Human-to-human transmission of Chlamydia psittaci in China, 2020: an epidemiological and aetiological investigation

Zhang, Zhenjie; Zhou, Hong; Cao, Huae; Ji, Jingkai; Zhang, Rongqiang; Li, Wenxin; Guo, Hongfeng; Chen, Long; Ma, Chuanmin; Cui, Mingxue; Wang, Jing; Chen, Hao; Ding, Guoyong; Yan, Chengxin; Dong, Liang; Holmes, Edward C.; Meng, Ling; Hou, Peiqiang; Shi, Weifeng

doi:10.1016/s2666-5247(22)00064-7

Cited by 42 publications

(47 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Between 4 December and 29 December 2020, participants included 17 laboratory-confirmed C. psittaci cases, excluding 5 asymptomatic cases (14). Clinical information, including complete blood counts, chest computed tomography (CT) imaging, X-rays, and blood biochemistry, of the C. psittaci cases were collected at the earliest time points after hospitalization.…”

Section: Clinical Data and Sample Preparationmentioning

confidence: 99%

“…In late 2020, we reported a large-scale outbreak of humanto-human transmission in Shandong Province, China, with 22 confirmed cases, eight of which rapidly progressed to severe pneumonia, leading to one death (14). To identify and characterize the host inflammatory response to C. psittaci infection, we collected peripheral blood samples from these psittacosis cases, as well as healthy controls, and performed transcriptome profiling and also functional analyses.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Host inflammatory response is the major factor in the progression of Chlamydia psittaci pneumonia

Zhang

Wang

et al. 2022

Front. Immunol.

Self Cite

View full text Add to dashboard Cite

PurposeChlamydia psittaci (C. psittaci) has caused sporadic, but recurring, fatal community-acquired pneumonia outbreaks worldwide, posing a serious threat to public health. Our understanding of host inflammatory responses to C. psittaci is limited, and many bronchitis cases of psittaci have rapidly progressed to pneumonia with deterioration.MethodsTo clarify the host inflammatory response in psittacosis, we analyzed clinical parameters, and compared transcriptomic data, concentrations of plasma cytokines/chemokines, and changes of immune cell populations in 17 laboratory-confirmed psittacosis cases, namely, 8 pneumonia and 9 bronchitis individuals, in order to assess transcriptomic profiles and pro-inflammatory responses.ResultsPsittacosis cases with pneumonia were found to have abnormal routine blood indices, liver damage, and unilateral pulmonary high-attenuation consolidation. Transcriptome sequencing revealed markedly elevated expression of several pro-inflammatory genes, especially interleukins and chemokines. A multiplex-biometric immunoassay showed that pneumonia cases had higher levels of serum cytokines (G-CSF, IL-2, IL-6, IL-10, IL-18, IP-10, MCP-3, and TNF-α) than bronchitis cases. Increases in activated neutrophils and decreases in the number of lymphocytes were also observed in pneumonia cases.ConclusionWe identified a number of plasma biomarkers distinct to C. psittaci pneumonia and a variety of cytokines elevated with immunopathogenic potential likely inducing an inflammatory milieu and acceleration of the disease progression of psittaci pneumonia. This enhances our understanding of inflammatory responses and changes in vascular endothelial markers in psittacosis with heterogeneous symptoms and should prove helpful for developing both preventative and therapeutic strategies.

show abstract

Section: Clinical Data and Sample Preparationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Host inflammatory response is the major factor in the progression of Chlamydia psittaci pneumonia

Zhang

Wang

et al. 2022

Front. Immunol.

Self Cite

View full text Add to dashboard Cite

show abstract

“…C. psittaci mainly infects humans who inhale dust containing respiratory secretions or dried droppings from infected birds (Shaw et al, 2019). Zhang et al (2022) report the human-to-human transmission of C. psittaci in China, but fewer than 5% of C. psittaci pneumonia cases were community-acquired (Petrovay and Balla, 2008;de Gier et al, 2018). C. psittaci pneumonia has been widely reported worldwide, including in China, the US, Europe, and Australia (Cheng et al, 2013;Branley et al, 2014;Shaw et al, 2019;Shi et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

“…C. psittaci mainly infects humans who inhale dust containing respiratory secretions or dried droppings from infected birds ( Shaw et al., 2019 ). Zhang et al. (2022) report the human-to-human transmission of C. psittaci in China, but fewer than 5% of C. psittaci pneumonia cases were community-acquired ( Petrovay and Balla, 2008 ; de Gier et al., 2018 ).…”

Section: Introductionmentioning

confidence: 99%

Clinical diagnosis and etiology of patients with Chlamydia psittaci pneumonia based on metagenomic next-generation sequencing

Liang

Dong

et al. 2022

Front. Cell. Infect. Microbiol.

View full text Add to dashboard Cite

The incidence of severe Chlamydia psittaci (C. psittaci) pneumonia and coinfections is increasing. Early detection of this condition is needed to prevent negative outcomes, along with detailed descriptions of its associated clinical characteristics. Our study contributes by undertaking etiological analysis of patients with C. psittaci pneumonia based on metagenomic next-generation sequencing (mNGS). A retrospective analysis of 30 patients with C. psittaci pneumonia was undertaken and confirmed by mNGS or polymerase chain reaction (PCR). Clinical manifestations of the severe and non-severe C. psittaci pneumonia groups were compared for clinical reference. Etiological analyses were also performed to comprehensively understand pathogeny and coinfection with other respiratory pathogens in C. psittaci patients. The absolute value of lymphocytes (LYM) in the severe group was lower than in the non-severe group. At the same time, neutrophil-to-lymphocyte ratio (NLR), procalcitonin (PCT), alanine aminotransferase (ALT), D-II polymer, brain natriuretic peptide (BNP), myoglobin (MYO), and cardiac troponin I (cTnI) were significantly higher (P < 0.05) in the severe group. mNGS has a broader pathogen spectrum and can more sensitively detect C. psittaci and other low-abundance pathogens with a higher positive detection rate (100%, 13/13 vs. 46%, 6/13, P <0.05) than conventional culture methods. mNGS detected the following dominant species associated with C. psittaci in patients: bacteria (53.2%, 39% gram-positive, 61% gram-negative), fungi (12.9%), and viruses (33.9%). A total of 73.3% (11/15) of patients had suspected coinfections, with a coinfection rate of 91.7% (11/12) in the severe group. No coinfection or death occurred in the non-severe group. Prognosis in the severe group was poor, with a mortality rate of 27.3% (3/11) for patients with coinfection. Eight of 11 patients with coinfections (72.7%) recovered. In conclusion, the clinical symptoms of severe C. psittaci pneumonia manifested as abnormal inflammatory indicators, impaired liver function, myocardial injury, coagulation, and relatively low immune responses. The higher proportion of patients with coinfections in our study supports the use of mNGS for comprehensive early detection of respiratory infections in patients with C. psittaci pneumonia. Simultaneous early identification of coinfections would further improve the clinical treatment of these patients.

show abstract

“…Human-to-human transmission has also been reported but is relatively rare. 6 Compared to other species of Chlamydia, C. psittaci is highly pathogenic and likely to cause severe systemic inflammatory reactions. 7 After infection, it first proliferates in the local monocyte-macrophage system in the respiratory tract.…”

Section: Discussionmentioning

confidence: 99%

Omadacycline for the Treatment of Severe Chlamydia psittaci Pneumonia Complicated with Multiple Organ Failure: A Case Report

Fang¹,

Xu²,

Tan³

et al. 2022

IDR

View full text Add to dashboard Cite

Psittacosis is a rare zoonotic disease caused by Chlamydia psittaci infection, and tetracyclines are the preferred treatment. Omadacycline is a novel tetracycline that has a strong in vitro antibacterial activity against atypical pathogens, including C. psittaci ; however, clinical data for its usage are lacking. We report a patient with severe C. psittaci -induced pneumonia presenting with a high fever, muscle aches, severe hepatic and renal insufficiency, and acute respiratory failure requiring tracheal intubation and mechanical ventilation. The condition was diagnosed using metagenomic next-generation sequencing. The patient was discharged after treatment with omadacycline. The findings of this study suggest that metagenomic next-generation sequencing is valuable for the rapid and accurate diagnosis of psittacosis. With its good safety profile and no requirement for dose adjustment in special populations, omadacycline is a new option for the treatment of severe C. psittaci pneumonia. However, additional case reports are needed to support this conclusion.

show abstract

Human-to-human transmission of Chlamydia psittaci in China, 2020: an epidemiological and aetiological investigation

Cited by 42 publications

References 27 publications

Host inflammatory response is the major factor in the progression of Chlamydia psittaci pneumonia

Host inflammatory response is the major factor in the progression of Chlamydia psittaci pneumonia

Clinical diagnosis and etiology of patients with Chlamydia psittaci pneumonia based on metagenomic next-generation sequencing

Omadacycline for the Treatment of Severe Chlamydia psittaci Pneumonia Complicated with Multiple Organ Failure: A Case Report

Contact Info

Product

Resources

About