Table 1.
Characteristics of patients with hospital-onset and community-onset PCP
| Characteristics | Hospital-onset PCP * | Community-onset PCP | P | Characteristics | Hospital-onset PCP * | Community-onset PCP | P |
|---|---|---|---|---|---|---|---|
| (n = 16) | (n = 79) | (n = 16) | (n = 79) | ||||
| Gender, male | 9 (56.3) | 51 (64.6) | 0.58 | Interstitial lung disease | 0 (0.0) | 8 (10.1) | 0.34 |
| Age, median years (IQR) | 42 (27–59) | 52 (39 to 63) | 0.13 | Connective tissue disease | 1 (6.3) | 4 (5.1) | 1.00 |
| Genotype | Others† | 2 (12.5) | 5 (6.3) | 0.34 | |||
| 1 | 8 (46.7) | 33 (41.7) | 0.58 | History of priory exposure to SMX more than 3 months | 2 (12.5) | 23 (29.1) | 0.22 |
| 2 | 2 (12.5) | 3 (3.8) | 0.20 | Days of BAL from admission, median (IQR) | 38 (18 to 63) | 2 (1 to 5) | <0.001 |
| 3 | 2 (12.5) | 19 (24.1) | 0.51 | Days of BAL from last chemotherapy, median (IQR)‡ | 17 (9 to 31) | 19 (15 to 30) | 0.44 |
| 4 | 0 (0.0) | 1 (1.3) | 1.00 | BAL neutrophil, median cells/mm3 (IQR) | 11 (0 to 80) | 19 (7 to 62) | 0.43 |
| Mixed | 4 (25.0) | 23 (29.1) | 1.00 | BAL lymphocyte, median cells/mm3 (IQR) | 50 (10 to 177) | 48 (12 to 145) | 0.84 |
| 1 and 2 | 1 (6.3) | 12 (15.2) | 0.69 | ANC, median cells/mm3 (IQR) | 5053 (883 to 8863) | 5968 (3818 to 9007) | 0.18 |
| 1 and 3 | 2 (12.5) | 9 (11.4) | 1.00 | ALC, median cells/mm3 (IQR) | 416 (130 to 1000) | 648 (331 to 1108) | 0.11 |
| 2 and 3 | 1 (6.3) | 2 (2.5) | 0.43 | LDH, median IU/L (IQR) | 364 (240 to 632) | 448 (330 to 620) | 0.35 |
| Underlying conditions | CRP, median mg/dL (IQR) | 10.2 (4.5 to 14.2) | 9.0 (4.0 to 20.3) | 0.43 | |||
| HIV infection | 0 (0.0) | 13 (16.5) | 0.12 | Initial severity at diagnosis§ | |||
| Transplantation | Severe | 11 (68.8) | 64 (81.0) | 0.32 | |||
| HSCT | 3 (18.8) | 6 (7.6) | 0.17 | Treatment | |||
| SOT | 3 (18.8) | 19 (23.1) | 0.76 | TMP/SMX usage as initial treatment | 14 (93.8) | 79 (100) | 0.17 |
| Malignancy | Treatment failure to initial regimen¶ | 6 (37.5) | 23 (29.1) | 0.57 | |||
| Solid tumour | 0 (0.0) | 8 (10.1) | 0.34 | Mechanical ventilation | 11 (68.8) | 42 (53.2) | 0.28 |
| Haematologic | 7 (43.8) | 16 (20.3) | 0.06 | 30-day mortality | 7 (43.8) | 18 (22.8) | 0.12 |
Data are numbers (%) of patients, unless otherwise indicated.
*Hospital-onset PCP was defined as pneumonia arising more than 5 days after admission when no signs and symptoms compatible with PCP were documented at the time of admission. Other patients were considered to have community-onset PCP.
†Autoimmune haemolytic anaemia and Steven-Johnson’s syndrome in patients with hospital-onset PCP. Henoch-Schönlein purpura, severe combined immunodeficiency, idiopathic thrombocytopenic purpura, ulcerative colitis, and unspecified glomerulonephritis in patients with community-onset PCP.
‡It was checked only in patients with a haematologic malignancy on chemotherapy.
§Severe PCP was defined as partial arterial oxygen pressure <60 mmHg while breathing room air or an alveolar-arterial oxygen difference ≥45.
¶Treatment failure was defined as one of the following situations: (1) progressive clinical deterioration as demonstrated by the inability to maintain a stable partial pressure of arterial oxygen despite an increase in the fraction of inspired oxygen, or (2) progressive deterioration of vital signs with a requirement for an increased fraction of inspired oxygen after 7 days of therapy.
ALC, absolute lymphocyte count; ANC, absolute neutrophil count; BAL, bronchoalveolar lavage; CRP, C-reactive protein; HSCT, haematopoietic stem cell transplantation; IQR, interquartile range; LDH, lactate dehydrogenase; PCP, Pneumocystis jirovecii pneumonia; SOT, solid organ transplantation; TMP/SMX, trimethoprim/sulfamethoxazole.