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Characterization of Pneumocystis jirovecii pneumonia at three tertiary comprehensive hospitals in southern China

  • Clinical Microbiology - Research Paper
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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.

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Availability of data and materials

The datasets analyzed during the current study are not publicly available due to privacy agreements of the participants of the study but are available from the corresponding author on reasonable request.

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Acknowledgements

The authors would like to thank Dr. Jianping Xu for his great help in this paper.

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Author notes

  1. Yan-Hui Chen and Xue-Yao Fang contributed equally to this work.

Authors and Affiliations

  1. Jiangxi Provincial Key Laboratory of Medicine, Clinical Laboratory of the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China

    Yan-Hui Chen, Xue-Yao Fang, Ya-Ping Hang, Yan-Ping Xiao, Xing-Wei Cao, Qiao-Shi Zhong & Long-Hua Hu

  2. Clinical Laboratory of People’s Hospital, Nanchang, Jiangxi, China

    Yue-Ting Li

  3. Clinical Laboratory of the First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China

    Yan-Ling Liu

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Contributions

All authors made substantial contributions to the data acquisition, analysis, or interpretation; reviewed and approved the final manuscript; and significantly contributed to this study. L-HH and Y-HC conceived and designed the experiments; Y-HC, X-YF, Y-TL, Y-LY, Y-PH, Y-PX, X-WC, and Q-SZ reviewed the electronic medical records and collected the data; Y-HC and X-YF analyzed the data; Y-HC, X-YF, Q-SZ, and L-HH drafted the manuscript; Y-HC, X-YF, Q-SZ, and L-HH had the final responsibility for the decision to submit the study for publication.

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Correspondence to Qiao-Shi Zhong or Long-Hua Hu.

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The authors confirm that the ethical policies of the journal, as noted in the author’s guideline page, have been adhered to. Data collection was conducted in accordance with guidelines outlined by the Declaration of Helsinki. The study was approved by the ethics committee of the Second Affiliated Hospital of Nanchang University, the First Affiliated Hospital of Nanchang University, the People’s Hospital, and Nanchang University in Jiangxi Province, China, and written informed consent was obtained from the patients or their next of kin (registration no. 2018024; 16 December 2018).

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Chen, YH., Fang, XY., Li, YT. et al. Characterization of Pneumocystis jirovecii pneumonia at three tertiary comprehensive hospitals in southern China. Braz J Microbiol 51, 1061–1069 (2020). https://doi.org/10.1007/s42770-020-00277-2

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