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Clinical Features, Treatment, and Outcome of Psittacosis Pneumonia: A Multicenter Study

BACKGROUND: We aimed to describe psittacosis pneumonia and risk factors for developing severe pneumonia in this multicenter clinical study. METHODS: We collected the data of psittacosis pneumonia cases diagnosed with metagenomic next-generation sequencing (mNGS) assay from April 2018 to April 2022 i...

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Autores principales: Ni, Yueyan, Zhong, Huanhuan, Gu, Yu, Liu, Li, Zhang, Qiang, Wang, Li, Wan, Bing, Chen, Shi, Cao, Min, Xu, Jin, Chen, Cheng, Chen, Yanbin, Sun, Siqing, Ji, Lei, Sun, Wenkui, Wang, Cheng, Yang, Jian, Lu, Xin, Shi, Bin, Feng, Chunlai, Su, Xin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9937045/
https://www.ncbi.nlm.nih.gov/pubmed/36817742
http://dx.doi.org/10.1093/ofid/ofac518
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author Ni, Yueyan
Zhong, Huanhuan
Gu, Yu
Liu, Li
Zhang, Qiang
Wang, Li
Wan, Bing
Chen, Shi
Cao, Min
Xu, Jin
Chen, Cheng
Chen, Yanbin
Sun, Siqing
Ji, Lei
Sun, Wenkui
Wang, Cheng
Yang, Jian
Lu, Xin
Shi, Bin
Feng, Chunlai
Su, Xin
author_facet Ni, Yueyan
Zhong, Huanhuan
Gu, Yu
Liu, Li
Zhang, Qiang
Wang, Li
Wan, Bing
Chen, Shi
Cao, Min
Xu, Jin
Chen, Cheng
Chen, Yanbin
Sun, Siqing
Ji, Lei
Sun, Wenkui
Wang, Cheng
Yang, Jian
Lu, Xin
Shi, Bin
Feng, Chunlai
Su, Xin
author_sort Ni, Yueyan
collection PubMed
description BACKGROUND: We aimed to describe psittacosis pneumonia and risk factors for developing severe pneumonia in this multicenter clinical study. METHODS: We collected the data of psittacosis pneumonia cases diagnosed with metagenomic next-generation sequencing (mNGS) assay from April 2018 to April 2022 in 15 tertiary hospitals in China. RESULTS: A total of 122 patients were enrolled; 50.0% had a definite history of bird exposure. In 81.2% of cases, onset happened in autumn or winter. The common symptoms were fever (99.2%), cough (63.1%), fatigue (52.5%), shortness of breath (50.0%), chills (37.7%), central nervous system symptoms (36.9%), myalgia (29.5%), and gastrointestinal tract symptoms (15.6%). Laboratory tests showed that >70% of cases had elevated C-reactive protein, procalcitonin, erythrocyte sedimentation rate, D-dimer, lactate dehydrogenase, and aspartate aminotransferase, and >50% had hyponatremia and hypoproteinemia. The most common imaging finding was consolidation (71.3%), and 42.6% of cases met the criteria for severe pneumonia. Age >65 years and male sex were the risk factors for severe pneumonia. The effective proportion of patients treated with tetracyclines was higher than that of fluoroquinolones (66/69 [95.7%] vs 18/58 [31.0%]; P < .001), and the median defervescence time was shorter. After medication adjustment when the diagnosis was clarified, 119 of 122 (97.5%) patients were finally cured and the other 3 (2.5%) died. CONCLUSIONS: Psittacosis pneumonia has a high rate of severe disease. Proven diagnosis could be rapidly confirmed by mNGS. Tetracycline therapy had a rapid effect and a high cure rate.
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spelling pubmed-99370452023-02-18 Clinical Features, Treatment, and Outcome of Psittacosis Pneumonia: A Multicenter Study Ni, Yueyan Zhong, Huanhuan Gu, Yu Liu, Li Zhang, Qiang Wang, Li Wan, Bing Chen, Shi Cao, Min Xu, Jin Chen, Cheng Chen, Yanbin Sun, Siqing Ji, Lei Sun, Wenkui Wang, Cheng Yang, Jian Lu, Xin Shi, Bin Feng, Chunlai Su, Xin Open Forum Infect Dis Major Article BACKGROUND: We aimed to describe psittacosis pneumonia and risk factors for developing severe pneumonia in this multicenter clinical study. METHODS: We collected the data of psittacosis pneumonia cases diagnosed with metagenomic next-generation sequencing (mNGS) assay from April 2018 to April 2022 in 15 tertiary hospitals in China. RESULTS: A total of 122 patients were enrolled; 50.0% had a definite history of bird exposure. In 81.2% of cases, onset happened in autumn or winter. The common symptoms were fever (99.2%), cough (63.1%), fatigue (52.5%), shortness of breath (50.0%), chills (37.7%), central nervous system symptoms (36.9%), myalgia (29.5%), and gastrointestinal tract symptoms (15.6%). Laboratory tests showed that >70% of cases had elevated C-reactive protein, procalcitonin, erythrocyte sedimentation rate, D-dimer, lactate dehydrogenase, and aspartate aminotransferase, and >50% had hyponatremia and hypoproteinemia. The most common imaging finding was consolidation (71.3%), and 42.6% of cases met the criteria for severe pneumonia. Age >65 years and male sex were the risk factors for severe pneumonia. The effective proportion of patients treated with tetracyclines was higher than that of fluoroquinolones (66/69 [95.7%] vs 18/58 [31.0%]; P < .001), and the median defervescence time was shorter. After medication adjustment when the diagnosis was clarified, 119 of 122 (97.5%) patients were finally cured and the other 3 (2.5%) died. CONCLUSIONS: Psittacosis pneumonia has a high rate of severe disease. Proven diagnosis could be rapidly confirmed by mNGS. Tetracycline therapy had a rapid effect and a high cure rate. Oxford University Press 2023-02-17 /pmc/articles/PMC9937045/ /pubmed/36817742 http://dx.doi.org/10.1093/ofid/ofac518 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Major Article
Ni, Yueyan
Zhong, Huanhuan
Gu, Yu
Liu, Li
Zhang, Qiang
Wang, Li
Wan, Bing
Chen, Shi
Cao, Min
Xu, Jin
Chen, Cheng
Chen, Yanbin
Sun, Siqing
Ji, Lei
Sun, Wenkui
Wang, Cheng
Yang, Jian
Lu, Xin
Shi, Bin
Feng, Chunlai
Su, Xin
Clinical Features, Treatment, and Outcome of Psittacosis Pneumonia: A Multicenter Study
title Clinical Features, Treatment, and Outcome of Psittacosis Pneumonia: A Multicenter Study
title_full Clinical Features, Treatment, and Outcome of Psittacosis Pneumonia: A Multicenter Study
title_fullStr Clinical Features, Treatment, and Outcome of Psittacosis Pneumonia: A Multicenter Study
title_full_unstemmed Clinical Features, Treatment, and Outcome of Psittacosis Pneumonia: A Multicenter Study
title_short Clinical Features, Treatment, and Outcome of Psittacosis Pneumonia: A Multicenter Study
title_sort clinical features, treatment, and outcome of psittacosis pneumonia: a multicenter study
topic Major Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9937045/
https://www.ncbi.nlm.nih.gov/pubmed/36817742
http://dx.doi.org/10.1093/ofid/ofac518
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