Open AccessCharacterization of Pneumocystis jirovecii pneumonia at three tertiary comprehensive hospitals in southern China
Author(s) -
Yanhui Chen,
Xueyao Fang,
Yueting Li,
Yanling Liu,
Yaping Hang,
Yanping Xiao,
Xingwei Cao,
Qiaoshi Zhong,
Longhua Hu
Publication year - 2020
Publication title -
brazilian journal of microbiology
Language(s) - English
Resource type - Journals
eISSN - 1678-4405
pISSN - 1517-8382
DOI - 10.1007/s42770-020-00277-2
Subject(s) - medicine , pneumocystis pneumonia , pneumonia , retrospective cohort study , trimethoprim , sulfamethoxazole , pneumocystis jirovecii , antibiotics , microbiology and biotechnology , biology
Due to the increasing use of immunosuppressant therapy, Pneumocystis jirovecii pneumonia (PJP) has become an emerging concern in human immunodeficiency virus (HIV)-negative patients. In this study, we conducted a retrospective study of 96 hospitalized patients with PJP from January 2015 to June 2019 at three tertiary comprehensive hospitals in Southern China. Information was collected regarding patient demographics, clinical manifestations, risk factors, laboratory analyses, radiological images, and treatment outcomes. PJP infection was most commonly found in middle-aged men. Kidney diseases (35.5%) and connective tissue diseases (38.7%) were the predominant risk factors for PJP. About half of the patients (48.4%) received glucocorticoid, immunosuppressant, and/or chemotherapy in a low dose or in a short-term (< 3 months). None of the patients had previously received trimethoprim-sulfamethoxazole (TMP-SMX) for PJP prophylaxis. All patients had two or more clinical manifestations (cough, dyspnea, fever, and chest pain). Biochemical investigations of CRP, ESR, PaO 2 , LDH, and KL-6 showed that over 90% of the patients exceeded the reference range of indicators. Our analyses revealed the dominant risk factors (HIV, kidney diseases, and connective tissue diseases) and the most consistent biochemical indicators (LDH, BG, and KL-6) for PJP. Moreover, early prophylaxis, diagnosis, and treatment should contribute to improve the survival of these PJP patients.