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DOI: 10.1002/vms3.

1244

ORIGINAL ARTICLE

A molecular survey of Chlamydia spp. infection in commercial


poultry and detection of Chlamydia pneumoniae in a commercial
turkey flock in Iran

Seyed Mohammad Mahdi Hashemian1 Seyed Ahmad Madani2


Manoochehr Allymehr1 Alireza Talebi1

1
Department of Poultry Health and Diseases,
Faculty of Veterinary Medicine, University of Abstract
Urmia, Urmia, Iran
Background: Chlamydiaceae are a group of gram-negative intracellular bacteria which
2
Department of Animal and Poultry Health
and Nutrition, Faculty of Veterinary Medicine,
can infect a wide variety of hosts. Some chlamydial agents are capable of crossing the
University of Tehran, Tehran, Iran host barrier and though they are potentially a risk to very different species. They also
pose a zoonotic risk for human and different chlamydial agents are linked to several
Correspondence
Manoochehr Allymehr, Department of Poultry medical maladies.
Health and Diseases, Faculty of Veterinary
Objectives: In this study, the presence of chlamydial agents in different commercial
Medicine, University of Urmia, Urmia, Iran.
Email: m.allymehr@urmia.ac.ir poultry flocks in Iran was investigated.
Methods: Swab and tissue samples were collected from 435 birds in 24 different com-
Funding information
Urmia University mercial poultry flocks. These samples were examined using a Chlamydiaceae-specific
real-time PCR assay targeting 23S rRNA gene. Positive samples then were subjected
to intergenic spacer rRNA (IGS) gene and major outer membrane protein gene (ompA)
PCRs. Finally, positive PCR products were sequenced and analysed.
Results: Only one flock of commercial turkey became positive. Partial DNA sequencing
of IGS gene revealed that all positive samples from the infected flock were Chlamy-
dia pneumoniae and were identical to previously studied isolates from koala (LPCoLN)
and frog (DC9). Further investigations showed slight dissimilarity in ompA gene of
C. pneumoniae from different hosts. The detected turkey isolates were located in a
different clade of phylogenetic tree, close to Western barred bandicoot and koala
isolates.
Conclusion: C. pneumoniae has passed the cross-species barrier in the past and there-
for it could potentially be zoonotic. To the best of authors’ knowledge, this is the first
report of C. pneumoniae infection in commercial turkey.

KEYWORDS
Chicken, Chlamydia pneumoniae; poultry, turkeys

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2 HASHEMIAN ET AL.

1 INTRODUCTION (Szymańska-Czerwińska et al., 2017), the United States (LI et al., 2017)
and Mexico (Ornelas-Eusebio et al., 2020). It was shown that C. galli-
The phylum Chamydiae currently encompasses a single class Chlamy- nacea infection is persistent and despite the asymptomatic nature of
dia and a single order Chlamydiales. Microorganisms which belong the infection, it can significantly affect the growth rate of broilers (Guo
to the Chlamydiaceae family are obligate intercellular, gram-negative et al., 2016). Other chlamydial agents like C. psittaci (Lagae et al., 2014),
bacteria with a unique biphasic life cycle (AbdelRahman & Bel- C. abortus (Szymańska-Czerwińska et al., 2017), C. muridarum, C. suis
land, 2005). It has only one genus with 12 known species, including and C. pecorum (Guo et al., 2016) and C. pneumoniae (Frutos et al., 2015)
Chlamydia abortus, Chlamydia avium, Chlamydia caviae, Chlamydia felis, have been isolated from poultry as well.
Chlamydia gallinacea, Chlamydia ibidis, Chlamydia muridarum, Chlamydia Most studies intended to assess the chlamydia infection rate in
pecorum, Chlamydia pneumoniae, Chlamydia suis, Chlamydia trachomatis Iran were concentrated on Psittaciformes and Columbiformes (Doosti
(Kuo et al., 2015; Sachse et al., 2015) and Chlamydia buteonis (Laroucau & Arshi, 2011; Golestani et al., 2020; Madani & Peighambari, 2013;
et al., 2019). There is a possibility of more novel species to be charac- Madani et al., 2011; Mahzounieh et al., 2020; Mina et al., 2019). There
terized in future as uncultured atypical strains have been found in some are few reports of chlamydia infection in other avian orders as well
studies (Christerson et al., 2010) and there was frequent introduction (Madani & Peighambari, 2013; Madani et al., 2011). The only report
of new species in the past decade (Laroucau et al., 2019; Sachse et al., on chlamydial infection in commercial poultry farms in Iran dates back
2014). to 2014 in which 13 out of 48 turkey farms were found to be posi-
Chlamydia psittaci was the first chlamydial agent discovered in birds tive for Chlamydiaceae DNA and further investigation revealed that
(Coles, 1930) and can infect more than 465 different avian species from none of the positive samples were C. psittaci (Tatari et al., 2016). In the
30 orders (Kaleta & Taday, 2003). All avian species are presumed to present study, the molecular detection and identification of chlamydial
be susceptible to the infection. Clinical manifestations related to avian infections in commercial poultry farms was attempted.
chlamydiosis can vary from an unapparent infection to a severe and
acute or chronic disease. Clinical signs and the outcome of the disease
depend on the host species, strain virulence and immune status of the 2 MATERIALS AND METHODS
bird. In the case of poultry, chickens have been considered relatively
resistant to C. psittaci but turkey industry had suffered greatly from this 2.1 Sampling
pathologic agent (Andersen et al., 1978; Page et al., 1975; Vanrompay,
2020; Walker et al., 1976). C. psittaci is also an important zoonotic agent Clinical specimens were collected from 21 poultry flocks, including five
that can be transferred from infected birds to human. Contact with broilers, five commercial layers, three broiler breeders, six commer-
birds appears to be the primary risk factor for human infection but indi- cial turkey and two turkey breeder flocks. Twenty birds were sampled
rect environmental exposure such as dried faeces from carriers may from each flock. For every live bird, triple swab sample was taken
also transmit the disease to human (Telfer et al., 2005; Williams et al., from conjunctiva, choanal cleft and cloaca, respectively, using a single
1998). There are numerous reports indicating the zoonotic transmis- sterile sampling swab (QC LAB). Each four swab samples were pooled
sion in slaughterhouses (Dickx et al., 2010; Irons et al., 1951; Laroucau together for DNA extraction. In addition, tissue samples, including liver,
et al., 2009; Newman et al., 1992). spleen, lung and air sac, were collected during necropsy of dead birds
C. gallinacea and C. avium have been recently discovered and charac- belonging to two commercial turkey flocks and one broiler breeder
terized in avian species (Sachse et al., 2014). C. avium is mostly found flock. Tissue samples from each bird were also pooled together to make
in pigeons and psittacine birds, whereas C. gallinacea is associated with a single specimen for an individual. In total, 24 commercial flocks were
chickens, turkeys and guinea fowl (Sachse et al., 2014). C. gallinacea investigated (Table 1).
seems to be zoonotic (Laroucau et al., 2009) but it is not yet confirmed
and needs further investigations.
Chlamydia is shed from infected birds via ocular and nasal dis- 2.2 DNA extraction
charges and faeces. This shedding can happen intermittently and
predisposing factors, such as stress, transportation, poor environmen- DNA extraction was performed by Exgene cell SV DNA extraction kit
tal conditions, overcrowding and other diseases might have a major (GeneAll Biotechnology) following the manufacturer’s instruction.
role in epidemiology of the infection (Vanrompay, 2020). Vertical trans-
mission of C. psittaci has been demonstrated in a variety of bird species
(Lublin et al., 1996; Wittenbrink et al., 1993) and it has been suggested 2.3 23S rRNA RT-PCR
for C. gallinacea (You et al., 2019). The chlamydial agents are environ-
mentally labile but they can survive in organic materials for months All samples were tested with a real-time PCR specific to all Chlamy-
(Longbottom & Coulter, 2003). diaceae family members (Ehricht et al., 2006). This assay amplified a
Several studies have been conducted recently in different countries 111 bp of 23S rRNA gene. Cycling conditions were 95◦ C for 10 min fol-
to assess the rate of chlamydial infection in commercial and non- lowed by 45 cycles of 95◦ C for 15 s and 60◦ C for 60 s. For every sample
commercial poultry. C. gallinacea was the prominent chlamydial agent 20 µL reaction mixture was prepared as follows: 10 µL of TaqMan Mas-
found in France (Hulin et al., 2015), China (Guo et al., 2016), Poland ter Mix (Ampliqon), 500 nM of Ch23S-F (5′-CTG AAA CCA GTA GCT
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HASHEMIAN ET AL. 3

TA B L E 1 Triple swab and tissue samples from different commercial poultry farms which were collected for molecular diagnosis of Chlamydia
spp. infection by a diagnostic real-time PCR targeting 23S rRNA.

No. of Total birds No. of pooled 23S rRNA IGS CTU/CTL Nested ompA Cpn ompA
Flock type farms sampled samplesa PCR PCR ompA PCR PCR PCR
Broiler 5 100 25 Negative NDb ND ND ND
Commercial layer 5 100 25 Negative ND ND ND ND
Broiler breeder 4 65 20 Negative ND ND ND ND
Turkey 8 130 40 4 4 Negative Negative 4
Turkey breeder 2 40 10 Negative ND ND ND ND
Total 24 435 120

Note: Positive samples have been subjected to conventional PCRs targeting intergenic spacer (IGS) and ompA (CTU/CTL, Nested ompA and Cpn ompA).
a
Each four swab samples were pooled together to form a single reduced sample. Tissue samples were investigated individually.
b
Not done. Assays shown by ND sign were not done for related specimens due to negative results from previous diagnostic real-time PCR.

TAT AAG CGGT-3′) and 500 nM of Ch23S-R (5′-ACC TCG CCG TTT PCR were initially investigated by CTU (5′ ATG AAA CTC TTG AAA
AAC TTA ACT CC-3′) primers, 200 nM of probe Ch23S-p (5′FAM-CTC TCG G 3′) and CTL (5′ CAA GAT TTT CTA GA(T/C) TTC AT(C/T) TTG
ATC ATG CAA AAG GCA CGC CG-TAMRA3′), 5 µL distilled deionized 3′) primers targeting an approximately 1000 bp of ompA (Denamur
water and 2 µL of sample DNA template (Ehricht et al., 2006). et al., 1991). Five microlitre of DNA template was added to a mixture
of 400 nM of each primer in 25 µL of Taq DNA polymerase Master Mix
Red (Ampliqon) and 18 µL of distilled deionized water. Cycling condi-
2.4 Intergenic spacer rRNA (IGS) PCR tions consisted of initial denaturation at 94◦ C for 120 s, followed by 40
cycles of 94◦ C for 60 s, 48◦ C for 60 s, and 72◦ C for 60 s and 5 min at
Positive samples from the first diagnostic PCR were further studied 72◦ C for final extension. Same samples were also studied by a nested
using another DNA amplification method described by Lutz-Wohlgroth PCR targeting a 389 to 404 bp of ompA as it was previously described
et al. (2006), targeting intergenic spacer rRNA (IGS). Larger product of (Sachse & Hotzel, 2003). For this procedure 191CHOMP (5′ GCI YTI
approximately 750–780 bp Chlamydiaceae family was expected in this TGG GAR TGY GGI TGY GCI AC 3′), CHOMP371 (5′ TTA GAA ICK GAA
PCR. The reaction mixture was consisted of five µL of DNA template, TTG IGC RTT IAY GTG IGC 3′), 218PSITT (5′ GTA ATT TCI AGC CCA
25 µL of 2x Taq DNA polymerase Master Mix Red (Ampliqon), 400 nM GCA CAA TTY GTG 3′) and CHOMP336s (5′ CCR CAA GMT TTT CTR
of forward primer (5′-CAA GGT GAG GCT GAT GAC-3′), 400 nM of GAY TTC AWY TTG TTR AT 3′) primers were used for the first and the
reverse primer (5′-AGT GGT CTC CCC AGA TTC-3′) and 18 µL of dis- second round of amplifications, respectively.
tilled deionized water. This mixture was subjected to amplification with Finally, another PCR assay targeted a 420 bp of the variable domain
10 min at 94◦ C for initial denaturation and then 40 cycles of 30 s at IV region of ompA. Cpn5P (5′ CCA ATA TGC ACA GTC CAA ACC TAA
94◦ C for denaturation, annealing at 54.4◦ C for 30 s, extension in 72◦ C AA 3′) and Cpn3P (5′ CTA GAT TTA AAC TTG ATC TGA CAG 3′) primers
for 45 s and finally 5 min at 72◦ C for final extension (Lutz-Wohlgroth were used (Wardrop et al., 1999). A 5-µL extracted sample was added
et al., 2006). to 25 µL of Taq DNA polymerase 2X Master Mix Red (Ampliqon), 18 µL
Following the thermocycler amplification, the PCR product was sub- of distilled deionized water and 400 nM of each primer. The cycling con-
mitted to 1% agarose gel electrophoresis and visualized by SafeStain ditions were composed of 95◦ C for 5 min for initial denaturation and
(SinaClon) colour under UV light. For this purpose, 0.8 µL of this colour then 40 cycles of 95◦ C for 1 min, 60◦ C for 1 min and 72◦ C for 1 min
was added to cooled mixture of 25 millilitres of TAE and 0.375-g and then 72◦ C for 5 min as final elongation.
agarose. The DNA sequences obtained from IGS and ompA PCR reactions
The positive samples were sent to be sequenced by Codon Genetic were then edited by BioEdit version 7.2.5.0 (Hall, 1999) and subse-
Group laboratory. quently aligned with other similar sequences obtained from GenBank.
The phylogenic tree was constructed using neighbour-joining method
by MEGA 11 (Saitou & Nei, 1987). The branch support was evaluated
2.5 Major outer membrane protein gene (ompA) by bootstrapping with 1000 pseudo-replicas.
PCR

The major outer membrane protein gene (ompA) has been investigated 3 RESULTS
to discriminate the Chlamydia sp. strains as the variability in this gene
between strains has been reported (Sayada et al., 1995; Wardrop et al., In total 435 samples from seven provinces of Iran (Markazi, Qom,
1999). Three different methodologies were applied for inspection of Isfahan, Tehran, Kermanshah, Khuzestan and Gilan) were investigated
ompA as first two ones had no PCR product. Positive samples from IGS- (Figure 1). Only four pooled samples from a commercial turkey flock
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4 HASHEMIAN ET AL.

F I G U R E 1 Geographical locations of the poultry farms that were sampled to investigate Chlamydia sp. infection from different provinces of
Iran. The type of each flock was indicated with a different shape. The only positive commercial turkey farm was located in Markazi province.

in Markazi were positive for 23S rRNA and IGS of Chlamydia sp. in The IGS sequences of turkey C. pneumoniae from the present study
PCR. The specimens from other flocks were negative in the diagnos- were deposited in GenBank with accession numbers: OM542331,
tic PCR performed in the current study and no Chlamydia spp. Infection OM542332, OM542333 and OM542334. The partial ompA
could be detected in them. The CTU/CTL (Denamur et al., 1991) and sequences were also submitted with accession numbers: OM631444,
the nested PCR (Sachse & Hotzel, 2003) for ompA gene performed on OM631445, OM631446 and OM631447.
positive samples from the initial PCR had no positive result. The posi-
tive samples from the turkey flock were also positive in the third ompA
PCR using Cpn primers (Table 1) (Bodetti et al., 2002). 4 DISCUSSION
The 756 bp products of IGS PCR from the positive turkey flock were
sequenced and compared to the relevant sequences in GenBank. Sur- In the present study, triple swab and tissue samples from 24 commer-
prisingly, they were all conformed to C. pneumoniae. They were 100% cial poultry flocks were investigated for the presence of Chlamydia spp.
identical to each other and were also completely similar to LPCoLN DNA using different PCR methods. Only a commercial turkey flock was
koala strain (CP001713) and DC9 frog strain (LN847058) as it is shown positive for C. pneumoniae as it was confirmed by IGS and ompA partial
in Figure 2. sequencing. Four out of five pooled samples from the affected turkey
The ompA PCR product sequences were compared to the Gen- flock were positive and the detected isolates were identical regarding
Bank using Basic Local Alignment Search Tool. All four sequences from the studied genes. C. pneumoniae infection was rarely reported in avian
the positive turkey flock were completely identical to each other, but species and to the best of authors’ knowledge, this is the first report of
there were nucleotide differences between ompA sequences obtained C. pneumoniae infection in commercial turkey.
in this study and other C. pneumoniae in the GenBank (Figure 3). Chickens as the most commercially raised poultry have been under
The turkey isolates differed in two nucleotides comparing to LPCoLN intense investigations for Chlamydiaceae infections. Although there
koala (CP001713) and WBB bandicoot (DQ358972) strains. They had are some reports of C. psittaci infection in chicken farms which some of
also six and seven nucleotide substitution compared to DC9 frog them showed signs of zoonotic transmission (Dickx et al., 2010; Lagae
(Anura sp.) (LN847053) and all human strains shown in phylogenic tree, et al., 2014) but most of the recent reports indicate C. gallinacea being
respectively. the most prevalent chlamydial agent in chickens with relatively high
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HASHEMIAN ET AL. 5

prevalence in some countries (Guo et al., 2016; Heijne et al., 2018;


Hulin et al., 2015; Laroucau et al., 2009; LI et al., 2017; Marchino
et al., 2022; Ornelas-Eusebio et al., 2020; Szymańska-Czerwińska et al.,
2017). The possibility of zoonotic transmission for C. gallinacea can-
not be ruled out (Laroucau et al., 2009) and recently, C. gallinacea has
been reported in people working in poultry farms suggesting a bird-to-
human transmission (Marchino et al., 2022). In our study in contrast to
many other studies neither C. psittaci, nor C. gallinacea was found. The
absence of these agents could be due to vast antibiotic administration
in commercial flocks as tetracyclines and fluoroquinolones are not yet
forbidden in Iranian poultry industry. On the other hand, commercial
poultries are exclusively raised in confined systems and closed barns in
Iran, and free-range productions are not yet applied in Iran except for
backyard non-commercial birds which were not sampled in this study.
It was shown that chlamydial infection has a reverse relationship with
confinement (Ornelas-Eusebio et al., 2020).
Chlamydiosis in turkey industry has been caused serious economic
loss (Vanrompay et al., 1993). Prevalence of C. psittaci infection in this
industry seems to be high in some countries (van Loock et al., 2005;
Vanrompay et al., 1997) and there are numerous reports on zoonotic
transmission from turkeys to people especially abattoir workers with
some casualties in past (Andersen et al., 1978; Dickx et al., 2010; Irons
F I G U R E 2 The evolutionary relationship of Chlamydia pneumoniae et al., 1951). C. gallinacea has been also identified in these birds but the
which has been detected in turkeys (CPT-IGS) inferred by using the
impact of this agent on turkeys is not yet clarified (Vogler et al., 2019).
neighbour joining method for partial intergenic spacer rRNA gene
sequence (756 bp) based on jukes-cantor model (1000 bootstraps). Because of the importance of C. psittaci infection in turkeys we col-
Bootstrap percentage support is presented at clade nodes. lected samples from 10 flocks including 2 turkey breeder and 8 turkey
broilers. Out of these flocks only one flock was infected with a rarely
reported in birds’ species, C. pneumoniae. The absence of other agents
could be due to the same reasons mentioned earlier including confined
production and possible antibiotic applications.
C. pneumoniae, which is the only chlamydial agent found in this
study, has an extremely divers host range. This agent has been iso-
lated from humans (Grayston, 1968), horses (Wills et al., 1990), reptiles
and amphibians (Bodetti et al., 2002), Australian marsupials like koalas
(Wardrop et al., 1999), bandicoots (Kutlin et al., 2007) and some bird
species (Frutos et al., 2015). Frutos et al. identified this agent in 48%
of captive birds from different avian species in Argentina. Interestingly
in that study the only sample taken from a chicken was positive for C.
pneumoniae (Frutos et al., 2015).
The rate of C. pneumoniae infection in humans is relatively high with
up to 96% seropositivity in adults (Wang et al., 1993). The infection can
cause vast spectrum of clinical signs from asymptomatic infection to
severe respiratory disease and pneumonia. It is believed that C. pneu-
moniae is responsible for 10% of all community-acquired pneumonia in
adults and 5% of bronchitis and sinusitis (Blasi et al., 2009; Hammer-
schlag, 2000). C. pneumoniae has been also linked with less common
conditions like atherosclerosis (Grayston, 2000), stroke (Saikku et al.,
1988), myocarditis (Wesslén et al., 1992), multiple sclerosis (Sriram

F I G U R E 3 The evolutionary relationship of Chlamydia pneumoniae et al., 1998) and Alzheimer’s disease (Balin et al., 1998). The human
which has been detected in turkeys (CPT-ompA) inferred by using the infection is chronologically considered a recent event since different
neighbour joining method for partial ompA sequence (420 bp) based isolates of this agent from human show little diversity, whereas isolates
on jukes-cantor model (1000 bootstraps). Bootstrap percentage from different animal species are significantly divers at molecular level
support is presented at clade nodes.
(Mitchell et al., 2010; Rattei et al., 2007). All Chlamydiaceae members
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6 HASHEMIAN ET AL.

are considered potentially zoonotic and C. pneumoniae has evidently CONFLICT OF INTEREST STATEMENT
passed the cross-species barrier. However, the importance of the ani- No potential conflict of interest was reported by the authors.
mal strains in public health is unknown but they could be considered
potentially zoonotic (Myers et al., 2009; Rattei et al., 2007). DATA AVAILABILITY STATEMENT
The PCR amplification of ompA gene using CTU/CTL primers (Dena- All data supporting this research are presented in this manuscript.
mur et al., 1991) was not possible for the detected turkey isolates in this
study. This could be the result of low sensitivity of these primers for ETHICS STATEMENT
non-C. psittaci strains since other researchers had similar experience The present study did not involve any human subject. All experimental
using these primers for non-psittaci Chlamydiaceae (Laroucau et al., procedures were carried out according to the standard animal experi-
2009; Madani & Peighambari, 2013). mentation protocols of the Veterinary Ethics Committee of Faculty of
In contrast to some recent investigations, the chlamydial infection Veterinary Medicine, Urmia University (IR-UU-AEC- 2381/PD/3).
in commercial poultry flocks of Iran seemed to be less prevalent than
some other countries (Guo et al., 2016; Heijne et al., 2018; Lagae ORCID
et al., 2014; LI et al., 2017; Ornelas-Eusebio et al., 2020; Szymańska- Seyed Mohammad Mahdi Hashemian https://orcid.org/0000-0001-
Czerwińska et al., 2017), based on the current study. In another study 5130-3288
conducted to assess chlamydia infection in commercial turkey flocks Seyed Ahmad Madani https://orcid.org/0000-0002-6498-2942
in Iran, 9.6% of sampled birds were positive in real-time PCR (Tatari Manoochehr Allymehr https://orcid.org/0000-0001-8656-0014
et al., 2016). Using the same nested PCR as our investigation (Sachse Alireza Talebi https://orcid.org/0000-0001-6476-0488
& Hotzel, 2003), Tatari et al. also failed to further characterize their
positive specimens. This indicates that probably another chlamydial PEER REVIEW
species, like the one we found in our study, might be involved in those The peer review history for this article is available at https://publons.
flocks as well. In another study on backyard turkeys in Khuzestan com/publon/10.1002/vms3.1244.
province in Iran, 58.9% of serum samples collected were positive for
C. psittaci antibody (Ghorbanpoor & Myahi, 2007). This might indicate REFERENCES
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AUTHOR CONTRIBUTIONS Christerson, L., Blomqvist, M., Grannas, K., Thollesson, M., Laroucau, K.,
Study concept and design: Seyed Ahmad Madani; Manoochehr Ally- Waldenström, J., Eliasson, I., Olsen, B., & Herrmann, B. (2010). A novel
mehr; Alireza Talebi. Acquisition of data: Seyed Mohammad Mahdi Chlamydiaceae-like bacterium found in faecal specimens from sea birds
from the Bering Sea. Environmental Microbiology Reports, 2(4), 605–610.
Hashemian. Analysis and interpretation of data: Seyed Ahmad Madani
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and Manoochehr Allymehr. Drafting of the manuscript: Seyed Moham- Coles, A. C. (1930). Micro-organisms in psittacosis. The Lancet, 1, 1011–
mad Mahdi Hashemian. Critical revision of the manuscript for impor- 1012.
tant intellectual content: Manoochehr Allymehr, Seyed Ahmad Madani, Denamur, E., Sayada, C., Souriau, A., Orfila, J., Rodolakis, A., & Elion, J. (1991).
Restriction pattern of the major outer-membrane protein gene provides
Alireza Talebi. Study supervision: Manoochehr Allymehr, Seyed Ahmad
evidence for a homogeneous invasive group among ruminant isolates of
Madani. Chlamydia psittaci. Journal of General Microbiology, 137(11), 2525–2530.
https://doi.org/10.1099/00221287-137-11-2525
ACKNOWLEDGEMENTS Dickx, V., Geens, T., Deschuyffeleer, T., Tyberghien, L., Harkinezhad, T.,
Beeckman, D. S. A., Braeckman, L., & Vanrompay, D. (2010). Chlamy-
The authors would like to thank Dr. Haddad Marandi for his kind
dophila psittaci zoonotic risk assessment in a chicken and turkey
technical assistance.
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