Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center.
Department of Internal Medicine, University of Ulsan College of Medicine and Asan Medical Center.
Jpn J Infect Dis. 2019 Jul 24;72(4):270-273. doi: 10.7883/yoken.JJID.2018.400. Epub 2019 Mar 26.
Subsequent to the increasing use of immunosuppressant therapy, Pneumocystis jirovecii pneumonia (PcP) has emerged as a life-threatening condition in human immunodeficiency virus (HIV)-negative patients. We investigated changes in epidemiological and clinical characteristics among PcP cases with and without HIV infections. Data of 424 patients diagnosed with PcP in a 2,700-bed Korean tertiary care hospital between February 2003 and April 2017 were retrospectively analyzed. The study included patients with compatible clinical findings in whom PcP was confirmed via direct immunofluorescence assay. The annual average number of cases increased from 12.2 (initial 5-year period) to 42.2 (recent 5-year period). In HIV-negative patients, hematologic malignancy (34.8%) and solid organ transplantation (32.9%) were the most frequent major underlying conditions, and immunosuppressive therapies including corticosteroids (342/362, 94.5%) and chemotherapy (122/362, 33.7%) were significantly associated with PcP infection (p ＜ 0.001 for both). The incidence of PcP has continued to increase among non-HIV-infected immunocompromised patients in recent years.
继免疫抑制剂治疗的广泛应用后，卡氏肺孢子虫肺炎（PCP）已成为人类免疫缺陷病毒（HIV）阴性患者的一种危及生命的疾病。我们研究了 HIV 感染和非 HIV 感染的 PC 患者的流行病学和临床特征的变化。对 2003 年 2 月至 2017 年 4 月期间在一家拥有 2700 张床位的韩国三级保健医院中确诊为 PC 的 424 名患者的资料进行了回顾性分析。研究纳入了临床表现相符且经直接免疫荧光检测确诊为 PC 的患者。每年 PC 患者的例数从最初的 5 年的 12.2 例增加到最近的 5 年的 42.2 例。在 HIV 阴性患者中，血液恶性肿瘤（34.8%）和实体器官移植（32.9%）是最常见的主要基础疾病，包括皮质类固醇（362 例中的 342 例，94.5%）和化疗（362 例中的 122 例，33.7%）在内的免疫抑制治疗与 PC 感染显著相关（均 p ＜ 0.001）。近年来，非 HIV 免疫功能低下患者中 PC 的发病率持续上升。
