Clinical Characteristics of Chlamydia psittaci Infection Diagnosed by Metagenomic Next-Generation Sequencing: A Retrospective Multi-Center Study in Fujian, China

Kaixiong Liu; Luling Wu; Gongping Chen; Dunhuan Zeng; Qiwei Zhong; Li Luo; Bin Song; Xiuhong Ying; Fayu Ni; Lifang Yu; Liyu Xu; Xin Lin; Xiaoyan Chen; Xin Zou; Jianhong Xiao; Yuekai Hu

doi:10.2147/IDR.S443953

Clinical Characteristics of Chlamydia psittaci Infection Diagnosed by Metagenomic Next-Generation Sequencing: A Retrospective Multi-Center Study in Fujian, China

Infect Drug Resist. 2024 Feb 21:17:697-708. doi: 10.2147/IDR.S443953. eCollection 2024.

Authors

Kaixiong Liu^#^{1

2

3}, Luling Wu^#^{4

5}, Gongping Chen^#^{1

2

3}, Dunhuan Zeng^{1

2

3}, Qiwei Zhong⁶, Li Luo^{1

2}, Bin Song⁷, Xiuhong Ying^{1

2}, Fayu Ni⁸, Lifang Yu⁸, Liyu Xu⁹, Xin Lin⁹, Xiaoyan Chen¹⁰, Xin Zou¹¹, Jianhong Xiao⁷, Yuekai Hu^{5

12

13}

Affiliations

¹ Department of Respiratory and Critical Care medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China.
² Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, People's Republic of China.
³ Institute of Respiratory Disease, Fujian Medical University, Fuzhou, People's Republic of China.
⁴ Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, People's Republic of China.
⁵ Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, People's Republic of China.
⁶ Department of Respiratory and Critical Care Medicine, Minnan Hospital, the First Affiliated Hospital of Fujian Medical University, Quau zhou, People's Republic of China.
⁷ Department of Respiratory and Critical Care Medicine, Mindong Hospital Affiliated to Fujian Medical University, Ningde, People's Republic of China.
⁸ Department of Respiratory, Fuqing General Hospital Affiliated to Fujian Medical University, Fuzhou, People's Republic of China.
⁹ Department of Respiratory and Critical Care Medicine, Fuzhou First Hospital of Fujian Medical University, Fuzhou, People's Republic of China.
¹⁰ Department of Emergency Medicine, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, People's Republic of China.
¹¹ Department of Respiratory and Critical Care Medicine, LongYan First Hospital Affiliated to Fujian Medical University, Longyan, People's Republic of China.
¹² Department of Infectious Diseases, First Affiliated Hospital of Fujian Medical University, Fuzhou, People's Republic of China.
¹³ Department of Infectious Diseases, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, People's Republic of China.

^# Contributed equally.

Abstract

Objective: This study aimed to describe and compare the epidemiological, demographic, clinical, laboratory and radiological characteristics as well as the complications, treatments, and outcomes of these patients.

Methods: We retrospectively investigated clinical data of patients with C. psittaci infection (psittacosis) in eight Grade IIIA hospitals of Fujian. Metagenomic next-generation sequencing (mNGS) was used identify C. psittaci in clinical samples of all included patients.

Results: A total of 74 patients (39 severe/35 non-severe) was diagnosed with psittacosis, 25 (33.8%) of whom had history of poultry exposure. Common symptoms included high fever (98% [37/74]), fatigue (52.7% [39/74]), and dyspnea (51.4% [38/74]). Common manifestations in imaging included consolidation (89.2%), pleural effusion (77.0%), and air bronchogram (66.2%). Common complications included acute respiratory distress syndrome (55.4% [41/74]), type I respiratory failure (52.7% [39/74]), acute liver injury (41.9% [31/74]), and secondary infection (27.0% [20/74]). The in-hospital mortality rate was 8.11% (6/74).

Conclusion: C. psittaci infection is represents an underestimated cause of CAP. For SCAP patients with poultry and bird contact history, specimens were encouraged to be sended for mNGS test in time. C. psittaci infection can lead to severe, multiple system involvement, and several complications. mNGS facilitate timely diagnosis of C. psittaci infection.

Keywords: Chlamydia psittaci; bronchoalveolar lavage fluid; community-acquired pneumonia; metagenomic next-generation sequencing.

Grants and funding

This work was supported by grants from the Fujian Provincial Health Technology Project (2020GGA053), Joint Funds for the Innovation of Science and Technology of Fujian Province (No.2060304) and the Natural Sciences Foundation of Fujian Province (2021J01228).