Outbreak of Chlamydia psittaci Infection in a Commercial Psittacine Breeding Aviary in Argentina.

Chlamydiosis, caused by Chlamydia psittaci is a bacterial infection found in at least 465 species of birds worldwide. It is highly contagious among birds and can spread to humans. In birds, the disease can manifest itself in acute, subacute, and chronic forms with signs including anorexia, diarrhea, lethargy, weight loss, or, occasionally, mucopurulent or serous oculonasal discharge. This article describes an outbreak of chlamydiosis that occurred in a commercial psittacine breeding aviary in 2021 in Buenos Aires province, Argentina. In total, 16 juvenile blue-fronted parrots, more than 60 blue-fronted parrot chicks, and 2 adult macaws died during the outbreak. In all cases, clinical signs were weight loss, diarrhea, yellowish green excrement, and respiratory distress. The necropsy of four juvenile blue-fronted parrots, two blue-fronted parrot chicks, and two adult macaws revealed cachexia, hepatomegaly, splenomegaly, splenic petechial hemorrhages, ascites, pulmonary edema, and hydropericardium. Histologically, multifocal lymphoplasmacytic and heterophilic airsaculitis, multifocal lymphoplasmacytic and necrotizing hepatitis with intracytoplasmic elementary bodies, multifocal necro-heterophilic hepatitis, multifocal lymphoplasmacytic nephritis, and diffuse heterophilic pneumonia were found. A presumptive diagnosis was established based on gross and microscopic lesions, and it was confirmed using immunohistochemistry and polymerase chain reactions. The sequencing and phylogenetic analysis of the ompA gene revealed genotype A and B of Chlamydia psittaci.

Are Mycoplasma pneumoniae coinfections frequent in COVID-19 patients? A systematic review.

Understanding the proportion of SARS-CoV-2 patients with Mycoplasmapneumoniae coinfection is crucial for treating patients suffering from coronavirus disease (COVID-19), help to ensure responsible use of antibiotics and minimize the negative consequences of overuse. In addition, this knowledge could have an impact on empirical antibiotic management guidelines for patients with COVID-19. This systematic review aimed to identify the prevalence of M. pneumoniae in patients with coronavirus disease 2019 (COVID-19). A bibliographic search of studies published in Spanish or English was conducted using the PubMed search engine. Fourteen articles from different continents (America, Asia and Europe) were included, involving a total of 5855 patients in these studies. The mean age of COVID-19 patients with M. pneumoniae was 48 years old (range 1-107), most of whom were male. The detection of laboratory-confirmed M. pneumoniae infection varied between 0 and 33.3%. Most of patients referred fever, cough, and dyspnea, and received empirical antibiotic treatment. Bacterial coinfection was not associated with increased ICU admission and mortality. The prevalence of coinfection showed extremely dissimilar figures according to the population studied and diagnostic criteria. However, it is important to develop Latin American studies, given the heterogeneity observed in the studies conducted in different countries. Standardized definitions should be developed in order to be able to assess the impact of coinfections in patients with a diagnosis of COVID-19.

First detection of Chlamydia avium in healthy Amazon parrots (Amazona aestiva) in Argentina.

In recent years, new Chlamydia species, other than Chlamydia psittaci, have been confirmed in birds. One of these new species, Chlamydia avium, was reported mainly in pigeons and parrots in Europe. Analyzing multimucosal swabs obtained from 7 Amazon parrots (Amazona aestiva) from illegal trade and admitted to the Reserva Experimental Horco Molle (Tucuman, Argentina) for their rehabilitation, we describe the finding of the genetic material of C. avium in 2 of these birds. There were no signs compatible with the chlamydiosis-like disease in the studied birds or in the rehabilitation center staff. The use of sensitive and wide-ranging molecular tools is necessary for the detection of all Chlamydiaceae present in birds and would aid in the selection of control measures in wildlife rehabilitation centers to prevent outbreaks in the facilities and the introduction of pathogens in nature. We provide the first molecular evidence of the presence of C. avium in Argentina and a new species of psittacine host.

ARTICLESARS-CoV-2 and Chlamydia pneumoniae co-infection:A review of the literature / Coinfección por Chlamydia pneumoniae y SARS-CoV-2: Una revisión de la literatura

Abstract Bacterial co-pathogens are commonly identified in viral respiratory infections and are important causes of morbid-mortality. The prevalence of Chlamydia (C.) pneumoniae infection in patients infected with SARS-CoV-2 has not been sufficiently studied. The objective of the present review was to describe the prevalence of C. pneumoniae in patients with coronavirus disease 2019 (COVID-19). A search in MEDLINE and Google Scholar databases for English language literature published between January 2020 and August 2021 was performed. Studies evaluating patients with confirmed COVID-19 and reporting the simultaneous detection of C. pneumoniae were included. Eleven articles were included in the systematic review (5 case cross-sectional studies and 6 retrospective studies). A total of 18450 patients were included in the eleven studies. The detection of laboratory-confirmed C. pneumoniae infection varied between 1.78 and 71.4% of the total number of co-infections. The median age of patients ranged from 35 to 71 years old and 65% were male. Most of the studies reported one or more pre-existing comorbidities and the majority of the patients presented with fever, cough and dyspnea. Lymphopenia and eosinopenia were described in COVID-19 co-infected patients. The main chest CT scan showed a ground glass density shadow, consolidation and bilateral pneumonia. Most patients received empirical antibiotics. Bacterial co-infection was not associated with increased ICU admission and mortality. Despite frequent prescription of broad-spectrum empirical antimicrobials in patients with coronavirus 2-associated respiratory infections, there is a paucity of data to support the association with respiratory bacterial co-infection. Prospective evidence generation to support the development of an antimicrobial policy and appropriate stewardship interventions specific for the COVID-19 pandemic are urgently required.

Resumen Los patógenos bacterianos pueden detectarse en las infecciones respiratorias virales y son una causa importante de morbimortalidad. La prevalencia de Chlamydia pneumoniae en pacientes infectados con SARS-CoV-2 ha sido poco estudiada. El objetivo de la presente revisión fue describir la prevalencia de C. pneumoniae en pacientes con enfermedad por coronavirus 2019 (COVID-19). Para ello se realizó una búsqueda bibliográfica en Medline y Google Académico, entre enero de 2020 y agosto de 2021. De la revisión surgieron 11 artículos (cinco estudios de casos transversales y seis estudios retrospectivos), que incluyeron un total de 18.450 pacientes. La detección de C. pneumoniae varió entre el 1,78 y 71,4% del total de las coinfecciones. La media de edad de los pacientes osciló entre los 35 y 71 años y el 65% fueron hombres. En la mayoría de los estudios se informaron comorbilidades preexistentes y la mayor parte de los pacientes presentó fiebre, tos y disnea. Además, se describió linfopenia y eosinofilopenia en pacientes con COVID-19 coinfectados. La principal manifestación en la tomografía computarizada fue densidad de vidrio esmerilado, consolidación y neumonía bilateral. La mayoría de los pacientes recibió antibióticos de manera empírica. La coinfección bacteriana no se asoció con un aumento de ingresos en cuidados intensivos ni mortalidad. A pesar de la prescripción de antimicrobianos empíricos en pacientes con infecciones respiratorias asociadas a coronavirus existen pocos reportes de detección de coinfección bacteriana. Es necesario generar evidencia para el desarrollo de políticas antimicrobianas e intervenciones de administración apropiadas y específicas en la pandemia de COVID-19.

SARS-CoV-2 and Chlamydia pneumoniae co-infection: A review of the literature.

Bacterial co-pathogens are commonly identified in viral respiratory infections and are important causes of morbid-mortality. The prevalence of Chlamydia (C.) pneumoniae infection in patients infected with SARS-CoV-2 has not been sufficiently studied. The objective of the present review was to describe the prevalence of C. pneumoniae in patients with coronavirus disease 2019 (COVID-19). A search in MEDLINE and Google Scholar databases for English language literature published between January 2020 and August 2021 was performed. Studies evaluating patients with confirmed COVID-19 and reporting the simultaneous detection of C. pneumoniae were included. Eleven articles were included in the systematic review (5 case cross-sectional studies and 6 retrospective studies). A total of 18450 patients were included in the eleven studies. The detection of laboratory-confirmed C. pneumoniae infection varied between 1.78 and 71.4% of the total number of co-infections. The median age of patients ranged from 35 to 71 years old and 65% were male. Most of the studies reported one or more pre-existing comorbidities and the majority of the patients presented with fever, cough and dyspnea. Lymphopenia and eosinopenia were described in COVID-19 co-infected patients. The main chest CT scan showed a ground glass density shadow, consolidation and bilateral pneumonia. Most patients received empirical antibiotics. Bacterial co-infection was not associated with increased ICU admission and mortality. Despite frequent prescription of broad-spectrum empirical antimicrobials in patients with coronavirus 2-associated respiratory infections, there is a paucity of data to support the association with respiratory bacterial co-infection. Prospective evidence generation to support the development of an antimicrobial policy and appropriate stewardship interventions specific for the COVID-19 pandemic are urgently required.

Encefalomielitis aguda diseminada por Mycoplasma pneumoniae en un niño previamente sano / Acute disseminated encephalomyelitis due to Mycoplasma pneumoniae in a previously healthy boy

Se presenta el caso de un niño de 5 años sin antecedentes de enfermedad, que se internó en terapia intensiva por convulsiones tónico-clónicas focalizadas en la cara y en el hemicuerpo derecho, con documentación de temperatura axilar de 37,4°C. Se descartó la presencia de gérmenes comunes y la etiología viral a través de estudios de muestras de líquido cefalorraquídeo (LCR). Se sospechó la presencia de Mycoplasma pneumoniae por comprobarse inmunofluorescencia positiva en suero para anticuerpos de clase IgM. El diagnóstico se confirmó mediante la detección del ADN de dicho patógeno sobre la biopsia cerebral efectuada por el método de la reacción en cadena de la polimerasa (PCR) y una histología compatible con encefalomielitis aguda diseminada. El paciente recibió tratamiento con claritromicina y su evolución fue favorable. Al menos dentro de nuestros conocimientos, este es el primer caso en el que se detectó ADN de M. pneumoniae en una biopsia cerebral por el método de PCR.

We present here the case of a previously healthy 5 year-old boy hospitalized in an intensive care unit due to tonic-clonic seizures focused on the face and right side of the body, and axillary temperature of 37.4 °C. Common bacterial and viral etiology was ruled out through studies of cerebrospinal fluid (CSF) samples. Mycoplasma pneumoniae was suspected by a positive immunofluorescence serum test for IgM class antibodies. Finally, with a brain biopsy, M. pneumoniae was confirmed by polymerase chain reaction (PCR) and acute disseminated encephalomyelitis by pathological anatomy. The patient was treated with clarithromycin and had an uneventful evolution. At least to our knowledge, this is the first case in which M. pneumoniae DNA was detected by PCR in a brain biopsy.

[Acute disseminated encephalomyelitis due to Mycoplasma pneumoniae in a previously healthy boy]. / Encefalomielitis aguda diseminada por Mycoplasma pneumoniae en un niño previamente sano.

We present here the case of a previously healthy 5 year-old boy hospitalized in an intensive care unit due to tonic-clonic seizures focused on the face and right side of the body, and axillary temperature of 37.4°C. Common bacterial and viral etiology was ruled out through studies of cerebrospinal fluid (CSF) samples. Mycoplasma pneumoniae was suspected by a positive immunofluorescence serum test for IgM class antibodies. Finally, with a brain biopsy, M. pneumoniae was confirmed by polymerase chain reaction (PCR) and acute disseminated encephalomyelitis by pathological anatomy. The patient was treated with clarithromycin and had an uneventful evolution. At least to our knowledge, this is the first case in which M. pneumoniae DNA was detected by PCR in a brain biopsy.

Persistencia de Ac IgM y ADN de M. pneumoniae en pacientes mayores de 18 años con ira / Persistence of Ac IgM and DNA of M. pneumoniae in patients older than 18 years with anger

INTRODUCCIÓN Los métodos moleculares para el diagnóstico de Micoplasma pneumoniae (Mp) son sensibles y más específicos que los serológicos. OBJETIVOS GENERALES Determinar la persistencia de anticuerpos (Ac) IgM y de ADN de Mp en adultos con infección respiratoria aguda (IRA) que requieren internación (casos) y en donantes de sangre. OBJETIVOS ESPECÍFICOS a) Determinar el tiempo que permanecen positivos (+) los Ac IgM anti-Mp por inmunofluorescencia (IF) en casos y donantes. b) Determinar el tiempo que permanece + la detección de ADN de Mp mediante PCR anidada (NPCR) en casos y donantes. c) Analizar las diferencias entre los resultados de ambos grupos. d) Aportar nuevos criterios para la interpretación de los mismos. MÉTODOS Estudio prospectivo, descriptivo y de cohortes que incluyó a >18 años (a) que requerían internación por presentar IRA y donantes de sangre que acudieron entre el 04/16 y 04/17. Los sujetos + por una o dos técnicas se siguieron por un año. Se tomaron muestras respiratorias, sangre y suero. Se utilizaron IF y NPCR. Las diferencias de resultados entre ambos grupos se estimaron mediante la prueba χ². RESULTADOS En 84 casos evaluables se obtuvo 30,9% de IF + y 15,5% de NPCR +. Dos fueron + por ambas pruebas. En 60 donantes se obtuvo 11,6% de IF +, 5% de NPCR +. Uno fue + por ambas pruebas. Las diferencias de resultados + entre casos y donantes fue estadísticamente significativa (p< 0,05). Se siguieron 11 de 37 casos +; 6 tuvieron NPCR + al menos por 2 meses (m) (1 por 10m) y un caso IF + hasta 7m. Se siguieron 6 donantes, 3 fueron IF + por 5m; 2 negativizaron la NPCR a los 2m y uno a los 10m. DISCUSIÓN Se observaron diferencias estadísticamente significativas entre los resultados de casos y donantes. La detección de IgM no permite establecer si la infección es o no reciente (casos + desde 2m a 1 año y hasta 5m en donantes). La NPCR serviría como método confirmatorio de infección reciente, aunque se observó un caso y un donante con persistencia de ADN

Mycoplasma pneumoniae detection with PCR in renal tissue of a patient with acute glomerulonephritis.

Renal disease concurrent with a Mycoplasma pneumoniae infection is uncommon. In this report we describe the clinical outcome of a 6-year-old patient who presented with a rapidly progressive glomerulonephritis that required dialysis. A kidney biopsy was performed, and the results revealed membranoprolipherative glomerulonephritis. The IgM serology was positive, and M. pneumoniae DNA was detected in a renal biopsy sample using a nested-PCR assay. The outcome was good.