Infection and Drug Resistance (Apr 2021)
Clinical Analysis of Metagenomic Next-Generation Sequencing Confirmed Chlamydia psittaci Pneumonia: A Case Series and Literature Review
Abstract
Xin-Qi Teng,1,* Wen-Cheng Gong,2,* Ting-Ting Qi,1 Guo-Hua Li,1 Qiang Qu,3 Qiong Lu,1 Jian Qu1 1Department of Pharmacy, The Second Xiangya Hospital, Central South University; Institute of Clinical Pharmacy, Central South University, Changsha, People’s Republic of China; 2Department of Pharmacy, Jiangxi Cancer Hospital of Nanchang University, Jiangxi Cancer Center, Nanchang, Jiangxi, People’s Republic of China; 3Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jian QuDepartment of Pharmacy, The Second Xiangya Hospital, Central South University, No. 139 Middle Renmin Road, Changsha, 410011, People’s Republic of ChinaTel +86-15973190614Fax +86-731-85292128Email [email protected]: Chlamydia psittaci infection is a zoonotic infectious disease, which mainly inhaled through the lungs when exposed to the secretions of poultry that carry pathogenic bacteria. The traditional respiratory specimens or serological antibody testing is slow, and the false-negative rate is high. Metagenomic next-generation sequencing (mNGS) gives a promising rapid diagnosis tool.Methods: We retrospectively summarized the clinical characteristics of five C. psittaci pneumonia patients diagnosed by mNGS, conducted a literature review summarizing the clinical characteristics of patients with C. psittaci pneumonia reported since 2010.Results: Five C. psittaci pneumonia patients confirmed by mNGS aged from 36 to 66 years with three males. About 60% of patients had a history of contact with avian or poultry. All patients had a high fever over 38.5 °C, cough, hypodynamia, hypoxemia, and dyspnea on admission. Two patients had invasive ventilator support and extracorporeal membrane oxygenation support. Inflammatory index levels on admission and follow-up were all higher than normal values. Doxycycline or moxifloxacin and their combination therapy were used in patients. Four patients improved and were discharged, and one patient died due to multiple organ failures and disseminated intravascular coagulation. We summarized 19 articles including 69 C. psittaci pneumonia patients and patients in 11 publications were identified by mNGS, and most patients are treated with tetracycline and quinolone with good outcomes.Conclusion: mNGS is a promising rapid diagnosis tool, which may increase the detection rate and shorten the diagnosis time of C. psittaci pneumonia. Further case-control studies are needed to confirm.Keywords: Chlamydia psittaci, pneumonia, psittacosis, chlamydia, mNGS
