Metagenomic next-generation sequencing for the diagnosis of Chlamydia psittaci pneumonia

Clin Respir J. 2022 Jul;16(7):513-521. doi: 10.1111/crj.13519. Epub 2022 Jun 20.

Abstract

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.

Keywords: Chlamydia psittaci; clinical analysis; metagenomic next-generation sequencing; pneumonia.

MeSH terms

  • Chlamydophila psittaci* / genetics
  • High-Throughput Nucleotide Sequencing
  • Humans
  • Pneumonia*
  • Psittacosis* / diagnosis
  • Psittacosis* / veterinary
  • Retrospective Studies