Application of Metagenomic Next-Generation Sequencing in the Diagnosis of Pneumonia Caused by Chlamydia psittaci

Tang, Jianmin; Tan, Wanmei; Luo, Lingxin; Xu, Huan; Li, Na

doi:10.1128/spectrum.02384-21

Cited by 18 publications

(12 citation statements)

References 24 publications

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“…reported similar results that patients with severe Chlamydia psittaci pneumonia showed higher levels of AST and LDH ( Su et al., 2021 ). In addition, our data suggested that liver injury was not associated with background hepatitis B virus infection, consistent with a recent finding reported by Tang et al ( Tang et al., 2022 ). However, all 5 patients with hepatitis B virus-related chronic liver disease had abnormal liver function, and hepatitis B virus infection may be a predisposing factor, which needs to be confirmed by more studies.…”

Section: Discussionsupporting

confidence: 93%

Clinical features and risk factors of liver injury in patients with Chlamydia psittaci pneumonia- a retrospective analysis

Guo,

Zhu,

Chen

2024

Front. Cell. Infect. Microbiol.

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BackgroundResearch into the effects of Chlamydia psittaci pneumonia on the liver has emerged in the last few years. However, no studies have systematically described liver injury in patients with psittacosis. We present the first report on the clinical features and risk factors of liver injury in patients with Chlamydia psittaci pneumonia.MethodsWe retrospectively collected the clinical parameters for 46 patients with Chlamydia psittaci pneumonia admitted to Jinhua Central Hospital from January 2019 to February 2023. We analyzed the liver function parameters and summarized the clinical characteristics and risk factors of liver injury.ResultsAmong the 46 patients, 39 (84.8%) had abnormal liver function, and 23 (50.0%) had liver injury. The ratio of patients with a history of alcohol consumption (39.1% vs. 4.3%, P =0.004) or severe pneumonia (56.5% vs. 26.1%, P =0.036) was higher in the liver injury group compared with the non-liver injury group. Laboratory tests showed higher lactate dehydrogenase (LDH) levels in the liver injury group (P <0.001). The optimal cut-off LDH level associated with liver injury was 473 IU/L as determined by ROC curve analysis. Furthermore, multivariate logistic regression analysis demonstrated that a history of alcohol consumption (odds ratio [OR] = 11.251; 95% confidence interval [CI] = 1.022 ~ 123.897, P =0.048) and an LDH level of ≥ 473IU/L (OR = 11.635, 95% CI = 1.832 ~ 73.869, P =0.009) were independent risk factors for liver injury.ConclusionsA history of alcohol consumption and an LDH level of over 473 IU/L are independent risk factors for Chlamydia psittaci pneumonia-related liver injury. It is recommended that particular attention be given to monitoring and evaluating liver function parameters when treating patients with Chlamydia psittaci pneumonia who have a high LDH level and history of alcohol consumption.

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Section: Discussionsupporting

confidence: 93%

Clinical features and risk factors of liver injury in patients with Chlamydia psittaci pneumonia- a retrospective analysis

Guo,

Zhu,

Chen

2024

Front. Cell. Infect. Microbiol.

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“…Due to the variable clinical presentations, absence of epidemiological information, and low clinicians’ awareness of this disease, rapid diagnosis of psittacosis is still a challenge in clinical, and delayed use of effective antibiotics may lead to high mortality in severe cases. For rare pathogens such as C. psittaci , mNGS has been recommended and applied for etiologic diagnosis, which significantly benefits the diagnosis of severe pneumonia ( Chen et al., 2020 ; Wu et al., 2021 ; Tang et al., 2022 ). In our patients, an accurate diagnosis of psittacosis mainly relies on an overall consideration of clinical characteristics, a specific epidemiological history, and an mNGS test for etiologic identification.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Metagenomic next-generation sequencing applied in diagnosing psittacosis caused by Chlamydia psittaci infection

Xu,

Wang,

et al. 2023

Front. Cell. Infect. Microbiol.

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BackgroundChlamydia psittaci is the causative agent of psittacosis in humans, while its rapid identification is hampered due to the lack of specificity of laboratory testing methods.Case presentationThis study reports four cases of C. psittaci infection after contact with a domestic parrot, all belonging to the same family. Common manifestations like fever, cough, headache, nausea, and hypodynamia appeared in the patients. Metagenomic next-generation sequencing (mNGS) aided the etiological diagnosis of psittacosis, revealing 58318 and 7 sequence reads corresponding to C. psittaci in two cases. The detected C. psittaci was typed as ST100001 in the Multilocus-sequence typing (MLST) system, a novel strain initially reported. Based on the results of pathogenic identification by mNGS, the four patients were individually, treated with different antibiotics, and discharged with favorable outcomes.ConclusionIn diagnosing psittacosis caused by a rare C. psittaci agent, mNGS provides rapid etiological identification, contributing to targeted antibiotic therapy and favorable outcomes. This study also reminds clinicians to raise awareness of psittacosis when encountering family members with a fever of unknown origin.

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“…In fact, C.psittaci pneumonia is often mis-and underdiagnosed in the past. With the progress of molecular biology in recent years, more and more studies have found that metagenomic next-generation sequencing(mNGS) or targeted next generation sequencing (tNGS) can enhance our ability to diagnose C.psittaci pneumonia [7][8][9]. While there have been some case reports or case series on the clinical manifestations of C.psittaci pneumonia or risk factors in severe patients, the sample sizes are limited [10,11].…”

Section: Discussionmentioning

confidence: 99%

Clinical features and a prediction model for early prediction of composite outcome in Chlamydia psittaci pneumonia: a multi-centre retrospective study in China

Yang

et al. 2023

Preprint

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Introduction: There has been growing concern about Chlamydia psittaci (C. psittaci ) pneumonia in recent years. C.psittaci pneumonia has atypical clinical manifestations and often ignored by clinicians. This study analyzed the clinical characteristics, explored the risk factors for composite outcome and established a prediction model for early predicting the risk of composite outcome among C.psittaci pneumonia patients.Methods We carried out a retrospective, observational cohort study in ten Chinese tertiary hospitals to investigate C. psittaci pneumonia. Only patients with confirmed cases of the disease were included, and their epidemiologic and clinical data were thoroughly collected and analyzed. The composite outcome of C. psittaci pneumonia was define as died during hospitalization, ICU admission and mechanical ventilation. Univariate and multivariable logistic regression analyses were conducted to determine the significant variables. A ten-fold cross-validation was performed to internally validate the model. Additionally, we evaluated the model performance using various methods, including receiver operating characteristics (ROC), C-index, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), decision curve analysis (DCA), and clinical impact curve analysis (CICA).Results In total, 119 C. psittaci pneumonia patients were included in the study. The patients were randomly divided into training (n = 83) and validation (n = 36) cohorts. CURB-65 was used to establish predictive Model 1. Multivariate logistic regression analysis identified three independent prognostic factors, including serum albumin, CURB-65, and white blood cell. These factors were employed to construct model 2. The model 2 had acceptable discrimination (AUC of 0.898 and 0.825 for the training and validation sets, respectively) and robust internal validity. Calibration plot demonstrated good agreement between the predicted and the actual composite outcome rate. In the training set, the specificity, sensitivity, NPV, and PPV for predicting composite outcome in nomogram model were 91.7%, 84.5%, 50.0%, and 98.4%, respectively. In the internal validation set, these values were 100.0%, 64.7%, 14.2%, and 100.0%, respectively. DCA and CICA showed that the nomogram model was clinically practical.Conclusions We developed a refined nomogram model for predicting the composite outcome in C.psittaci pneumonia patients. This nomogram model enables early and accurate C.psittaci pneumonia patients’ evaluation, which may improved clinical outcomes.

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Application of Metagenomic Next-Generation Sequencing in the Diagnosis of Pneumonia Caused by Chlamydia psittaci

Abstract: Psittacosis pneumonia is easily underdiagnosed and misdiagnosed. In this study, we use mNGS in the diagnosis of psittacosis pneumonia.

Cited by 18 publications

References 24 publications

Clinical features and risk factors of liver injury in patients with Chlamydia psittaci pneumonia- a retrospective analysis

Clinical features and risk factors of liver injury in patients with Chlamydia psittaci pneumonia- a retrospective analysis

Case Report: Metagenomic next-generation sequencing applied in diagnosing psittacosis caused by Chlamydia psittaci infection

Clinical features and a prediction model for early prediction of composite outcome in Chlamydia psittaci pneumonia: a multi-centre retrospective study in China

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