Characterization of Pneumocystis jirovecii pneumonia at three tertiary comprehensive hospitals in southern China
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CLINICAL MICROBIOLOGY - RESEARCH PAPER
Characterization of Pneumocystis jirovecii pneumonia at three tertiary comprehensive hospitals in southern China Yan-Hui Chen 1 & Xue-Yao Fang 1 & Yue-Ting Li 2 & Yan-Ling Liu 3 & Ya-Ping Hang 1 & Yan-Ping Xiao 1 & Xing-Wei Cao 1 & Qiao-Shi Zhong 1 & Long-Hua Hu 1 Received: 13 November 2019 / Accepted: 16 April 2020 # Sociedade Brasileira de Microbiologia 2020
Abstract 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, PaO2, 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. Keywords Pneumocystis jirovecii . Pneumonia . Serologic biomarkers . HIV . Non-HIV-immunocompromised patients
Introduction Pneumocystis jirovecii pneumonia (PJP) is a life-threatening, opportunistic pulmonary infectious disease associated with considerable morbidity and mortality [1]. Despite being first identified over a century ago, Pneumocystis pneumonia (PCP) Yan-Hui Chen and Xue-Yao Fang contributed equally to this work. Responsible Editor: Rosana Puccia. * Qiao-Shi Zhong [email protected] * Long-Hua Hu [email protected] 1
Jiangxi Provincial Key Laboratory of Medicine, Clinical Laboratory of the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
2
Clinical Laboratory of People’s Hospital, Nanchang, Jiangxi, China
3
Clinical Laboratory of the First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
remained largely unrecognized until the 1980s [2]. Although Pneumocystis was long considered to be a genus of protozoa, subsequent ribosomal RNA sequencing revealed it to be a fungus [2]. The nomenclature of Pneumocystis was changed from Pneumocystis carinii, which infects rats, to Pneumocystis jirovecii, which i
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