Epidemiology and Clinical Relevance of Pneumocystis jirovecii in Non-Human Immunodeficiency Virus Patients at a Tertiary Care Center in Central Europe: A 3-Year Retrospective Study

中欧一家三级医疗中心非人类免疫缺陷病毒感染者中卡氏肺孢子虫的流行病学和临床意义:一项为期3年的回顾性研究

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Abstract

Background/Objectives: This study examines the clinical characteristics of Pneumocystis jirovecii pneumonia (PjP) in non-Human immunodeficiency virus (HIV) patients in Hungary to describe its local epidemiological properties. Methods: Our study was conducted at a clinical center with more than 1700 beds at the University of Debrecen in Hungary. We included all patients without HIV infection for whom a diagnostic evaluation for Pneumocystis infection had been requested between 1 January 2022 and 31 December 2024. Results: In total, 21 cases of PjP were identified from 122 requests at the University of Debrecen Clinical Center between 2022 and 2024. The overall 30-day mortality rate was 43% in PjP. Admission to the intensive care unit (odds ratio [OR] 5.44, 95% confidence interval [CI] 1.87-14.09, p = 0.001), the need for mechanical ventilation (OR 4.09, 95% CI 1.45-12.14, p = 0.015) and hematological malignancies (OR 3.24, 95% CI 1.23-9.18, p = 0.024), were associated with Pneumocystis PCR positivity. Furthermore, a significant association was observed between elevated levels of C-reactive protein (OR 1.01, 95% CI 1-1.01, p = 0.001), 30-day mortality (OR 2.86, 95% CI 1.09-7.92, p = 0.049), and Pneumocystis PCR positivity. Regarding diagnostic platforms used, Fujifilm Wako assay detected serum (1-3)-β-D-glucan positivity (>7 pg/mL) from 352 copies/mL in non-HIV patients with probable PJP. Conclusions: Our study serves as a gap-filling investigation, providing an overview of Pneumocystis epidemiology in the Central European region.

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