-
Microbiology Spectrum Aug 2022Psittacosis is an uncommon disease which mainly presents as community-acquired pneumonia (CAP). We aim to apply metagenomic next-generation sequencing (mNGS) as a...
Psittacosis is an uncommon disease which mainly presents as community-acquired pneumonia (CAP). We aim to apply metagenomic next-generation sequencing (mNGS) as a promising tool in the diagnosis of psittacosis pneumonia and to describe its clinical spectrum to provide physicians with a better understanding and recognition of this disease. Thirteen cases of psittacosis pneumonia were diagnosed by using mNGS. A retrospective analysis of the data on clinical manifestations, laboratory data, computed tomography (CT) images, new diagnosis tools, treatments, and outcomes was summarized. These patients had common symptoms of fever and weakness; some had poor appetite, cough, myalgia, and headache. Ten patients developed acute respiratory distress syndrome (ARDS), among which six patients were severe pneumonia cases and needed ventilator therapy. Most patients got psittacosis pneumonia during the cold season. Ten cases were sporadic, but three were family clustering. All of the 13 patients were traced to an exposure history to birds, cat, or poultry, among which 2 only touched the innards of killed poultry before cooking, which may be an atypical exposure history not been reported before, to our knowledge. Most patients had various degrees of liver dysfunction. Air-space consolidations, along with ground-glass opacities and reticular shadows, were detected on chest CT scan. mNGS takes 48 to 72 h to provide results and helps to diagnose psittacosis. After being diagnosed by mNGS, with effective medicines, all patients finally had complete recoveries. The use of mNGS can improve the diagnostic rate of psittacosis pneumonia and shorten the course of disease control. Psittacosis pneumonia is easily underdiagnosed and misdiagnosed. In this study, we use mNGS in the diagnosis of psittacosis pneumonia. We found this disease is prone in the cold season, and touching the innards of killed poultry during cooking may be an atypical exposure history which has not been reported before to our knowledge. There are sporadic cases and family outbreak cases as well. Except for typical symptoms of fever and weakness, headache may be the main and only symptom in some patients. The rate of severe pneumonia is high among inpatients with psittacosis pneumonia, and the incidence of hepatic involvements is also high. Psittacosis pneumonia can be cured if the diagnosis is accurate and in time, even if it is severe pneumonia on admission. Some problems worthy of our attention about psittacosis pneumonia were put forward, such as its sick season, special exposure history, the rate of severe disease, and the high cure rate. mNGS can quickly and objectively detect more rare pathogenic microorganisms in clinical specimens without the need for specific amplification and has an advantage in the diagnosis of rare pathogenic bacteria in difficult cases such as psittacosis pneumonia. The use of mNGS can improve the accuracy and reduce the delay in the diagnosis of psittacosis, which shortens the course of disease control.
Topics: Chlamydophila psittaci; Headache; High-Throughput Nucleotide Sequencing; Humans; Pneumonia; Psittacosis; Retrospective Studies
PubMed: 35938720
DOI: 10.1128/spectrum.02384-21 -
Respiratory Medicine Case Reports 2022Psittacosis is a infectious disease caused by , which presents as pneumonia in humans. The diagnosis of psittacosis is challenging, however, Metagenomic next-generation...
Psittacosis is a infectious disease caused by , 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 pneumonia who were admitted to the Intensive Care Unit. 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.
PubMed: 35875605
DOI: 10.1016/j.rmcr.2022.101709 -
International Journal of Infectious... Sep 2022Here, we retrospectively described the diagnosis and treatment of 32 cases diagnosed with Chlamydia psittaci pneumonia during the COVID-19 pandemic.
OBJECTIVES
Here, we retrospectively described the diagnosis and treatment of 32 cases diagnosed with Chlamydia psittaci pneumonia during the COVID-19 pandemic.
METHODS
Clinical information was collected from all the patients. Reverse transcription-PCR and ELISAs were conducted for the detection of COVID-19 using nasal swabs and bronchoalveolar lavage fluid (BALF) samples. Metagenomic next-generation sequencing (mNGS) was performed for the identification of causative pathogens using BALF, peripheral blood and sputum samples. End-point PCR was performed to confirm the mNGS results.
RESULTS
All 32 patients showed atypical pneumonia and had infection-like symptoms that were similar to COVID-19. Results of reverse transcription-PCR and ELISAs ruled out COVID-19 infection. mNGS identified C. psittaci as the suspected pathogen in these patients within 48 hours, which was validated by PCR, except for three blood samples. The sequence reads that covered fragments of C. psittaci genome were detected more often in BALF than in sputum or blood samples. All patients received doxycycline-based treatment regimens and showed favorable outcomes.
CONCLUSION
This retrospective study, with the highest number of C. psittaci pneumonia enrolled cases in China so far, suggests that human psittacosis may be underdiagnosed and misdiagnosed clinically, especially in the midst of the COVID-19 pandemic.
Topics: COVID-19; Chlamydophila psittaci; Humans; Influenza, Human; Mycoses; Pandemics; Pneumonia; Pneumonia, Mycoplasma; Psittacosis; Retrospective Studies
PubMed: 35842216
DOI: 10.1016/j.ijid.2022.07.027 -
The Lancet. Microbe Oct 2022
Topics: Chlamydophila psittaci; Humans; Psittacosis
PubMed: 35817065
DOI: 10.1016/S2666-5247(22)00191-4 -
PloS One 2022Psittacosis pneumonia is a community-acquired pneumonia caused by Chlamydia psittaci. It is usually under-diagnosed due to its atypical clinical presentation and lack of...
BACKGROUND
Psittacosis pneumonia is a community-acquired pneumonia caused by Chlamydia psittaci. It is usually under-diagnosed due to its atypical clinical presentation and lack of routine laboratory tests.
METHODS
To better understand the clinical features, 52 patients diagnosed with psittacosis pneumonia by metagenomic next-generation sequencing (mNGS) were enrolled in this study. The clinical, radiological and pathological characteristics were retrospectively analyzed.
RESULTS
The onset of psittacosis pneumonia in this study occurred all year round, with a peak from December to January. Most of the patients were 51-80 years old. About 65.38% of patients had a history of exposure to poultry or parrots. Abnormalities of multiple clinical signals were detected in these patients. Elevated levels of neutrophil ratio, C-reactive protein, erythrocyte sedimentation rate, and procalcitonin were detected in most patients. Radiological evidence revealed air-space consolidation or ground-glass opacities in lungs of all patients, which is the typical feature of psittacosis pneumonia. In addition, hyperemia, swelling of bronchial mucosa, and bronchial patency were detected by bronchoscopy in all patients, and bronchial sub-mucosal edema, inflammatory cells infiltration and alveolar epithelial hyperplasia were identified in the bronchial mucosa and alveolar tissue. Beta-lactam antibiotics were administered for empirical treatment before mNGS in 17 patients but showed no improvement. The treatment was switched to doxycycline or moxifloxacin immediately since psittacosis pneumonia were suspected and confirmed by mNGS detection (within 48 hours). After receiving adjustment of treatment, 94.23% (49/52) of patients were cured successfully.
CONCLUSIONS
In conclusion, mNGS may be a promising approach for clinical diagnosis of psittacosis. For patients with a history of exposure to birds, hyperpyrexia, nonproductive cough, multiple elevated inflammatory markers, and air-space consolidation in lung, psittacosis pneumonia should be considered, especially when beta-lactam antibiotics showed limited efficacy.
Topics: Aged; Aged, 80 and over; Anti-Bacterial Agents; Chlamydial Pneumonia; Chlamydophila psittaci; Humans; Hyperplasia; Middle Aged; Pneumonia; Psittacosis; Retrospective Studies; beta-Lactams
PubMed: 35816485
DOI: 10.1371/journal.pone.0270896 -
Biochimica Et Biophysica Acta.... Oct 2022Although the protective effects of Chlamydia psittaci plasmid-encoded protein CPSIT_P7 as vaccine antigens to against chlamydial infection have been confirmed in our...
Although the protective effects of Chlamydia psittaci plasmid-encoded protein CPSIT_P7 as vaccine antigens to against chlamydial infection have been confirmed in our previous study, the function and mechanism of CPSIT_P7 inducing innate immunity in the antibacterial response remain unknown. Here, we found that plasmid protein CPSIT_P7 could induce M1 macrophage polarization upregulating the genes of the surface molecule CD86, proinflammatory cytokines (TNF-α, IL-6, and IL-1β), and antibacterial effector NO synthase 2 (iNOS). During M1 macrophage polarization, macrophages acquire phagocytic and microbicidal competence, which promotes the host antibacterial response. As we observed that CPSIT_P7-induced M1 macrophages could partially reduce the infected mice pulmonary Chlamydia psittaci load. Furthermore, CPSIT_P7 induced M1 macrophage polarization through the TLR4-mediated MAPK and NF-κB pathways. Collectively, our results highlight the effect of CPSIT_P7 on macrophage polarization and provide new insights into new prevention and treatment strategies for chlamydial infection.
Topics: Animals; Anti-Bacterial Agents; Chlamydophila psittaci; Macrophages; Mice; Mitogen-Activated Protein Kinases; NF-kappa B; Plasmids; Psittacosis; Toll-Like Receptor 4
PubMed: 35809864
DOI: 10.1016/j.bbamcr.2022.119324 -
Journal of Infection in Developing... Jun 2022Chlamydia psittaci pneumonia is a zoonotic infectious disease caused by Chlamydia psittaci. Its clinical manifestations are nonspecific. Diagnosis of the disease is... (Review)
Review
INTRODUCTION
Chlamydia psittaci pneumonia is a zoonotic infectious disease caused by Chlamydia psittaci. Its clinical manifestations are nonspecific. Diagnosis of the disease is difficult. In recent years, next-generation sequencing has played an important role in pathogen detection. We report two cases with severe Chlamydia psittaci pneumonia confirmed by next-generation sequencing.
CASE STUDY
The first case is that of a 50-year old man who presented with high fever for four days and cough with sputum for two days. The second case is that of a 57-year-old man who was admitted with high fever for one week, dyspnea and cough with sputum for four days. The second man worked at a chicken farm in the last two months. In both cases, the usual laboratory examination for pathogens detection was negative, and the initial anti-infectious therapy had limited effect. The bronchoalveolar lavage fluid of case 1 and the blood and sputum of case 2 were sent for next-generation sequencing which resulted in sequence reads of Chlamydia psittaci. Antibiotics were adjusted according to the diagnosis.
RESULTS
The diagnosis of the two cases was confirmed by next-generation sequencing detecting Chlamydia psittaci, and the patients had positive results after treatment.
CONCLUSIONS
The two cases suggest that next-generation sequencing could be used in early diagnosis of Chlamydia psittaci infection to initiate specific anti-infection therapy in time.
Topics: Bronchoalveolar Lavage Fluid; Chlamydophila psittaci; Cough; Humans; Pneumonia; Psittacosis
PubMed: 35797307
DOI: 10.3855/jidc.16166 -
Frontiers in Microbiology 2022is the causative agent of psittacosis, a worldwide zoonotic disease. A rapid, specific, and sensitive diagnostic assay would be benefit for infection control. In this...
is the causative agent of psittacosis, a worldwide zoonotic disease. A rapid, specific, and sensitive diagnostic assay would be benefit for infection control. In this study, an assay combining recombinase-aided amplification and a lateral flow strip (RAA-LF) for the detection of active infection was developed. The RAA-LF assay targeted the gene of and could be accomplished in 15 min at a single temperature (39°C). The analytical sensitivity of the assay was as low as 1 × 10 copies/μl and no cross-reaction with some other intracellular pathogens was observed. Moreover, all feces samples from mice infected with at day-1 post-infection were positive in the RAA-LF assay. In conclusion, the RAA-LF assay provides a convenient, rapid, specific and sensitive method for detection of active infection and it is also suitable for detection in field.
PubMed: 35770169
DOI: 10.3389/fmicb.2022.928025 -
Frontiers in Cellular and Infection... 2022To evaluate the value of metagenomic next-generation sequencing (mNGS) for the early diagnosis of psittacosis, and to investigate its epidemiology by whole-genome...
BACKGROUND
To evaluate the value of metagenomic next-generation sequencing (mNGS) for the early diagnosis of psittacosis, and to investigate its epidemiology by whole-genome capture.
METHODS
Twenty-one bronchoalveolar lavage fluid (BALF) and blood samples of 16 psittacosis patients from multiple centers during August 2019 to September 2021 were analyzed retrospectively. mNGS with normal datasets (10 M 75-bp single-end reads after sequencing) and larger datasets (30 M 150-bp paired-end reads after sequencing) as well as quantitative real-time polymerase chain reaction (qPCR) were used to detect the pathogen. Also, whole-genome capture of was applied to draw the phylogenetic tree.
RESULTS
mNGS successfully detected the pathogen in all 16 cases (100%), while qPCR was positive only in 5 out of 10 cases (50%), indicating a significantly higher sensitivity of mNGS than qPCR ( < 0.01). BALF-mNGS performed better than blood-mNGS (16/16 versus 3/5, < 0.05). In addition, larger datasets (the read counts have tripled, and the base number was 12-fold larger compared to clinical mNGS with a normal dataset) of mNGS showed significantly increased contents of human DNA ( < 0.05) and decreased reads per million of the pathogen, suggesting no improvement. Whole-genome capture results of five samples (>60% coverage and >1 depth) were used to construct the phylogenetic tree.
CONCLUSION
Significant advantages of mNGS with normal datasets were demonstrated in early diagnosing psittacosis. It is the first study to use whole-genome capture to analyze epidemiological information.
Topics: High-Throughput Nucleotide Sequencing; Humans; Metagenomics; Phylogeny; Psittacosis; Retrospective Studies; Sensitivity and Specificity
PubMed: 35734579
DOI: 10.3389/fcimb.2022.872899 -
The Clinical Respiratory Journal Jul 2022The aim of this study was to investigate the clinical characteristics of Chlamydia psittaci pneumonia and evaluate the diagnostic value of Metagenomic Next-Generation...
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.
Topics: Chlamydophila psittaci; High-Throughput Nucleotide Sequencing; Humans; Pneumonia; Psittacosis; Retrospective Studies
PubMed: 35724965
DOI: 10.1111/crj.13519