Gaining an Understanding of Pneumocystosis in Wales

被引:4
作者
Ayling-Smith, Jonathan [1 ,2 ]
Backx, Matthijs [3 ]
Grant, Elizabeth [1 ]
Dhillon, Rishi [3 ]
Duckers, Jamie [4 ]
Hood, Kerenza [2 ]
White, P. Lewis [3 ]
机构
[1] Cardiff & Vale Univ Hlth Board, Univ Hosp Wales, Cardiff CF14 4XW, Wales
[2] Cardiff Univ, Coll Biomed & Life Sci, Cardiff CF10 3AT, Wales
[3] Publ Hlth Wales, Cardiff CF10 4BZ, Wales
[4] Univ Hosp Llandough, All Wales Adult Cyst Fibrosis Ctr, Penarth CF64, Wales
关键词
Pneumocystis; PcP; incidence; HIV; non-HIV; Wales; JIROVECII PNEUMONIA; DIAGNOSIS;
D O I
10.3390/jof9060660
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
Pneumocystis pneumonia (PcP) is a serious complication of many significant immunocompromising conditions. Prior incidence estimates in Wales are based on PcP's presentation in the HIV and transplant populations. The objectives were to describe the incidence of PcP in Wales using laboratory reporting measures and assess the impact of underlying immunosuppression cause on mortality. All positive PCR results for PcP between 2015 and 2018 were identified. The total number of unique positives with clinical and radiological correlation was 159 patients, a mean of 39.75 annually. The healthcare records of these patients were reviewed. The mortality at one month was 35.2% and 49.1% at one year. HIV remains the commonest cause of immunosuppression but has lower mortality than non-HIV conditions (12% vs. 59% at one year, p < 0.00001). Non-HIV conditions were categorised as life-threatening and non-life threatening but had a non-significant mortality (66% vs. 54%; p = 0.149), highlighting the negative impact of PcP. An incidence of PcP in Wales of 1.23-1.26 cases per 100,000 has been identified, 32-35% greater than the upper limit previously estimated. There is high mortality in non-HIV patients regardless of immunosuppression cause. A heightened awareness of PcP in these groups will hasten diagnosis and potentially improve mortality.
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页数:10
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