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Pneumocystis jirovecii Pneumonia in Patients with or without AIDS, France

Identifieur interne : 000E81 ( Main/Exploration ); précédent : 000E80; suivant : 000E82

Pneumocystis jirovecii Pneumonia in Patients with or without AIDS, France

Auteurs : Antoine Roux [France] ; Emmanuel Canet [France] ; Sandrine Valade [France] ; Florence Gangneux-Robert [France] ; Samia Hamane ; Ariane Lafabrie [France] ; Daniéle Maubon [France] ; Anne Debourgogne [France] ; Soléne Le Gal [France] ; Fréderic Dalle [France] ; Marion Leterrier [France] ; Dominique Toubas [France] ; Christelle Pomares [France] ; Anne Pauline Bellanger ; Julie Bonhomme [France] ; Antoine Berry [Canada] ; Isabelle Durand-Joly [France] ; Denis Magne ; Denis Pons [France] ; Christophe Hennequin [France] ; Eric Maury [France] ; Patricia Roux [France] ; Élie Azoulay

Source :

RBID : Hal:hal-01483948

English descriptors

Abstract

Pneumocystis jirovecii pneumonia (PCP) in patients without AIDS is increasingly common. We conducted a prospective cohort study of consecutive patients with proven PCP; of 544 patients, 223 (41%) had AIDS (AIDS patients) and 321 (59%) had other immunosuppressive disorders (non-AIDS patients). Fewer AIDS than non-AIDS patients required intensive care or ventilation, and the rate of hospital deaths—17.4% overall—was significantly lower for AIDS versus non-AIDS patients (4% vs. 27%; p<0.0001). Multivariable analysis showed the odds of hospital death increased with older age, receipt of allogeneic bone marrow transplant, immediate use of oxygen, need for mechanical ventilation, and longer time to treatment; HIV-positive status or receipt of a solid organ transplant decreased odds for death. PCP is more often fatal in non-AIDS patients, but time to diagnosis affects survival and is longer for non-AIDS patients. Clinicians must maintain a high index of suspicion for PCP in immunocompromised patients who do not have AIDS.


Url:
DOI: 10.3201/eid2009.131668


Affiliations:

Links toward previous steps (curation, corpus...)

Le document en format XML

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<author>
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<idno type="DOI">10.3201/eid2009.131668</idno>
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<title level="j">Emerging Infectious Diseases</title>
<idno type="ISSN">1080-6040</idno>
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<date type="datePub">2014-09</date>
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<term> France</term>
<term> HIV/AIDS</term>
<term> Pneumocystis jirovecii</term>
<term> cancer</term>
<term> fungi</term>
<term> immunosuppressive disorder</term>
<term> mechanical ventilation</term>
<term> pneumonia</term>
<term> prophylaxis</term>
<term> respiratory infections</term>
<term> transplantation</term>
<term> viruses</term>
<term>Immune suppression</term>
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<front>
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<p>Pneumocystis jirovecii pneumonia (PCP) in patients without AIDS is increasingly common. We conducted a prospective cohort study of consecutive patients with proven PCP; of 544 patients, 223 (41%) had AIDS (AIDS patients) and 321 (59%) had other immunosuppressive disorders (non-AIDS patients). Fewer AIDS than non-AIDS patients required intensive care or ventilation, and the rate of hospital deaths—17.4% overall—was significantly lower for AIDS versus non-AIDS patients (4% vs. 27%; p<0.0001). Multivariable analysis showed the odds of hospital death increased with older age, receipt of allogeneic bone marrow transplant, immediate use of oxygen, need for mechanical ventilation, and longer time to treatment; HIV-positive status or receipt of a solid organ transplant decreased odds for death. PCP is more often fatal in non-AIDS patients, but time to diagnosis affects survival and is longer for non-AIDS patients. Clinicians must maintain a high index of suspicion for PCP in immunocompromised patients who do not have AIDS.</p>
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<li>Canada</li>
<li>France</li>
</country>
<region>
<li>Champagne-Ardenne</li>
<li>Grand Est</li>
<li>Lorraine (région)</li>
<li>Provence-Alpes-Côte d'Azur</li>
<li>Région Bretagne</li>
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<li>Metz</li>
<li>Nancy</li>
<li>Reims</li>
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<li>Université de Lorraine</li>
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<name sortKey="Magne, Denis" sort="Magne, Denis" uniqKey="Magne D" first="Denis" last="Magne">Denis Magne</name>
</noCountry>
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<name sortKey="Roux, Antoine" sort="Roux, Antoine" uniqKey="Roux A" first="Antoine" last="Roux">Antoine Roux</name>
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<name sortKey="Bonhomme, Julie" sort="Bonhomme, Julie" uniqKey="Bonhomme J" first="Julie" last="Bonhomme">Julie Bonhomme</name>
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<name sortKey="Lafabrie, Ariane" sort="Lafabrie, Ariane" uniqKey="Lafabrie A" first="Ariane" last="Lafabrie">Ariane Lafabrie</name>
<name sortKey="Le Gal, Solene" sort="Le Gal, Solene" uniqKey="Le Gal S" first="Soléne" last="Le Gal">Soléne Le Gal</name>
<name sortKey="Leterrier, Marion" sort="Leterrier, Marion" uniqKey="Leterrier M" first="Marion" last="Leterrier">Marion Leterrier</name>
<name sortKey="Maubon, Daniele" sort="Maubon, Daniele" uniqKey="Maubon D" first="Daniéle" last="Maubon">Daniéle Maubon</name>
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<name sortKey="Pomares, Christelle" sort="Pomares, Christelle" uniqKey="Pomares C" first="Christelle" last="Pomares">Christelle Pomares</name>
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<name sortKey="Valade, Sandrine" sort="Valade, Sandrine" uniqKey="Valade S" first="Sandrine" last="Valade">Sandrine Valade</name>
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