Mortality of Pneumocystis jirovecii pneumonia in intensive care units: a post-hoc analysis of an international multicenter study by ESGCIP and EFISG

Area of Science:

• Critical Care Medicine
• Infectious Diseases
• Pulmonology

Background:

• Pneumocystis jirovecii pneumonia (PJP) is a severe, life-threatening infection.
• In intensive care units (ICUs), PJP is increasingly seen in non-human immunodeficiency virus (HIV)-infected patients.
• Non-HIV related conditions are emerging as significant risk factors for PJP development.

Purpose of the Study:

• To analyze prognostic factors for PJP patients in the ICU.
• To identify predictors of mortality in this patient population.
• To understand the evolving landscape of PJP in non-HIV infected individuals.

Main Methods:

• Post-hoc analysis of a multicenter, multinational, retrospective study.
• Inclusion of 107 ICU patients with PJP (proven or presumptive).
• Univariable and multivariable regression analyses to assess mortality predictors.

Main Results:

• Overall 30-day mortality for PJP in the ICU was 52.7%.
• Metastatic solid tumor (HR 3.49) and chronic liver disease (HR 2.44) were independently associated with increased 30-day mortality.
• These associations remained significant after accounting for center effects.

Conclusions:

• PJP mortality in ICU patients remains high.
• Non-HIV related conditions like metastatic solid tumors and chronic liver disease are critical mortality predictors.
• Improved understanding of these factors is vital for better PJP management and patient survival.