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Epidemiology and Infection Nov 2017Psittacosis is a zoonotic infectious disease caused by the transmission of the bacterium Chlamydia psittaci from birds to humans. Infections in humans mainly present as... (Meta-Analysis)
Meta-Analysis Review
Psittacosis is a zoonotic infectious disease caused by the transmission of the bacterium Chlamydia psittaci from birds to humans. Infections in humans mainly present as community-acquired pneumonia (CAP). However, most cases of CAP are treated without diagnostic testing, and the importance of C. psittaci infection as a cause of CAP is therefore unclear. In this meta-analysis of published CAP-aetiological studies, we estimate the proportion of CAP caused by C. psittaci infection. The databases MEDLINE and Embase were systematically searched for relevant studies published from 1986 onwards. Only studies that consisted of 100 patients or more were included. In total, 57 studies were selected for the meta-analysis. C. psittaci was the causative pathogen in 1·03% (95% CI 0·79-1·30) of all CAP cases from the included studies combined, with a range between studies from 0 to 6·7%. For burden of disease estimates, it is a reasonable assumption that 1% of incident cases of CAP are caused by psittacosis.
Topics: Chlamydophila psittaci; Community-Acquired Infections; Humans; Pneumonia, Bacterial; Psittacosis
PubMed: 28946931
DOI: 10.1017/S0950268817002060 -
Chinese Medical Journal Jan 2021
Topics: Chlamydophila psittaci; Humans; Pneumonia; Psittacosis
PubMed: 33410632
DOI: 10.1097/CM9.0000000000001313 -
BMC Infectious Diseases Jun 2021Psittacosis, which is also known as parrot fever, is Chlamydia psittaci (C. psittaci) caused infectious disease. The clinical manifestations vary from asymptomatic... (Review)
Review
A case of chlamydia psittaci caused severe pneumonia and meningitis diagnosed by metagenome next-generation sequencing and clinical analysis: a case report and literature review.
BACKGROUND
Psittacosis, which is also known as parrot fever, is Chlamydia psittaci (C. psittaci) caused infectious disease. The clinical manifestations vary from asymptomatic infection to severe atypical pneumonia or even fatal meningitis. Early recognition of psittacosis is difficult because of its nonspecific clinical manifestations. Culture and gene probe techniques for C. psittaci are not available for routine clinical use, which makes the diagnosis difficult too. Although psittacosis has increasingly been recognized and reported in recent years, cure of severe pneumonia complicated with meningitis, with etiologic diagnosis aided by the use of metagenomic next-generation sequencing (mNGS), is still uncommon. So, it is necessary to report and review such potentially fatal case.
CASE PRESENTATION
This report describes a 54-year-old woman with C. psittaci caused severe atypical pneumonia and meningitis. She presented with symptoms of fever, dry cough and dyspnea, accompanied by prominent headache. Her condition deteriorated rapidly to respiratory failure and lethargy under the treatment of empirical antibacterial agents, and was treated with invasive mechanical ventilation soon. She denied contact with birds, poultry or horses, but unbiased mNGS of both the bronchoalveolar lavage fluid (BALF) and the cerebrospinal fluid (CSF) identified sequence reads corresponding to C. psittaci infection, and there was no sequence read corresponding to other probable pathogens. Combined use of targeted antimicrobial agents of tetracyclines, macrolides and fluoroquinolones was carried out, and the patient's condition improved and she was discharged home 28 days later. Her status returned close to premorbid condition on day 60 of follow-up.
CONCLUSIONS
When clinicians come across a patient with atypical pneumonia accompanied by symptoms of meningitis, psittacosis should be taken into consideration. mNGS is a promising detection method in such condition and is recommended.
Topics: Animals; Anti-Infective Agents; Chlamydial Pneumonia; Chlamydophila psittaci; Female; Fluoroquinolones; High-Throughput Nucleotide Sequencing; Humans; Macrolides; Meningitis; Metagenome; Middle Aged; Psittacosis; Tetracyclines; Treatment Outcome
PubMed: 34193063
DOI: 10.1186/s12879-021-06205-5 -
Emerging Microbes & Infections Dec 2022Severe Community Acquired Pneumonia (SCAP) challenges public health globally. Considerable improvements in molecular pathogen testing emerged in the last few years. Our...
Severe Community Acquired Pneumonia (SCAP) challenges public health globally. Considerable improvements in molecular pathogen testing emerged in the last few years. Our prospective study combinedly used traditional culture, antigen tests, PCR and mNGS in SCAP pathogen identification with clinical outcomes. From June 2018 to December 2019, we conducted a multi-centre prospective study in 17 hospitals of SCAP patients within 48 hours of emergency room stay or hospitalization in China. All clinical data were uploaded into an online database. Blood, urine and respiratory specimens were collected for routine culture, antigen detection, PCR and mNGS as designed appropriately. Aetiology confirmation was made by the local attending physician group and scientific committee according to microbiological results, clinical features, and response to the treatment. Two hundred seventy-five patients were included for final analysis. Combined detection methods made identification rate up to 74.2% (222/299), while 14.4% (43/299) when only using routine cultures and 40.8% (122/299) when not using mNGS. Influenza virus (23.2%, 46/198), (19.6%, 39/198), (14.6%, 29/198), (12.6%, 25/198), (11.1%, 22/198) were the top five common pathogens. The in-hospital mortality of patients with pathogen identified and unidentified was 21.7% (43/198) and 25.9% (20/77), respectively. In conclusion, early combined detection increased the pathogen identification rate and possibly benefitted survival. Influenza virus, , was the leading cause of SCAP in China, and there was a clear seasonal distribution pattern of influenza viruses. Physicians should be aware of the emergence of uncommon pathogens, including and .
Topics: Adult; Chlamydophila psittaci; Community-Acquired Infections; Humans; Pneumonia, Bacterial; Prospective Studies; Psittacosis
PubMed: 35081880
DOI: 10.1080/22221751.2022.2035194 -
CA: a Cancer Journal For Clinicians 2016Extranodal marginal zone lymphoma of the mucosa-associated lymphoid tissue (MALT lymphoma) accounts for 7% to 8% of newly diagnosed lymphomas. Because of its association... (Review)
Review
Extranodal marginal zone lymphoma of the mucosa-associated lymphoid tissue (MALT lymphoma) accounts for 7% to 8% of newly diagnosed lymphomas. Because of its association with infectious causes, such as Helicobacter pylori (HP) or Chlamydophila psittaci (CP), and autoimmune diseases, it has become the paradigm of an antigen-driven malignancy. MALT lymphoma usually displays an indolent course, and watch-and-wait strategies are justified initially in a certain percentage of patients. In patients with gastric MALT lymphoma or ocular adnexal MALT lymphoma, antibiotic therapy against HP or CP, respectively, is the first-line management of choice, resulting in lymphoma response rates from 75% to 80% after HP eradication and from 33% to 65% after antibiotic therapy for CP. In patients who have localized disease that is refractory to antibiotics, radiation is widely applied in various centers with excellent local control, whereas systemic therapies are increasingly being applied, at least in Europe, because of the potentially systemic nature of the disease. Therefore, the objective of this review is to briefly summarize the clinicopathologic characteristics of this distinct type of lymphoma along with current data on management strategies.
Topics: Anti-Bacterial Agents; Autoimmune Diseases; Helicobacter Infections; Humans; Lymphoma, B-Cell, Marginal Zone; Neoplasm Staging; Prognosis; Psittacosis; Radiotherapy, Adjuvant; Risk Factors; Treatment Outcome
PubMed: 26773441
DOI: 10.3322/caac.21330 -
The Lancet. Microbe Jul 2022Chlamydia psittaci can infect a wide range of avian species, occasionally causing psittacosis (also known as parrot fever) in humans. Most human psittacosis cases are...
BACKGROUND
Chlamydia psittaci can infect a wide range of avian species, occasionally causing psittacosis (also known as parrot fever) in humans. Most human psittacosis cases are associated with close contact with pet birds or poultry. In December, 2020, an outbreak of severe community-acquired pneumonia of unknown aetiology was reported in a hospital in Shandong province, China, and some of the patients' close contacts had respiratory symptoms. Our aims were to determine the causative agent of this epidemic and whether there had been human-to-human transmission.
METHODS
For this epidemiological and aetiological investigation study, we enrolled patients who had community-acquired pneumonia confirmed by chest CT at two local hospitals in Shandong Province in China. We collected sputum, bronchoalveolar lavage fluid, and nasopharyngeal swab samples from participants and detected pathogens by surveying for 22 target respiratory microbes using a commercial assay, followed by metagenomic next-generation sequencing, specific nested PCR, and qPCR tests. We excluded individuals who were C psittaci-negative on both tests. We recruited close contacts of the C psittaci-positive patients, and tested nasopharyngeal swabs from the close contacts and samples from ducks from the processing plant where these patients worked. We then integrated the epidemiological, clinical, and laboratory data to reveal the potential chain of transmission of C psittaci that characterised this outbreak.
FINDINGS
Between Dec 4 and 29, 2020, we used metagenomic next-generation sequencing and different PCR-based approaches to test 12 inpatients with community-acquired pneumonia, of whom six (50%) were workers at a duck-meat processing plant and two (17%) were unemployed people, who were positive for C psittaci and enrolled in this study. We contacted 61 close contacts of the six patients who worked at the duck-meat processing plant, of whom 61 (100%) were enrolled and tested, and we determined that the community-acquired pneumonia outbreak was caused by C psittaci. Within the outbreak cluster, 17 (77%) of 22 participants had confirmed C psittaci infections and five (23%) of 22 participants were asymptomatic C psittaci carriers. The outbreak had begun with avian-to-human transmission, and was followed by secondary and tertiary human-to-human transmission, which included transmission by several asymptomatic carriers and by health-care workers. In addition, some of the participants with confirmed C psittaci infection had no identified source of infection, which suggested cryptic bacterial transmission.
INTERPRETATION
Our study data might represent the first documented report of human-to-human transmission of C psittaci in China. Therefore, C psittaci has the potential to evolve human-to-human transmission via various routes, should be considered an elevated biosecurity and emergent risk, and be included as part of the routine diagnosis globally, especially for high-risk populations.
FUNDING
Academic Promotion Programme of Shandong First Medical University, National Science and Technology Major Project, ARC Australian Laureate Fellowship.
Topics: Animals; Australia; Birds; China; Chlamydophila psittaci; Community-Acquired Infections; Humans; Pneumonia; Psittacosis
PubMed: 35617977
DOI: 10.1016/S2666-5247(22)00064-7 -
International Journal of General... 2023Psittacosis pneumonia is a zoonosis caused by Chlamydia psittacosis infection, mainly resulting from contact with aerosols of birds or poultry's urine, feces, and... (Review)
Review
Psittacosis pneumonia is a zoonosis caused by Chlamydia psittacosis infection, mainly resulting from contact with aerosols of birds or poultry's urine, feces, and excrement. The clinical manifestations range from general symptoms of infection to severe acute respiratory syndrome and systemic diseases, currently diagnosed using metagenomic next-generation sequencing (mNGS) to improve diagnostic accuracy. To date, most reports have only discussed human exposure to poultry disease. However, the latest studies have shown that human-to-human transmission of Chlamydia psittaci occurs not only between infected patients and their close contacts but also between secondary contacts. After looking back on relevant literature at home and abroad in the past ten years, this paper reviews the diagnosis, diagnosis and treatment, and progress in epidemiological research of Psittacosis pneumonia.
PubMed: 36628298
DOI: 10.2147/IJGM.S396074 -
Deutsches Arzteblatt International Mar 2010Zoonoses were already a subject of intense interest even before the SARS and avian influenza epidemics arose. For many years, chlamydiae have been hypothesized to be... (Review)
Review
BACKGROUND
Zoonoses were already a subject of intense interest even before the SARS and avian influenza epidemics arose. For many years, chlamydiae have been hypothesized to be important zoonotic pathogens, because of their wide distribution and their infectious cycle. This article provides an overview of the current state of knowledge on this subject.
METHODS
The authors present a selective review of the literature as well as their own findings.
RESULTS
The scientific knowledge of the distribution and infectious cycle of chlamydiae is still inadequate. The laboratory diagnosis of chlamydial zoonoses remains unsatisfactory in both human and veterinary medicine, as there are no commercially available sensitive and species-specific tests. Acute chlamydial infections are usually treated with macrolides, tetracyclines, or quinolones. Persistent varieties are not covered by standard therapy.
CONCLUSIONS
There is a considerable need for research on chlamydial infections, especially with regard to the diagnosis and treatment of persistent varieties.
Topics: Animal Husbandry; Animals; Animals, Domestic; Bird Diseases; Birds; Cattle; Cattle Diseases; Chlamydia; Chlamydia Infections; Chronic Disease; Diagnosis, Differential; Humans; Oligonucleotide Array Sequence Analysis; Poultry Diseases; Psittacosis; Risk Factors; Sensitivity and Specificity; Species Specificity; Swine; Swine Diseases; Zoonoses
PubMed: 20358033
DOI: 10.3238/arztebl.2010.0174 -
Journal of the American Veterinary... Dec 2002Considerable progress continues to be made in understanding chlamydial organisms, their host species, diagnosis, and treatment. (1-3) Thus, national guidelines are... (Review)
Review
Considerable progress continues to be made in understanding chlamydial organisms, their host species, diagnosis, and treatment. (1-3) Thus, national guidelines are updated annually to provide a standardized approach to handling infections in humans and birds. (2-3) Prior to development of these guidelines, considerable variation in approach by state agencies has been documented. (39) A more recent national assessment of state regulations and procedures has not been conducted. Decreasing imports of birds and increasing education may contribute to a reduction in human risk from avian infections. Keeping new birds separate from old birds in aviaries and poultry production facilities may reduce the incidence of avian chlamydiosis. Although wide-scale testing of birds may not be cost effective, (28) focal testing and treatment may help reduce human risk. The recent loss of a major source for pelleted feed for small birds, such as budgerigars, was a severe setback for veterinarians and local agencies in managing this disease. However, new medication formulas under development may help to address this problem. (2-3)
Topics: Animals; Bird Diseases; Birds; Chlamydophila psittaci; Disease Outbreaks; Humans; Mammals; Poultry; Psittacosis; Zoonoses
PubMed: 12494967
DOI: 10.2460/javma.2002.221.1710 -
Frontiers in Immunology 2022() has caused sporadic, but recurring, fatal community-acquired pneumonia outbreaks worldwide, posing a serious threat to public health. Our understanding of host...
PURPOSE
() has caused sporadic, but recurring, fatal community-acquired pneumonia outbreaks worldwide, posing a serious threat to public health. Our understanding of host inflammatory responses to is limited, and many bronchitis cases of psittaci have rapidly progressed to pneumonia with deterioration.
METHODS
To clarify the host inflammatory response in psittacosis, we analyzed clinical parameters, and compared transcriptomic data, concentrations of plasma cytokines/chemokines, and changes of immune cell populations in 17 laboratory-confirmed psittacosis cases, namely, 8 pneumonia and 9 bronchitis individuals, in order to assess transcriptomic profiles and pro-inflammatory responses.
RESULTS
Psittacosis cases with pneumonia were found to have abnormal routine blood indices, liver damage, and unilateral pulmonary high-attenuation consolidation. Transcriptome sequencing revealed markedly elevated expression of several pro-inflammatory genes, especially interleukins and chemokines. A multiplex-biometric immunoassay showed that pneumonia cases had higher levels of serum cytokines (G-CSF, IL-2, IL-6, IL-10, IL-18, IP-10, MCP-3, and TNF-α) than bronchitis cases. Increases in activated neutrophils and decreases in the number of lymphocytes were also observed in pneumonia cases.
CONCLUSION
We identified a number of plasma biomarkers distinct to pneumonia and a variety of cytokines elevated with immunopathogenic potential likely inducing an inflammatory milieu and acceleration of the disease progression of psittaci pneumonia. This enhances our understanding of inflammatory responses and changes in vascular endothelial markers in psittacosis with heterogeneous symptoms and should prove helpful for developing both preventative and therapeutic strategies.
Topics: Biomarkers; Bronchitis; Chemokine CXCL10; Chlamydophila psittaci; Cytokines; Granulocyte Colony-Stimulating Factor; Humans; Interleukin-10; Interleukin-18; Interleukin-2; Interleukin-6; Pneumonia; Psittacosis; Transfer Factor; Tumor Necrosis Factor-alpha
PubMed: 36119044
DOI: 10.3389/fimmu.2022.929213