2026-04-13T06:41:22Zhttps://recercat.cat/oai/request

oai:recercat.cat:2072/4853272025-11-07T13:34:58Zcom_2072_98col_2072_378192

00925njm 22002777a 4500 dc Giacobbe, Daniel Roberto author Dettori, Silvia author Di Pilato, Vincenzo author Asperges, Erika author Ball, Lorenzo author Berti, Enora author Blennow, Ola author Bruzzone, Bianca author Calvet, Laure author Capra Marzani, Federico author Casabella Pernas, Antonio author Choudaly, Sofia author Dartevel, Anais author De Pascale, Gennaro author Di Meco, Gabriele author Fallon, Melissa author Galerneau, Louis-Marie author Gallego, Miguel author Giacomini, Mauro author González Sáez, Adolfo author Hänsel, Luise author Icardi, Giancarlo author Koehler, Philipp author Lagrou, Katrien author Lahmer, Tobias author Lewis White, P. author Magnasco, Laura author Marchese, Anna author Marelli, Cristina author Marín-Arriaza, Mercedes author Martin-Loeches, Ignacio author Mekontso-Dessap, Armand author Mikulska, Malgorzata author Mularoni, Alessandra author Nordlander, Anna author Poissy, Julien author Russelli, Giovanna author Signori, Alessio author Tascini, Carlo author Vaconsin, Louis-Maxime author Vargas, Joel author Vena, Antonio author Wauters, Joost author Pelosi, Paolo author Timsit, Jean-Francois author Bassetti, Matteo author JIR-ICU investigators author Universitat Autònoma de Barcelona author 2023 Background: Pneumocystis jirovecii pneumonia (PJP) is an opportunistic, life-threatening disease commonly affecting immunocompromised patients. The distribution of predisposing diseases or conditions in critically ill patients admitted to intensive care unit (ICU) and subjected to diagnostic work-up for PJP has seldom been explored. Materials and methods: The primary objective of the study was to describe the characteristics of ICU patients subjected to diagnostic workup for PJP. The secondary objectives were: (i) to assess demographic and clinical variables associated with PJP; (ii) to assess the performance of Pneumocystis PCR on respiratory specimens and serum BDG for the diagnosis of PJP; (iii) to describe 30-day and 90-day mortality in the study population. Results: Overall, 600 patients were included in the study, of whom 115 had presumptive/proven PJP (19.2%). Only 8.8% of ICU patients subjected to diagnostic workup for PJP had HIV infection, whereas hematological malignancy, solid tumor, inflammatory diseases, and solid organ transplants were present in 23.2%, 16.2%, 15.5%, and 10.0% of tested patients, respectively. In multivariable analysis, AIDS (odds ratio [OR] 3.31; 95% confidence interval [CI] 1.13-9.64, p = 0.029), non-Hodgkin lymphoma (OR 3.71; 95% CI 1.23-11.18, p = 0.020), vasculitis (OR 5.95; 95% CI 1.07-33.22, p = 0.042), metastatic solid tumor (OR 4.31; 95% CI 1.76-10.53, p = 0.001), and bilateral ground glass on CT scan (OR 2.19; 95% CI 1.01-4.78, p = 0.048) were associated with PJP, whereas an inverse association was observed for increasing lymphocyte cell count (OR 0.64; 95% CI 0.42-1.00, p = 0.049). For the diagnosis of PJP, higher positive predictive value (PPV) was observed when both respiratory Pneumocystis PCR and serum BDG were positive compared to individual assay positivity (72% for the combination vs. 63% for PCR and 39% for BDG). Cumulative 30-day mortality and 90-day mortality in patients with presumptive/proven PJP were 52% and 67%, respectively. Conclusion: PJP in critically ill patients admitted to ICU is nowadays most encountered in non-HIV patients. Serum BDG when used in combination with respiratory Pneumocystis PCR could help improve the certainty of PJP diagnosis. Biomarker Diagnosis ICU PCR Pneumocystis Pneumonia Serum β-D-Glucan Pneumocystis jirovecii pneumonia in intensive care units : a multicenter study by ESGCIP and EFISG