Details

Autor(en) / Beteiligte

• Kim, Soo Jung
• Lee, Jinwoo
• Cho, Young-Jae
• Park, Young Sik
• Lee, Chang-Hoon
• Yoon, Ho Il
• Lee, Sang-Min
• Yim, Jae-Joon
• Lee, Jae Ho
• Yoo, Chul-Gyu
• Lee, Choon-Taek
• Kim, Young Whan
• Han, Sung Koo
• Kim, Hong Bin
• Park, Jong Sun

Titel

Prognostic factors of Pneumocystis jirovecii pneumonia in patients without HIV infection

Ist Teil von

• The Journal of infection, 2014-07, Vol.69 (1), p.88-95

Ort / Verlag

Amsterdam: Elsevier Ltd

Erscheinungsjahr

2014

Quelle

MEDLINE

Beschreibungen/Notizen

• Summary Objectives The incidence of Pneumocystis jirovecii pneumonia (PCP) in patients without HIV infection (non-HIV PCP) has been increasing along with the increased use of chemotherapeutic agents and immunosuppressants, but the prognostic factors of non-HIV PCP remain unclear. This study aimed to identify the prognostic factors of non-HIV PCP. Methods Immunocompromised patients without HIV infection who were diagnosed and treated for PCP were included. The PCP diagnosis was based on positive direct fluorescent antibody (DFA) or polymerase chain reaction (PCR) results and compatible clinical symptoms and radiological findings. Results In total, 372 non-HIV patients with positive PCP DFA or PCR findings were screened and 173 were included. Univariate analysis indicated that age, smoking, chronic lung disease or hematologic malignancy, chemotherapeutic agents, high alveolar–arterial oxygen gradient (D[A–a]O2 ), C-reactive protein, albumin, blood urea nitrogen (BUN), CMV antigenemia, combined bacteremia, high percentage of neutrophils and rate of co-infection in BAL fluid, and mechanical ventilator care were related to the prognosis of non-HIV PCP. Multivariate analysis revealed that high D(A–a)O2, combined bacteremia, increased BUN and preexisting lung disease were indicators of a poor prognosis. Conclusions High D(A–a)O2, combined bacteremia, increased BUN and preexisting lung disease were independent factors of poor prognosis in non-HIV PCP patients.