Health Protection Agency, London, UK.
Emerg Infect Dis. 2013 Mar;19(3):386-92. doi: 10.3201/eid1903.121151.
After an increase in the number of reported cases of Pneumocystis jirovecii pneumonia in England, we investigated data from 2000-2010 to verify the increase. We analyzed national databases for microbiological and clinical diagnoses of P. jirovecii pneumonia and associated deaths. We found that laboratory-confirmed cases in England had increased an average of 7% per year and that death certifications and hospital admissions also increased. Hospital admissions indicated increased P. jirovecii pneumonia diagnoses among patients not infected with HIV, particularly among those who had received a transplant or had a hematologic malignancy. A new risk was identified: preexisting lung disease. Infection rates among HIV-positive adults decreased. The results confirm that diagnoses of potentially preventable P. jirovecii pneumonia among persons outside the known risk group of persons with HIV infection have increased. This finding warrants further characterization of risk groups and a review of P. jirovecii pneumonia prevention strategies.
在英国报告的卡氏肺孢子虫肺炎病例数量增加后，我们调查了 2000-2010 年的数据以验证这一增长。我们分析了国家微生物学和临床诊断数据库以及与卡氏肺孢子虫肺炎相关的死亡病例。我们发现，英国实验室确诊病例的年增长率平均为 7%，死亡证明和住院人数也有所增加。住院人数表明，在未感染艾滋病毒的患者中，卡氏肺孢子虫肺炎的诊断有所增加，特别是在接受过移植或患有血液恶性肿瘤的患者中。发现了一个新的风险因素：预先存在的肺部疾病。艾滋病毒阳性成年人的感染率有所下降。研究结果证实，在已知艾滋病毒感染者这一已知高危人群之外，可预防的卡氏肺孢子虫肺炎的诊断有所增加。这一发现需要进一步确定风险人群，并审查卡氏肺孢子虫肺炎的预防策略。
