Survival in Immunocompromised Adults with Pneumocystis jirovecii Pneumonia: A Multicenter ID-IRI Study

Cag, Yasemin; Caskurlu, Hulya; Ankarali, Handan; Cascio, Antonio; Lakatos, Botond; Lakatos, Aron; Cernat, Roxana; Pekok, Abdullah; Ramosaco, Ergys; Kulzhanova, Sholpan; Oprea, Cristiana; Lanzafame, Massimiliano; Hakamifard, Atousa; Tehrani, Hamed; İnce, Nevin; Baljic, Rusmir; Rahimi, Bilal; Vatansever, Gokhan; Tasbakan, Meltem; Vural-Akbal, Halenur; Fernandez, Ricardo; Quiles, Claudia; Alkan, SEVİL; Harxhi, Arjan; Dumitru, Irina; Korkmaz, Nesibe; Al Naqbi, Aisha; Vieceli, Tarsila; ESER KARLIDAĞ, Gülden; Khedr, Reham; Angioni, Goffredo; Almajid, Fahad; Del Vecchio, Rosa; Yardımcı, Ahmet; ERDEM, Hakan

doi:10.1007/s11046-026-01099-w

Survival in Immunocompromised Adults with Pneumocystis jirovecii Pneumonia: A Multicenter ID-IRI Study

Cag Y., Caskurlu H., Ankarali H., Cascio A., Lakatos B., Lakatos A., ...Daha Fazla

Mycopathologia, cilt.191, sa.5, 2026 (SCI-Expanded, Scopus)

Yayın Türü: Makale / Tam Makale
Cilt numarası: 191 Sayı: 5
Basım Tarihi: 2026
Doi Numarası: 10.1007/s11046-026-01099-w
Dergi Adı: Mycopathologia
Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CAB Abstracts, EMBASE, Environment Index, MEDLINE, Natural Science Collection (ProQuest), Biological Science Database (ProQuest), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest), Pharma Collection (ProQuest)
Anahtar Kelimeler: Hematologic malignancies, HIV infection, Immunocompromised host, Mortality, Opportunistic infections, Pneumocystis pneumonia
Çanakkale Onsekiz Mart Üniversitesi Adresli: Evet

Özet

Purpose: Pneumocystis jirovecii pneumonia (PJP) is a life-threatening opportunistic infection in immunocompromised patients. The aim of this study was to identify risk factors associated with in-hospital 30-day all-cause mortality among PJP in patients with HIV and hematologic malignancies where PJP is the most prevalent. Methods: We conducted a multicenter, international, retrospective cohort study of consecutive hospitalized patients aged > 17 years with PJP between January 1, 2010, and March 1, 2024. Only patients with laboratory-confirmed PJP were included. Results: Overall, 156 patients were included to study. Of the 156 patients, 115 (73.7%) were male, and the median age was 43 years (IQR 35–52). Of the patients, 130 (83.3%) were people living with HIV, including 126 newly diagnosed cases, while 26 (16.7%) had hematologic malignancies. Overall, PJP prophylaxis was used in only 4.5% of patients. According to the immunofluorescence assay or conventional staining methods used as the reference standard, the positivity rate of P. jirovecii PCR in BAL samples was 96.4%. Intensive care unit admission was required for 60 patients (38.5%), of whom 51 (85.0%) required mechanical ventilation. The overall in-hospital 30-day all-cause mortality rate was 14.1%. In the multivariable logistic regression analysis, higher respiratory rate (OR 1.092; 95% CI 1.002–1.190), higher SOFA score (OR 1.757; 95% CI 1.311–2.356), increased neutrophil count (OR 1.332; 95% CI 1.141–1.555), pleural effusion on chest X-ray (OR 7.268; 95% CI 1.382–38.212), and a prior history of PJP (OR 19.537; 95% CI 1.462–261.2) were independently associated with increased in-hospital 30-day all-cause mortality. Conclusions: Our findings indicate that greater clinical severity and respiratory compromise are associated with increased mortality risk, underscoring the value of early recognition of high-risk patients to guide timely management.