia psittaci pneumonia complicated with organizing pneumonia is rare. It can be diagnosed by next-generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF) and lung biopsy. Treatment of moxifloxacin sequential to clarithromycin combined with corticosteroids is effective, and the prognosis is satisfactory. We introduce a rare case of C. psittaci pneumonia complicated with organizing pneumonia, and the treatment is successful.
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