TABLE 1.
Demographics, clinical characteristics, treatments, and outcomes of 166 non-HIV-infected patients with Pneumocystis jirovecii pneumoniaa
| Characteristic | Values for patients with indicated disease status |
P | ||
|---|---|---|---|---|
| All (n = 166) | Mild to moderate (n = 46) | Severe (n = 120) | ||
| Demographics | ||||
| Age (yrs), median (IQR) | 55 (42–64) | 51 (37–60) | 56 (44–64) | 0.04 |
| Male gender | 103 (62.0) | 27 (58.7) | 76 (63.3) | 0.58 |
| Underlying disease | ||||
| Hematologic malignancy | 58 (34.9) | 19 (41.3) | 39 (32.5) | 0.29 |
| Solid-organ transplantation | 51 (30.7) | 18 (39.1) | 33 (27.5) | 0.15 |
| Solid tumor | 27 (16.3) | 6 (13.0) | 21 (17.5) | 0.49 |
| Connective-tissue disease | 16 (9.6) | 3 (6.5) | 13 (10.8) | 0.56 |
| Interstitial lung disease | 15 (9.0) | 4 (8.7) | 11 (9.2) | >0.99 |
| HSCT recipient | 13 (7.8) | 6 (13.0) | 7 (5.8) | 0.19 |
| Immunosuppressive agent use (≤1 mo) | 153 (92.2) | 43 (93.5) | 110 (91.7) | >0.99 |
| Steroid | 71 (42.8) | 15 (32.6) | 56 (46.7) | 0.10 |
| T-cell immunosuppressantb | 58 (34.9) | 19 (41.3) | 39 (32.5) | 0.29 |
| Anticancer agent | 67 (40.4) | 19 (41.3) | 48 (40.0) | 0.88 |
| Pulmonary coidentification | ||||
| Bacteria | 6 (3.6) | 2 (4.4) | 4 (3.3) | 0.67 |
| CMV | 43 (25.9) | 11 (23.9) | 32(26.7) | 0.72 |
| Laboratory findings | ||||
| CRP (mg/dl), median (IQR) | 10.2 (4.8–17.6) | 5.9 (3.1–10.6) | 12.8 (6.1–20.1) | <0.001 |
| LDH (IU/liter), median (IQR) | 461 (341–624) | 370 (320–459) | 490 (378–660) | 0.003 |
| PaO2 (mm Hg), median (IQR) | 82 (64–109) | 101 (80–135) | 74 (61–96) | <0.001 |
| AaDO2 (mm Hg), median (IQR) | 113 (43–196) | 19 (8–31) | 156 (83–226) | <0.001 |
| APACHE II score, median (IQR) | 16 (12–21) | 13 (10–16) | 18 (14–23) | <0.001 |
| Mechanical ventilation at initial presentation | 34 (20.5) | 1 (2.2) | 33 (27.5) | <0.001 |
| Treatment | ||||
| Treatment duration (days), median (IQR) | 18 (14–23) | 15 (14–20) | 19 (14–24) | 0.02 |
| TMP-SMX as initial regimenc | 161/162 (99.4) | 42/43 (97.7) | 119/119 (100) | 0.27 |
| Change to second-line regimenc | 57/162 (35.2) | 11/43 (25.6) | 46/119 (38.7) | 0.12 |
| Due to treatment failure | 42/162 (25.9) | 4/43 (9.3) | 38/119 (31.9) | 0.004 |
| Due to adverse reaction | 17 (10.2) | 7 (15.2) | 10 (8.3) | 0.25 |
| Outcome | ||||
| 30-day all-cause mortality | 36 (21.7) | 2 (4.3) | 34 (28.3) | 0.001 |
| 60-day all-cause mortality | 49 (29.5) | 5 (10.9) | 52 (43.3) | <0.001 |
| In-hospital mortality | 48 (28.9) | 2 (4.3) | 46 (38.3) | <0.001 |
Data are no. (%) of patients unless indicated otherwise. IQR, interquartile range; HSCT, hematopoietic stem cell transplantation; CMV, cytomegalovirus; CRP, C-reactive protein; LDH, lactate dehydrogenase; AaDO2, alveolar-arterial oxygen difference; APACHE, acute physiology and chronic health evaluation; TMP-SMX, trimethoprim-sulfamethoxazole.
The immunosuppressants included cyclosporine, tacrolimus, mycophenolate mofetil, tumor necrosis factor alpha (TNF-α) blockers, specific monoclonal antibodies (such as alemtuzumab), and nucleoside analogues.
A total of 4 patients were excluded from the analysis due to death before treatment initiation.