Pates Katharine, Periselneris Jimstan, Russell Mark D, Mehra Varun, Schelenz Silke, Galloway James B
Department of Respiratory Medicine, Kings College Hospital, Kings College Hospital NHS Foundation Trust, London, UK.
Department of Respiratory Medicine, Kings College Hospital, Kings College Hospital NHS Foundation Trust, London, UK.
J Infect. 2023 Apr;86(4):385-390. doi: 10.1016/j.jinf.2023.02.014. Epub 2023 Feb 10.
Pneumocystis pneumonia (PCP) is an opportunistic infection that causes significant morbidity and mortality in the immunocompromised population. This population is growing and diversifying, yet contemporary epidemiology is lacking. We investigated the population-level incidence of PCP over the past decade.
We conducted a descriptive study of all hospital admissions in England from April 2012 to March 2022. PCP episodes, age, median length of stay, gender and episodes of other respiratory fungal infections were collected. Consumption of Trimethoprim-Sulfamethoxazole was obtained between January 2019 and May 2022.
The incidence of PCP increased from 2·2-4·5/100,000 population between 2012/2013 and 2019/2020 (p < 0·0001). There was a drop in 2020/2021 to 2·7/100,000 before returning to 3.9/100,000 in 2021/2022. PCP episodes rose as a proportion of all-cause admissions as well as a proportion of episodes due to other fungal infections. The proportion of PCP patients aged 75+ increased from 14% to 26%. The median length of stay was 13.5 days. Consumption of intravenous Trimethoprim-Sulfamethoxazole increased from 0.24 × 100,000 to 0.30 × 100,000 defined daily doses.
The incidence of PCP is rising rapidly and represents a significant burden to the healthcare system. Further study into who is at risk of PCP is needed to better determine who should be given prophylaxis.
肺孢子菌肺炎（PCP）是一种机会性感染，在免疫功能低下人群中会导致严重的发病和死亡。这一人群正在增长且日益多样化，但目前缺乏当代流行病学数据。我们调查了过去十年中PCP的人群发病率。
我们对2012年4月至2022年3月期间英格兰所有住院患者进行了描述性研究。收集了PCP发作情况、年龄、中位住院时间、性别以及其他呼吸道真菌感染发作情况。获取了2019年1月至2022年5月期间甲氧苄啶-磺胺甲恶唑的使用量。
PCP发病率在2012/2013年至2019/2020年期间从2.2/10万人口增加到4.5/10万人口（p<0.0001）。2020/2021年降至2.7/10万，之后在2021/2022年又回升至3.9/10万。PCP发作占所有病因住院的比例以及占其他真菌感染发作的比例均有所上升。75岁及以上PCP患者的比例从14%增加到26%。中位住院时间为13.5天。静脉注射甲氧苄啶-磺胺甲恶唑的使用量从0.24×10万定义日剂量增加到0.30×10万定义日剂量。
PCP发病率正在迅速上升，给医疗系统带来了重大负担。需要进一步研究哪些人有患PCP的风险，以便更好地确定哪些人应接受预防治疗。
