1887

Abstract

is an important cause of community-acquired pneumonia (CAP). The spectrum of CAP due to ranges from mild, self-limited to acute respiratory failure and the early identification of this disease can be challenging. Metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid has the potential to improve the pathogen identification in severe CAP.

Metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid has the potential to rapidly identify pathogens in severe CAP. The early identification and appropriate use of antibiotics can improve the prognosis of severe CAP caused by .

The aim of the study is to describe the clinical spectrum of severe psittacosis pneumonia to provide a better understanding of this disease and to demonstrate that mNGS is an effective method for pathogen detection.

Retrospective case analysis from November 2019 to November 2020 was performed. Sixteen cases of severe psittacosis pneumonia were diagnosed through mNGS. Clinical features, laboratory findings, imaging features, treatment and outcome were summarized.

Frequent symptoms included fever (16/16, 100%), dyspnoea (16/16, 100%), cough (12/16, 75%), sputum (11/16, 69%) and headache (9/16, 56%). The median leukocytosis was within the normal range, while C-reactive proteins, CK, LDH, AST, D-Dimer were significantly elevated. The feature of computed tomography included ground-glass opacity with consolidation and multiple lobar distributions. The total number of sequences of identified from bronchoalveolar lavage by mNGS varied from 58 to 57115. Five patients underwent noninvasive mechanical ventilation, four patients underwent high flow humidified oxygen therapy and one patient underwent invasive mechanical ventilation. Two patients had septic shock needing vasoactive medications. All of the sixteen patients experienced full recoveries.

. The symptoms of severe CAP caused by were not typical while laboratory results may have some clues. The mNGS technology can early detect of psittacosis, reduce unnecessary use of antibiotics and short the course of the disease.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.001456
2021-11-24
2021-12-03
Loading full text...

Full text loading...

References

  1. Böcker S, Heurich A, Franke C, Monajembashi S, Sachse K et al. Chlamydia psittaci inclusion membrane protein IncB associates with host protein Snapin. Int J Med Microbiol 2014; 304:542–553 [View Article]
    [Google Scholar]
  2. Hogerwerf L, De Gier B, Baan B, Van Der Hoek W et al. Chlamydia psittaci (psittacosis) as a cause of community-acquired pneumonia: a systematic review and meta-analysis. Epidemiol Infect 2017; 145:3096–3105 [View Article]
    [Google Scholar]
  3. Gautam J, Krawiec C. Chlamydia Pneumonia, in StatPearls. Treasure Island 2020
    [Google Scholar]
  4. Wallensten A, Fredlund H, Runehagen A. Multiple human-to-human transmission from a severe case of psittacosis, Sweden, January–February 2013. Euro Surveill 2014; 19:42 [View Article]
    [Google Scholar]
  5. Lei J-H, Xu Y, Jiang Y-F, Shi Z-H, Guo T et al. Clustering cases of Chlamydia psittaci pneumonia in COVID-19 screening ward staff. Clin Infect Dis 2020ciaa1681 [View Article] [PubMed]
    [Google Scholar]
  6. Ojeda Rodriguez JA, Modi P, Brady MF. Psittacosis Pneumonia, in StatPearls. Treasure Island 2020
    [Google Scholar]
  7. Hogerwerf L, Roof I, de Jong MJK, Dijkstra F, van der Hoek W et al. Animal sources for zoonotic transmission of psittacosis: a systematic review. BMC Infect Dis 2020; 20:192 [View Article] [PubMed]
    [Google Scholar]
  8. Spoorenberg SM. Chlamydia psittaci: a relevant cause of community-acquired pneumonia in two Dutch hospitals. Neth J Med 2016; 74:75
    [Google Scholar]
  9. Wu X, Li Y, Zhang M, Li M, Zhang R et al. Etiology of severe community-acquired pneumonia in adults based on metagenomic next-generation sequencing: a prospective multicenter study. Infect Dis Ther 2020; 9:1003–1015 [View Article]
    [Google Scholar]
  10. Smith KA, Bradley KK, Stobierski MG, Tengelsen LA et al. Compendium of measures to control Chlamydophila psittaci (formerly Chlamydia psittaci) infection among humans (psittacosis) and pet birds, 2005. J Am Vet Med Assoc 2005; 226:532–539 [View Article]
    [Google Scholar]
  11. Kozuki E, Arima Y, Matsui T, Sanada Y, Ando S et al. Human psittacosis in Japan: notification trends and differences in infection source and age distribution by gender, 2007 to 2016. Ann Epidemiol 2020; 44:60–63 [View Article]
    [Google Scholar]
  12. Langelier C, Kalantar KL, Moazed F, Wilson MR, Crawford ED et al. tegrating host response and unbiased microbe detection for lower respiratory tract infection diagnosis in critically ill adults. Proc Natl Acad Sci USA 2018; 115:E12353–E12362 [View Article]
    [Google Scholar]
  13. Ai J-W, Zhang Y, Zhang H-C, Xu T, Zhang W-H et al. Era of molecular diagnosis for pathogen identification of unexplained pneumonia, lessons to be learned. Emerg Microbes Infect 2020; 9:597–600 [View Article]
    [Google Scholar]
  14. Chen L, Liu W, Zhang Q, Xu K, Ye G et al. RNA based mNGS approach identifies a novel human coronavirus from two individual pneumonia cases in 2019 Wuhan outbreak. Emerg Microbes Infect 2020; 9:313–319 [View Article]
    [Google Scholar]
  15. Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD et al. fectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis 2007; 44:S27–S72 [View Article]
    [Google Scholar]
  16. Vande Weygaerde Y, Versteele C, Thijs E, De Spiegeleer A, Boelens J et al. An unusual presentation of a case of human psittacosis. Respir Med Case Rep 2018; 23:138–142 [View Article] [PubMed]
    [Google Scholar]
  17. Wen Y, Chen Y, Li L, Xu M, Tan Y et al. Localization and characterization of a putative cysteine desulfurase in Chlamydia psittaci. J Cell Biochem 2018; 120:4409–4422 [View Article]
    [Google Scholar]
  18. Centers for Disease Control and Prevention Compendium of measures to control Chlamydia psittaci infection among humans (psittacosis) and pet birds (avian chlamydiosis), 2000. MMWR Recomm Rep 2000; 49:3–17
    [Google Scholar]
  19. Rybarczyk J, Versteele C, Lernout T, Vanrompay D et al. Human psittacosis: a review with emphasis on surveillance in Belgium. Acta Clinica Belgica 2019; 75:42–48 [View Article]
    [Google Scholar]
  20. Knittler MR, Sachse K. Chlamydia psittaci: update on an underestimated zoonotic agent. Pathog Dis 2014; 73:1–15 [View Article]
    [Google Scholar]
  21. Chen X, Cao K, Wei Y, Qian Y, Liang J et al. Metagenomic next-generation sequencing in the diagnosis of severe pneumonias caused by Chlamydia psittaci. Infection 2020; 48:535–542 [View Article]
    [Google Scholar]
  22. Petrovay F, Balla E. Two fatal cases of psittacosis caused by Chlamydophila psittaci. J Med Microbiol 2008; 57:1296–1298 [View Article]
    [Google Scholar]
  23. Nieuwenhuizen AA, Dijkstra F, Notermans DW, van der Hoek W et al. Laboratory methods for case finding in human psittacosis outbreaks: a systematic review. BMC Infect Dis 2018; 18:442 [View Article] [PubMed]
    [Google Scholar]
  24. Zhang P, Chen Y, Li S, Li C, Zhang S et al. Metagenomic next-generation sequencing for the clinical diagnosis and prognosis of acute respiratory distress syndrome caused by severe pneumonia: a retrospective study. PeerJ 2020; 8:e9623 [View Article] [PubMed]
    [Google Scholar]
  25. Xie Y, Du J, Jin W, Teng X, Cheng R et al. Next generation sequencing for diagnosis of severe pneumonia: China, 2010–2018. Journal of Infection 2019; 78:158–169 [View Article]
    [Google Scholar]
  26. Yang L, Haidar G, Zia H, Nettles R, Qin S et al. Metagenomic identification of severe pneumonia pathogens in mechanically-ventilated patients: a feasibility and clinical validity study. Respir Res 2019; 20:265 [View Article]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.001456
Loading
/content/journal/jmm/10.1099/jmm.0.001456
Loading

Data & Media loading...

Supplements

Supplementary material 1

PDF

Most cited this month Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error