Psittacosis caused severe community-acquired pneumonia accompanied by acute hypoxic respiratory failure: a multicenter retrospective cohort study from China

Abstract

Introduction Psittacosis can cause severe community-acquired pneumonia (CAP). The clinical manifestations of psittacosis range from subclinical to fulminant psittacosis with multi-organ failure. It is essential to summarize the clinical characteristic of patients with severe psittacosis accompanied by acute hypoxic respiratory failure (AHRF). Methods This retrospective study included patients with severe psittacosis caused CAP accompanied by AHRF from 19 tertiary hospitals of China. We recorded the clinical data, antimicrobial therapy, respiratory support, complications, and outcomes. Chlamydia psittaci was detected on the basis of metagenomic next-generation sequencing performed on bronchoalveolar lavage fluid samples. Patient outcomes were compared between the treatment methods. Results This study included 45 patients with severe CAP and AHRF caused by psittacosis from April 2018 to May 2021. The highest incidence of these infections was between September and April. There was a history of poultry contact in 64.4% of the patients. The median PaO2/FiO2 of the patients was 119.8 (interquartile range, 73.2 to 183.6) mmHg. Four of 45 patients (8.9%) died in the ICU, and the median ICU duration was 12 days (interquartile range, 8 to 21) days. There were no significant differences between patients treated with fluoroquinolone initially and continued after the diagnosis, fluoroquinolone initially followed by tetracycline, and fluoroquinolone combined with tetracycline. Conclusion Psittacosis caused severe CAP seems not rare, especially in the patients with the history of exposure to poultry or birds. Empirical treatment that covers atypical pathogens may benefit such patients, which fluoroquinolones might be considered as an alternative.

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

“…Culture is still the gold standard for the diagnosis of C. psittaci infection, but the diagnosis and treatment of C. psittaci infection will be delayed due to its strict nutritional requirements and long culture time. Besides, serological detection techniques such as immunofluorescence and complement binding assay have drawbacks such as long detection cycles, insufficient specificity or sensitivity [ 10 ]. With the development of detection technology, while ensuring specificity and sensitivity, researchers have further increased their requirements for detection speed.…”

Case Report of Severe Chlamydia psittaci Pneumonia Treated with Omadacycline

“…There is no significant difference in efficacy between patients initially treated with fluoroquinolones, sequentially treated with tetracyclines, or treated with a combination of fluoroquinolones and tetracyclines. 13 …”

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

“…Psittacosis is a systemic disease that can affect multiple systems and cause damage to multiple organs, with the lungs being the main target organ ( Radomski et al., 2016 ). The clinical manifestations of Chlamydia psittaci pneumonia vary significantly, ranging from asymptomatic patients to patients with fever and respiratory symptoms, respiratory failure, severe pneumonia, or multi-organ failure ( Meijer et al., 2021 ; Tang et al., 2023 ; Yang et al., 2023 ).…”