Clinical characteristics of Pneumocystis carinii pneumonia complicated with acute respiratory failure in 123 immunocompromised patients
10.16718/j.1009-7708.2025.03.002
- VernacularTitle:免疫缺陷人群肺孢子菌肺炎合并急性呼吸衰竭123例临床特征分析
- Author:
Xiuhua LIN
1
;
Jiaping LIN
;
Yixian SHI
;
Siting ZHANG
;
Xin LIN
;
Lei CHEN
;
Hui LI
;
Baosong XIE
Author Information
1. 福建医科大学孟超肝胆医院呼吸内科,350001
- Publication Type:Journal Article
- Keywords:
Pneumocystis jiroveci pneumonia;
respiratory failure;
risk factor
- From:
Chinese Journal of Infection and Chemotherapy
2025;25(3):248-253
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors for acute respiratory failure in immunocompromised patients with Pneumocystis jirovecii pneumonia(PJP).Methods Clinical data of 123 immunocompromised patients complicated with PJP hospitalized at Mengchao Hepatobiliary Hospital of Fujian Medical University from January 2021 to December 2023 were retrospectively collected and analyzed.SPSS 22.0 statistical software package was used to perform multivariate binary logistic regression analysis to identify risk factors for acute respiratory failure in PJP patients.Results Among the 123 PJP patients,77 were HIV-positive,and 46 were HIV-negative.HIV-negative PJP patients were more likely to have comorbidities such as hypertension(P＜0.001),diabetes mellitus(P＜0.001),coronary heart disease(P=0.034),chronic kidney disease(P＜0.001),chronic liver disease(P=0.019),chronic lung disease(P=0.011),and malignant tumor(P＜0.001).They were also more prone to respiratory failure(P＜0.001)and ICU admission(P＜0.001).The HIV-positive patients had significantly lower CD4+T lymphocyte counts and albumin levels(P＜0.001).Forty patients developed acute respiratory failure,and six patients died.Multivariate analysis showed that high neutrophil-to-lymphocyte ratio(NLR)(P=0.031),non-HIV infection(P=0.002),and concomitant infections with other pathogens(P＜0.001)were independent risk factors for incidence of respiratory failure.ROC curve analysis revealed that the area under the curve(AUC)was 0.686(0.584,0.789)for non-HIV infection,0.731(0.637,0.826)for concomitant infections with other pathogens,0.648(0.546,0.750)for NLR.The predicted probability was 0.845(0.778,0.912).Conclusions Non-HIV infection,high NLR,and concomitant infections with other pathogens are independent risk factors for incidence of respiratory failure in PJP patients.The panel combining these factors provides a higher predictive value for respiratory failure.Timely assessment of patient condition and early treatment are vital for better outcomes.
