Article Dans Une Revue European Journal of Clinical Microbiology and Infectious Diseases Année : 2021

Characteristics and outcome according to underlying disease in non-AIDS patients with acute respiratory failure due to Pneumocystis pneumonia

1 UPD7 - Université Paris Diderot - Paris 7
2 AP-HP - Hopital Saint-Louis [AP-HP]
3 SBIM - Service de biostatistique et information médicale de l’hôpital Saint Louis (Equipe ECSTRA)
4 CRESS (U1153 / UMR_A 1125) - Centre for Research in Epidemiology and Statistics | Centre de Recherche Épidémiologie et Statistiques
5 Service de pneumologie [Hôpital Foch]
6 VIM (UR 0892) - Virologie et Immunologie Moléculaires
7 Irset - Institut de recherche en santé, environnement et travail
8 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
9 TIMC-TrEE - Translational microbial Evolution and Engineering
10 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
11 SIMPA - Stress, Immunité, Pathogènes
12 CHRU Brest - Centre Hospitalier Régional Universitaire de Brest
13 CHU Dijon - Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand
14 PAM - Procédés Alimentaires et Microbiologiques [Dijon]
15 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
16 CHU Reims - Hôpital universitaire Robert Debré [Reims]
17 CHU - Hôpital Pasteur [Nice]
18 C3M - Centre méditerranéen de médecine moléculaire
19 LCE - Laboratoire Chrono-environnement (UMR 6249)
20 Service de parasitologie et mycologie [CHRU de Besançon]
21 CHU Caen
22 ABTE - Aliments Bioprocédés Toxicologie Environnements
23 CPTP - Centre de Physiopathologie Toulouse Purpan
24 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
25 Infinity - Institut Toulousain des Maladies Infectieuses et Inflammatoires
26 Hôpital Claude Huriez [Lille]
27 CHU Saint-Antoine [AP-HP]
28 CHU Gabriel Montpied [Clermont-Ferrand]
29 CRSA - Centre de Recherche Saint-Antoine
Sandrine Valade
Eric Maury
  • Fonction : Auteur
  • PersonId : 897445
  • IdRef : 113128274

Résumé

In the non-AIDS group, several underlying conditions and immune defects could lead to different PCP presentations. This study compared PCP presentation and outcome according to the underlying disease. A secondary analysis of a previously published prospective observational study including 544 PCP patients was done. Only non-AIDS patients were included. Underlying disease was defined as chronic lymphocytic leukemia (CLL), organ transplantation, solid cancer, allogeneic hematopoietic stem cell transplant (AHSCT), other hematological diseases, and immunosuppressive treatment. Clinical characteristics and outcomes were compared between groups. Multiple correspondent analyses compared clinical characteristics at diagnosis. Day 30 mortality was analyzed. Three hundred and twenty-one patients were included in the study. The underlying diseases were hematological malignancy (n = 75), AHSCT (n = 14), CLL (n = 19), solid organ transplant (n = 94), solid tumor (n = 39), and immunosuppressive treatment (n = 57). Compared with other underlying diseases, PCP related to CLL was closer to PCP related to AIDS presentation (long duration of symptoms before diagnosis, high level of dyspnea, and low oxygen saturation at diagnosis). Day 30 mortality was associated with underlying disease, oxygen flow, and shock at ICU admission. PCP presentations may vary according to the underlying reason for immunosuppression. Response to treatment and adjuvant steroid therapy should be analyzed regarding this result.
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Dates et versions

hal-03131261 , version 1 (23-03-2021)

Identifiants

Citer

Gaston Burghi, Lucie Biard, Antoine Roux, Sandrine Valade, Florence Robert-Gangneux, et al.. Characteristics and outcome according to underlying disease in non-AIDS patients with acute respiratory failure due to Pneumocystis pneumonia. European Journal of Clinical Microbiology and Infectious Diseases, 2021, 40 (6), pp.1191-1198. ⟨10.1007/s10096-020-04118-w⟩. ⟨hal-03131261⟩
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