Clinical Characteristics of Chlamydia psittaci Pneumonia Infection in Central South China,Infectious Diseases and Therapy

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Clinical Characteristics of Chlamydia psittaci Pneumonia Infection in Central South China
Infectious Diseases and Therapy ( IF 4.7 ) Pub Date : 2022-06-20 , DOI: 10.1007/s40121-022-00662-4
Min Yang _{1,

2,

3} , Dan-Hui Yang _{1,

2,

3} , Huan Yang ₄ , Shui-Zi Ding _{1,

2,

3} , Cai-Hong Liu ₅ , Hui-Ming Yin ₆ , Dan Liu ₇ , Ping Chen _{1,

2,

3} , Hong Luo _{1,

2,

3}

Affiliation

Introduction

Chlamydia psittaci pneumonia has been a global public health hotspot in recent years. Although some scattered cases of C. psittaci pneumonia have been reported, there is a lack of large case studies worldwide.

Methods

In this multicenter, observational study, we recruited all consecutive patients with confirmed C. psittaci pneumonia from October 4, 2018, to October 23, 2020, in nine tertiary general hospitals in Central-South China. Epidemiologic and clinical data from patients’ electronic medical records were collected and analyzed.

Results

One hundred and sixteen patients with C. psittaci pneumonia were included in the study. The mean age was 59.7 years. Fever (96.6%) and cough (65.5%) were the most common clinical symptoms. Most patients presented with an increase in the proportion of neutrophils, neutrophil to lymphocyte ratio, LDH, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) and a significant decrease in lymphocytes. The main CT lung findings were consolidation (81%) and pleural effusion (35.3%), and bilateral lung consolidation was mainly found in severe patients. Chlamydia psittaci DNA was detected in BALF (bronchoalveolar lavage fluid) or blood samples by metagenomic next-generation sequencing (mNGS) in all patients. Use of quinolone was associated with shorter length of hospital stay and fever duration after antibiotic use. Multivariate logistic regression analysis indicated that respiratory support was associated with both severe pneumonia and in-hospital death.

Conclusions

The clinical phenotype of C. psittaci pneumonia is complex and variable. mNGS is helpful in the diagnosis and treatment of C. psittaci pneumonia, and early treatment with quinolone may benefit patients.

中文翻译：

华中南部地区鹦鹉热衣原体肺炎感染的临床特点

介绍

近年来，鹦鹉热衣原体肺炎已成为全球公共卫生热点。尽管已经报道了一些零星的鹦鹉热肺炎病例，但世界范围内缺乏大型案例研究。

方法

在这项多中心、观察性研究中，我们招募了2018 年 10 月 4 日至 2020 年 10 月 23 日期间在华中南九家三级综合医院连续确诊的所有鹦鹉热肺炎患者。收集和分析来自患者电子病历的流行病学和临床数据。

结果

116 名鹦鹉热肺炎患者被纳入研究。平均年龄为 59.7 岁。发热（96.6%）和咳嗽（65.5%）是最常见的临床症状。大多数患者的中性粒细胞比例、中性粒细胞与淋巴细胞的比例、LDH、丙氨酸氨基转移酶（ALT）和天冬氨酸氨基转移酶（AST）均增加，淋巴细胞显着减少。CT肺部主要表现为实变（81%）和胸腔积液（35.3%），双侧肺实变主要见于重症患者。鹦鹉热衣原体通过宏基因组下一代测序 (mNGS) 在所有患者中检测到 BALF（支气管肺泡灌洗液）或血液样本中的 DNA。喹诺酮类药物的使用与抗生素使用后住院时间和发热持续时间的缩短有关。多变量逻辑回归分析表明，呼吸支持与重症肺炎和院内死亡均相关。