Identification and comparison of Chlamydia psittaci, Legionella and Mycoplasma pneumonia infection
Abstract Introduction Conventional etiological detection and pathogenic antibody methods make it challenging to identify the atypical pathogens among the community‐acquired pneumonia (CAP). Metagenomic next‐generation sequencing (mNGS) could rapidly detect all potentially infectious diseases and ide...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-05-01
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| Series: | The Clinical Respiratory Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/crj.13603 |
| _version_ | 1797818879393660928 |
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| author | Ning Zhu Daibing Zhou Ruyu Yuan Yiminniyaze Ruzetuoheti Jing Li Xiujuan Zhang Shengqing Li |
| author_facet | Ning Zhu Daibing Zhou Ruyu Yuan Yiminniyaze Ruzetuoheti Jing Li Xiujuan Zhang Shengqing Li |
| author_sort | Ning Zhu |
| collection | DOAJ |
| description | Abstract Introduction Conventional etiological detection and pathogenic antibody methods make it challenging to identify the atypical pathogens among the community‐acquired pneumonia (CAP). Metagenomic next‐generation sequencing (mNGS) could rapidly detect all potentially infectious diseases and identifies novel or potential pathogens. Methods Eighteen patients diagnosed with atypical CAP were enrolled in this retrospective study, including nine Chlamydia psittaci pneumonia (C. p), four Legionella pneumonia (L. p) and five Mycoplasma pneumonia (M. p). We simultaneously tested bronchoalveolar lavage fluid (BALF) samples for conventional microbiological methods and mNGS, and blood specimens were analysed. We also collected and compared baseline and clinical characteristics and treatment responses. Results Patients with C. p and L. p had similar symptoms, including fever, cough, headache, dyspnoea, asthenia, shivering and headache, compared with M. p, whose symptoms were slight. C. p and L. p usually showed multiple lobar distributions with pleural effusion. Serologic testing indicated that L. p had higher levels of white blood cells (WBCs), neutrophils, C‐reactive protein (CRP), procalcitonin (PCT), alanine aminotransferase (ALT), lactate dehydrogenase (LDH) and creatinine compared with M. p and L. p (p < 0.05). However, patients with C. p had lower levels of albumin (p < 0.05), and M. p had a minimum risk of cardiac volume loads (p < 0.05). CD4/CD8 ratio, lymphocytes, aspartate aminotransferase (AST), creatine kinase (CK), cell counting of BALF and coagulation had no difference (p < 0.05). Pathogenic IgM assay showed that 4/5 cases were positive for M. p and no positive detection for C. p and L. p infection. We timely adjusted the antibiotics according to the final mNGS results. Eventually, 16/18 patients recovered fully. Conditions of L. p patients were worse than those of C. p patients, and those of M. p patients were the least. Conclusion Early application of mNGS detection increased the atypical pathogenic identification, improved the prognosis and made up for the deficiency of conventional detection methods. |
| first_indexed | 2024-03-13T09:15:38Z |
| format | Article |
| id | doaj.art-de097d518fff4ece9f0d13c756cbd22a |
| institution | Directory Open Access Journal |
| issn | 1752-6981 1752-699X |
| language | English |
| last_indexed | 2024-03-13T09:15:38Z |
| publishDate | 2023-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Clinical Respiratory Journal |
| spelling | doaj.art-de097d518fff4ece9f0d13c756cbd22a2023-05-26T10:50:31ZengWileyThe Clinical Respiratory Journal1752-69811752-699X2023-05-0117538439310.1111/crj.13603Identification and comparison of Chlamydia psittaci, Legionella and Mycoplasma pneumonia infectionNing Zhu0Daibing Zhou1Ruyu Yuan2Yiminniyaze Ruzetuoheti3Jing Li4Xiujuan Zhang5Shengqing Li6Department of Respiratory and Critical Care Medicine, Huashan Hospital Fudan University Shanghai ChinaDepartment of Respiratory and Critical Care Medicine, Huashan Hospital Fudan University Shanghai ChinaDepartment of Respiratory and Critical Care Medicine, Huashan Hospital Fudan University Shanghai ChinaDepartment of Respiratory and Critical Care Medicine, Huashan Hospital Fudan University Shanghai ChinaDepartment of Respiratory and Critical Care Medicine, Huashan Hospital Fudan University Shanghai ChinaDepartment of Respiratory and Critical Care Medicine, Huashan Hospital Fudan University Shanghai ChinaDepartment of Respiratory and Critical Care Medicine, Huashan Hospital Fudan University Shanghai ChinaAbstract Introduction Conventional etiological detection and pathogenic antibody methods make it challenging to identify the atypical pathogens among the community‐acquired pneumonia (CAP). Metagenomic next‐generation sequencing (mNGS) could rapidly detect all potentially infectious diseases and identifies novel or potential pathogens. Methods Eighteen patients diagnosed with atypical CAP were enrolled in this retrospective study, including nine Chlamydia psittaci pneumonia (C. p), four Legionella pneumonia (L. p) and five Mycoplasma pneumonia (M. p). We simultaneously tested bronchoalveolar lavage fluid (BALF) samples for conventional microbiological methods and mNGS, and blood specimens were analysed. We also collected and compared baseline and clinical characteristics and treatment responses. Results Patients with C. p and L. p had similar symptoms, including fever, cough, headache, dyspnoea, asthenia, shivering and headache, compared with M. p, whose symptoms were slight. C. p and L. p usually showed multiple lobar distributions with pleural effusion. Serologic testing indicated that L. p had higher levels of white blood cells (WBCs), neutrophils, C‐reactive protein (CRP), procalcitonin (PCT), alanine aminotransferase (ALT), lactate dehydrogenase (LDH) and creatinine compared with M. p and L. p (p < 0.05). However, patients with C. p had lower levels of albumin (p < 0.05), and M. p had a minimum risk of cardiac volume loads (p < 0.05). CD4/CD8 ratio, lymphocytes, aspartate aminotransferase (AST), creatine kinase (CK), cell counting of BALF and coagulation had no difference (p < 0.05). Pathogenic IgM assay showed that 4/5 cases were positive for M. p and no positive detection for C. p and L. p infection. We timely adjusted the antibiotics according to the final mNGS results. Eventually, 16/18 patients recovered fully. Conditions of L. p patients were worse than those of C. p patients, and those of M. p patients were the least. Conclusion Early application of mNGS detection increased the atypical pathogenic identification, improved the prognosis and made up for the deficiency of conventional detection methods.https://doi.org/10.1111/crj.13603Chlamydia psittacicommunity‐acquired pneumonia (CAP)Legionellametagenomic next‐generation sequencing (mNGS)Mycoplasmatreatment |
| spellingShingle | Ning Zhu Daibing Zhou Ruyu Yuan Yiminniyaze Ruzetuoheti Jing Li Xiujuan Zhang Shengqing Li Identification and comparison of Chlamydia psittaci, Legionella and Mycoplasma pneumonia infection The Clinical Respiratory Journal Chlamydia psittaci community‐acquired pneumonia (CAP) Legionella metagenomic next‐generation sequencing (mNGS) Mycoplasma treatment |
| title | Identification and comparison of Chlamydia psittaci, Legionella and Mycoplasma pneumonia infection |
| title_full | Identification and comparison of Chlamydia psittaci, Legionella and Mycoplasma pneumonia infection |
| title_fullStr | Identification and comparison of Chlamydia psittaci, Legionella and Mycoplasma pneumonia infection |
| title_full_unstemmed | Identification and comparison of Chlamydia psittaci, Legionella and Mycoplasma pneumonia infection |
| title_short | Identification and comparison of Chlamydia psittaci, Legionella and Mycoplasma pneumonia infection |
| title_sort | identification and comparison of chlamydia psittaci legionella and mycoplasma pneumonia infection |
| topic | Chlamydia psittaci community‐acquired pneumonia (CAP) Legionella metagenomic next‐generation sequencing (mNGS) Mycoplasma treatment |
| url | https://doi.org/10.1111/crj.13603 |
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