Pneumocystis jirovecii pneumonia in intensive ...
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Article dans une revue scientifique: Article original
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Title :
Pneumocystis jirovecii pneumonia in intensive care units: a multicenter study by ESGCIP and EFISG
Author(s) :
Giacobbe, Daniele Roberto [Auteur]
Dettori, Silvia [Auteur]
Di Pilato, Vincenzo [Auteur]
Asperges, Erika [Auteur]
Ball, Lorenzo [Auteur]
Berti, Enora [Auteur]
Blennow, Ola [Auteur]
Bruzzone, Bianca [Auteur]
Calvet, Laure [Auteur]
Capra Marzani, Federico [Auteur]
Casabella, Antonio [Auteur]
Choudaly, Sofia [Auteur]
Unité de Glycobiologie Structurale et Fonctionnelle - UMR 8576 [UGSF]
Dartevel, Anais [Auteur]
De Pascale, Gennaro [Auteur]
Di Meco, Gabriele [Auteur]
Fallon, Melissa [Auteur]
Galerneau, Louis-Marie [Auteur]
Gallego, Miguel [Auteur]
Giacomini, Mauro [Auteur]
González Sáez, Adolfo [Auteur]
Hänsel, Luise [Auteur]
Icardi, Giancarlo [Auteur]
Koehler, Philipp [Auteur]
Lagrou, Katrien [Auteur]
Lahmer, Tobias [Auteur]
Lewis White, P. [Auteur]
Magnasco, Laura [Auteur]
Marchese, Anna [Auteur]
Marelli, Cristina [Auteur]
Marín-Arriaza, Mercedes [Auteur]
Martin-Loeches, Ignacio [Auteur]
Mekontso-Dessap, Armand [Auteur]
Mikulska, Malgorzata [Auteur]
Mularoni, Alessandra [Auteur]
Nordlander, Anna [Auteur]
Poissy, Julien [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Unité de Glycobiologie Structurale et Fonctionnelle (UGSF) - UMR 8576
Russelli, Giovanna [Auteur]
Signori, Alessio [Auteur]
Tascini, Carlo [Auteur]
Vaconsin, Louis-Maxime [Auteur]
Vargas, Joel [Auteur]
Vena, Antonio [Auteur]
Wauters, Joost [Auteur]
Pelosi, Paolo [Auteur]
Timsit, Jean-Francois [Auteur]
Bassetti, Matteo [Auteur]
Cerchiaro, Matteo [Auteur]
Zaccarelli, Mario [Auteur]
Robba, Chiara [Auteur]
Battaglini, Denise [Auteur]
Brunetti, Iole [Auteur]
Del Puente, Filippo [Auteur]
Mora, Sara [Auteur]
de la Villa, Sofía [Auteur]
Valerio, Maricela [Auteur]
Muñoz, Patricia [Auteur]
Lombardi, Gianmarco [Auteur]
Cesarano, Melania [Auteur]
Gennenzi, Veronica [Auteur]
Meersseman, Philippe [Auteur]
Hermans, Greet [Auteur]
Wilmer, Alexander [Auteur]
Razazi, Keyvan [Auteur]
Carteaux, Guillaume [Auteur]
De Prost, Nicolas [Auteur]
Cornely, Oliver A. [Auteur]
Seidel, Danila [Auteur]
Alastruey-Izquierdo, Ana [Auteur]
Garcia Borrega, Jorge [Auteur]
Bonnal, Christine [Auteur]
de Montmollin, Etienne [Auteur]
Dessajan, Julien [Auteur]
Ceresini, Mariaelena [Auteur]
Mojoli, Francesco [Auteur]
Vola, Ambra [Auteur]
Garnaud, Cécile [Auteur]
Díaz, Emili [Auteur]
Gasch, Oriol [Auteur]
Prina, Elena [Auteur]
Rasch, Sebastian [Auteur]
Dibos, Miriam [Auteur]
Haschka, Stefanie [Auteur]
Dettori, Silvia [Auteur]
Di Pilato, Vincenzo [Auteur]
Asperges, Erika [Auteur]
Ball, Lorenzo [Auteur]
Berti, Enora [Auteur]
Blennow, Ola [Auteur]
Bruzzone, Bianca [Auteur]
Calvet, Laure [Auteur]
Capra Marzani, Federico [Auteur]
Casabella, Antonio [Auteur]
Choudaly, Sofia [Auteur]
Unité de Glycobiologie Structurale et Fonctionnelle - UMR 8576 [UGSF]
Dartevel, Anais [Auteur]
De Pascale, Gennaro [Auteur]
Di Meco, Gabriele [Auteur]
Fallon, Melissa [Auteur]
Galerneau, Louis-Marie [Auteur]
Gallego, Miguel [Auteur]
Giacomini, Mauro [Auteur]
González Sáez, Adolfo [Auteur]
Hänsel, Luise [Auteur]
Icardi, Giancarlo [Auteur]
Koehler, Philipp [Auteur]
Lagrou, Katrien [Auteur]
Lahmer, Tobias [Auteur]
Lewis White, P. [Auteur]
Magnasco, Laura [Auteur]
Marchese, Anna [Auteur]
Marelli, Cristina [Auteur]
Marín-Arriaza, Mercedes [Auteur]
Martin-Loeches, Ignacio [Auteur]
Mekontso-Dessap, Armand [Auteur]
Mikulska, Malgorzata [Auteur]
Mularoni, Alessandra [Auteur]
Nordlander, Anna [Auteur]
Poissy, Julien [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Unité de Glycobiologie Structurale et Fonctionnelle (UGSF) - UMR 8576
Russelli, Giovanna [Auteur]
Signori, Alessio [Auteur]
Tascini, Carlo [Auteur]
Vaconsin, Louis-Maxime [Auteur]
Vargas, Joel [Auteur]
Vena, Antonio [Auteur]
Wauters, Joost [Auteur]
Pelosi, Paolo [Auteur]
Timsit, Jean-Francois [Auteur]
Bassetti, Matteo [Auteur]
Cerchiaro, Matteo [Auteur]
Zaccarelli, Mario [Auteur]
Robba, Chiara [Auteur]
Battaglini, Denise [Auteur]
Brunetti, Iole [Auteur]
Del Puente, Filippo [Auteur]
Mora, Sara [Auteur]
de la Villa, Sofía [Auteur]
Valerio, Maricela [Auteur]
Muñoz, Patricia [Auteur]
Lombardi, Gianmarco [Auteur]
Cesarano, Melania [Auteur]
Gennenzi, Veronica [Auteur]
Meersseman, Philippe [Auteur]
Hermans, Greet [Auteur]
Wilmer, Alexander [Auteur]
Razazi, Keyvan [Auteur]
Carteaux, Guillaume [Auteur]
De Prost, Nicolas [Auteur]
Cornely, Oliver A. [Auteur]
Seidel, Danila [Auteur]
Alastruey-Izquierdo, Ana [Auteur]
Garcia Borrega, Jorge [Auteur]
Bonnal, Christine [Auteur]
de Montmollin, Etienne [Auteur]
Dessajan, Julien [Auteur]
Ceresini, Mariaelena [Auteur]
Mojoli, Francesco [Auteur]
Vola, Ambra [Auteur]
Garnaud, Cécile [Auteur]
Díaz, Emili [Auteur]
Gasch, Oriol [Auteur]
Prina, Elena [Auteur]
Rasch, Sebastian [Auteur]
Dibos, Miriam [Auteur]
Haschka, Stefanie [Auteur]
Journal title :
Critical Care
Abbreviated title :
Crit Care
Volume number :
27
Pages :
323
Publisher :
BioMed Central
Publication date :
2023-08-24
ISSN :
1364-8535
English keyword(s) :
Pneumocystis
PCR
Pneumonia
ICU
Diagnosis
Biomarker
Serum β-D-Glucan
PCR
Pneumonia
ICU
Diagnosis
Biomarker
Serum β-D-Glucan
HAL domain(s) :
Sciences du Vivant [q-bio]
Chimie/Chimie théorique et/ou physique
Chimie/Chimie théorique et/ou physique
English abstract : [en]
Background
Pneumocystis jirovecii pneumonia (PJP) is an opportunistic, life-threatening disease commonly affecting immunocompromised patients. The distribution of predisposing diseases or conditions in ...
Show more >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.Show less >
Show more >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.Show less >
Language :
Anglais
Peer reviewed article :
Oui
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
Université de Lille
CNRS
CNRS
Research team(s) :
Glycobiology in fungal Pathogenesis and Clinical Applications
Submission date :
2024-03-01T10:03:57Z
2024-03-01T11:38:13Z
2024-03-01T11:38:13Z
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