Pneumocystis pneumonia suspected cases in 604 non-HIV and HIV patients
Pneumocystis pneumonia suspected cases in 604 non-HIV and HIV patients
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DOI：
10.1016/j.ijid.2016.03.018
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发表时间：
2016-05-01
影响因子：
8.4
通讯作者：
Picot, Stephane
中科院分区：
文献类型：
--
作者：
Bienvenu, Anne-Lise;Traore, Karim;Picot, Stephane
背景：肺孢子虫肺炎（PCP）是免疫功能受损患者中最具破坏性的真菌性疾病之一。有效的抗病毒治疗减少了艾滋病患者的PCP的负担，但这种疾病的患病率增加的人接受免疫抑制therapy.Methods：我们回顾性分析了艾滋病毒和非艾滋病毒PCP患者在我们的部门在九年期间诊断。从诊断程序期间完成的本地数据库中收集数据。对于每一个病人，人口统计学，临床，放射学，生物学和治疗数据进行了analysed.Results：共收到21,274支气管肺泡样本从患者疑似肺囊虫病在研究期间，导致出院诊断为PCP的604例（143 HIV阳性和461 HIV阴性）。在研究期间，非艾滋病毒患者与艾滋病毒患者出现PCP的比例从1.7增加到5.6。在第14天的死亡率为16%，主要发生在非HIV患者（20.6%相比，1.4%，P < 0.0001），而非HIV患者在诊断时症状比AIDS patient.Conclusions：这项研究提出了一个较高的数量的HIV和非HIV患者在一个单一的中心与PCP。肺孢子虫病现在是接受免疫抑制治疗的患者面临的一个重要健康挑战，死亡率很高。这项研究强调，需要制定预防非艾滋病毒患者PCP的国际指南。(C)2016作者由Elsevier Ltd代表国际传染病学会出版。这是CC BY-NC-ND许可证下的开放获取文章（http：//creativecommons.org/licenses/bync-nd/4.0/）。
Background: Pneumocystis pneumonia (PCP) is one of the most devastating fungal diseases in patients with impaired immunity. Effective antiviral therapies have reduced the burden of PCP among AIDS patients, but an increase in the prevalence of this disease among persons receiving immunosuppressive therapies has been reported.Methods: We retrospectively reviewed HIV and non-HIV PCP patients diagnosed in our department during a nine year period. Data were collected from the local database completed during the diagnosis procedure. For each patient, demographic, clinical, radiological, biological and therapeutic data were analyzed.Results: A total of 21,274 bronchoalveolar samples were received from patients suspected of pneumocystosis during the study period, leading to a discharge diagnosis of PCP for 604 patients (143 HIV-positive and 461 HIV-negative). The ratio of non-HIV versus HIV patients presenting PCP increased from 1.7 to 5.6 during the study period. The mortality rate at day 14 was 16%, occurring mostly in non-HIV patients (20.6% compared to 1.4%, P < 0.0001), while non-HIV patients were less symptomatic at diagnosis than AIDS patients.Conclusions: This study presents one of the higher number of HIV and non-HIV patients presenting with PCP in a single center. Pneumocystosis is now a crucial health challenge for patients receiving immunosuppressive therapy, with a high mortality rate. This study highlights the need for international guidelines for prophylaxis of PCP in non-HIV patients. (C) 2016 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/bync-nd/4.0/).