Evaluation of clinical characteristics and risk factors associated with Chlamydia psittaci infection based on metagenomic next-generation sequencing

Abstract

Introduction This study aimed to evaluate the clinical characteristics, imaging examination, laboratory examination and treatment options of Chlamydia psittaci associated pneumonia, as well as the risk factors affecting the progress of Chlamydia psittaci pneumonia, in order to improve the effect of therapeutics. Methods We retrospectively analyzed the clinical data of patients with chlamydia psittaci associated pneumonia in the First Affiliated Hospital of Nanchang University from January 2021 to December 2021. The patient's past medical history, clinical manifestations, laboratory examinations, chest CT findings, treatment status, and prognosis data were collected. Results All cases of Chlamydia psittaci in our research have been confirmed by mNGS. Among 46 cases of Chlamydia psittaci pneumonia, Poultry exposure was reported in 35 cases. In severe cases of Chlamydia psittaci pneumonia, Neutrophils, Procalcitonin(PCT), Lactate Dehydrogenase(LDH), Hydroxybutyrate Dehydrogenase(HBDH), Creatine Kinase Isoenzymes-B(CK-MB) and D-Dimer levels were remarkably higher than that of non-severe cases, except for lymphocytes(all P < 0.05). Chest CT scans showed Bilateral, multiple lobar lungs, pleural effusions involvement in those suffering from severe Chlamydia psittaci pneumonia(P < 0.05). Multivariate analysis revealed that higher lymphocyte(OR 0.836, 95% CI 0.714–0.962, P = 0.041) was the only protective factor for survival. Despite the difference in alpha diversity between the severe and mild groups of Chlamydia psittaci pneumonia, the slight difference was not significant. There were notable differences between the two pathogens, including Streptococcus australis and Streptococcus pneumoniae(P < 0.05). Conclusion Metagenomic next-generation sequencing (mNGS) is an effective detection method for the early diagnosis and selection of appropriate antibiotics for Chlamydia psittaci pneumonia.