Grupo de Investigación en Microbiología y Ambiente (GIMA), Universidad de San Buenaventura, Cartagena, Colombia.
Grupo de Investigación Traslacional en Biomedicina y Biotecnología (GITB&B), Corporación para el Desarrollo de la Investigación en Biomedicina & Biotecnología, Cartagena, Colombia.
PLoS One. 2024 May 9;19(5):e0302055. doi: 10.1371/journal.pone.0302055. eCollection 2024.
Pneumocystis jirovecii pneumonia (PJP) is a well-known and frequent opportunistic infection in HIV patients. However, there has been an increase in the number of reports of PJP in other immunosuppressed patients with autoimmune inflammatory disorders or because of chemotherapy and high doses of steroids, especially when used in combination as part of immunosuppressive therapy.
Despite the increasing importance of PJP in non-HIV patients, there is a lack of comprehensive and updated information on the epidemiology, pathogenesis, diagnosis, microbiology, treatments, and prophylaxis of this infection in this population. Therefore, the objective of this systematic review is to synthesize information on these aspects, from a perspective of evidence-based medicine.
The protocol is prepared following the preferred reporting items for systematic reviews and meta-analyses (PRISMA-P) guidelines. We will perform a systematic review of literature published between January 2010 and July 2023, using the databases PubMed, Google Scholar, ScienceDirect, and Web of Science. In addition, manual searches will be carried out through related articles, and references to included articles. The main findings and clinical outcomes were extracted from all the eligible studies with a standardized instrument. Two authors will independently screen titles and abstracts, review full texts, and collect data. Disagreements will be resolved by discussion, and a third reviewer will decide if there is no consensus. We will synthesize the results using a narrative or a meta-analytic approach, depending on the heterogeneity of the studies.
It is expected that this systematic review will provide a comprehensive and up-to-date overview of the state-of-the-art of PJP in non-HIV patients. Furthermore, the study will highlight possible gaps in knowledge that should be addressed through new research.
Here, we present the protocol for a systematic review which will consider all existing evidence from peer-reviewed publication sources relevant to the primary and secondary outcomes related to diagnosing and managing PJP in non-HIV patients.
卡氏肺孢子虫肺炎（PJP）是 HIV 患者中一种众所周知且频繁发生的机会性感染。然而，在患有自身免疫性炎症性疾病或因化疗和大剂量类固醇而导致免疫抑制的其他患者中，PJP 的报告数量有所增加，尤其是当这些药物联合用于免疫抑制治疗时。
尽管非 HIV 患者中 PJP 的重要性日益增加，但关于该人群中这种感染的流行病学、发病机制、诊断、微生物学、治疗和预防，缺乏全面和最新的信息。因此，本系统综述的目的是从循证医学的角度综合这些方面的信息。
该方案按照系统评价和荟萃分析的首选报告项目（PRISMA-P）指南制定。我们将对 2010 年 1 月至 2023 年 7 月期间发表的文献进行系统综述，使用 PubMed、Google Scholar、ScienceDirect 和 Web of Science 数据库。此外，还将通过相关文章和纳入文章的参考文献进行手动搜索。使用标准化工具从所有合格研究中提取主要发现和临床结果。两位作者将独立筛选标题和摘要、审查全文并收集数据。如果没有达成共识，将通过讨论解决分歧，并由第三位审稿人决定。我们将根据研究的异质性，使用叙述或荟萃分析方法综合结果。
预计本系统综述将提供非 HIV 患者中 PJP 最新、全面的概述。此外，该研究将强调可能存在的知识空白，应通过新的研究来解决这些空白。
在这里，我们提出了一项系统综述的方案，该综述将考虑所有来自同行评议出版物的现有证据，这些证据与非 HIV 患者中 PJP 的诊断和管理相关的主要和次要结局有关。
