Clinical characteristics of 5 cases of <i>Chlamydia psittaci</i> pneumonia diagnosed by metagenomics next-generation sequencing_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 ZHU Qiaozhen , CHEN Keying , CHEN Jiming , HUANG Lixia , LI Zhiying , HONG Yongzhong

Department of Respiratory and Critical Care Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, Guangdong 518000, P. R. China;

Corresponding author：

ZHU Qiaozhen, Email: 619206642@qq.com

Keywords：

Chlamydia psittaci; metagenomics next-generation sequencing; tetracycline drugs; quinolone drugs

DOI：

10.7507/1671-6205.202104071

Video：

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Objective To analysis and explore the value of metagenomics next-generation sequencing (mNGS) and clinical characteristics of Chlamydia psittaci (C. psittaci) pneumonia. Methods Totally 5 patients who were diagnosed with C. psittaci pneumonia and were treated in the Department of Respiratory and Critical Care Medicine and the Department of Infectious Diseases of Huazhong University of Science and Technology Union Shenzhen Hospital from Febuary 2021 to March 2021 were enrolled in the study. The clinical data of the patients were analyzed, and the clinical characteristics of the disease and treatment experience were summarized. Results The main symptoms of the 5 patients were high fever and cough, 4 of them had a history of raising parrots. The white blood cell and the neutrophils were mostly normal or slightly increased, the C reactive protein and erythrocyte sedimentation rate were significantly increased. The chest CT showed exudation and consolidation of one or several lung lobes. The serious patients might develop respiratory failure, if they were not treated by effective antibiotics. The diagnosis was based on clinical manifestations, contact history and alveolar lavage fluid that were detected by mNGS technology of C. psittaci nucleic acid sequence. The accuracy of detecting pathogens in alveolar lavage fluid by mNGS was high. In addition, mNGS could also identify other bacteria or viruses. After the timely adjustment of treatment, the condition of the patients was improved relied on tetracycline drugs or quinolone drugs, which shortened the diagnosis time and course of C. psittaci pneumnonia and reduced the use of unnecessary antibacterial drugs. Conclusions mNGS is of great significance in diagnosing C. psittaci pneumonia. The timely use of appropriate antibacterial drugs can achieve favorable therapeutic effect.

Citation： ZHU Qiaozhen, CHEN Keying, CHEN Jiming, HUANG Lixia, LI Zhiying, HONG Yongzhong. Clinical characteristics of 5 cases of Chlamydia psittaci pneumonia diagnosed by metagenomics next-generation sequencing. Chinese Journal of Respiratory and Critical Care Medicine, 2022, 21(1): 7-11. doi: 10.7507/1671-6205.202104071 Copy

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11.	刘芳, 苑少欣, 李显庭, 等. 9例聚集性鹦鹉热肺炎临床和流行病学特征. 中华医院感染学杂志, 2021, 31(16): 2462-2466.
12.	赵仁淹, 柴海娜, 郑瑞强. 病原体二代测序辅助诊断鹦鹉热衣原体重症肺炎一例. 中华内科杂志, 2020, 59(12): 989-991.
13.	Rybarczyk J, Versteele C, Lernout T, et al. Human psittacosis: a review with emphasis on surveillance in Belgium. Acta Clin Belg, 2020, 75(1): 42-48.
14.	Opota O, Jaton K, Branley J, et al. Improving the molecular diagnosis of Chlamydia psittaci and Chlamydia abortus infection with a species-specific duplex real-time PCR. J Med Microbiol, 2015, 64(10): 1174-1185.
15.	Li Y, Sun B, Tang X, et al. Application of metagenomic next-generation sequencing for bronchoalveolar lavage diagnostics in critically ill patients. Eur J Clin Microbiol Infect Dis, 2020, 39(2): 369-374.
16.	Kohlhoff SA, Hammerschlag MR. Treatment of Chlamydial infections: 2014 update. Expert Opin Pharmacother, 2015, 16(2): 205-212.
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1. 陈灏珠主编. 实用内科学第12版. 北京: 人民卫生出版社, 2005, 1681-1682.
2. 蔡柏蔷, 李龙芸主编. 协和呼吸病学. 北京: 中国协和医科大学出版社, 2005, 637-648.
3. Fraeyman A, Boel A, Van Vaerenbergh K, et al. Atypical pneumonia due to Chlamydophila psittaci: 3 case reports and review of literature. Acta Clin Belg, 2010, 65(3): 192-196.
4. Gacouin A, Revest M, Letheulle J, et al. Distinctive features between community-acquired pneumonia (CAP) due to Chlamydophila psittaci and CAP due to Legionella pneumophila admitted to the intensive care unit (ICU). Eur J Clin Microbiol Infect Dis, 2012, 31(10): 2713-2718.
5. 刘领, 吴文杰, 耿艳杰, 等. 鹦鹉热衣原体肺炎1例报告并文献复习. 临床肺科杂志, 2015, 20(8): 1543-1544.
6. 张文源, 杨保华. 鹦鹉热肺炎2例报道. 临床肺科杂志, 2009, 14(7): 978.
7. Rane V, Khailin K, Williams J, et al. Underdiagnosis of Chlamydia trachomatis and Chlamydia psittaci revealed by introduction of respiratory multiplex PCR assay with Chlamydiaceae family primers. Diagn Microbiol Infect Dis, 2018, 90(3): 163-166.
8. 张郡, 唐光健, 王淑兰, 等. 鹦鹉热肺炎的影像学表现. 中华放射学杂志, 2005, 39(11): 1134-1137.
9. Branley JM, Weston KM, England J. Clinical features of endemic community-acquired psittacosis. New Microbes New Infect, 2014, 2(1): 7-12.
10. 陆晓旻, 朱际平, 陈扬, 等. 基于宏基因组二代测序诊断的鹦鹉热衣原体肺炎的流行病学特征分析. 中国临床研究, 2022, 35(1): 1-5.
11. 刘芳, 苑少欣, 李显庭, 等. 9例聚集性鹦鹉热肺炎临床和流行病学特征. 中华医院感染学杂志, 2021, 31(16): 2462-2466.
12. 赵仁淹, 柴海娜, 郑瑞强. 病原体二代测序辅助诊断鹦鹉热衣原体重症肺炎一例. 中华内科杂志, 2020, 59(12): 989-991.
13. Rybarczyk J, Versteele C, Lernout T, et al. Human psittacosis: a review with emphasis on surveillance in Belgium. Acta Clin Belg, 2020, 75(1): 42-48.
14. Opota O, Jaton K, Branley J, et al. Improving the molecular diagnosis of Chlamydia psittaci and Chlamydia abortus infection with a species-specific duplex real-time PCR. J Med Microbiol, 2015, 64(10): 1174-1185.
15. Li Y, Sun B, Tang X, et al. Application of metagenomic next-generation sequencing for bronchoalveolar lavage diagnostics in critically ill patients. Eur J Clin Microbiol Infect Dis, 2020, 39(2): 369-374.
16. Kohlhoff SA, Hammerschlag MR. Treatment of Chlamydial infections: 2014 update. Expert Opin Pharmacother, 2015, 16(2): 205-212.
17. Chen XC, Cao K, Wei Y, et al. Metagenomic next-generation sequencing in the diagnosis of severe pneumonias caused by Chlamydia psittaci]. Infection, 2020, 48(4): 535-542.

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Chinese Journal of Respiratory and Critical Care Medicine

Clinical characteristics of 5 cases of Chlamydia psittaci pneumonia diagnosed by metagenomics next-generation sequencing

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