Cargando…

Gaining an Understanding of Pneumocystosis in Wales

Pneumocystis pneumonia (PcP) is a serious complication of many significant immunocompromising conditions. Prior incidence estimates in Wales are based on PcP’s presentation in the HIV and transplant populations. The objectives were to describe the incidence of PcP in Wales using laboratory reporting...

Descripción completa

Detalles Bibliográficos
Autores principales: Ayling-Smith, Jonathan, Backx, Matthijs, Grant, Elizabeth, Dhillon, Rishi, Duckers, Jamie, Hood, Kerenza, White, P. Lewis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10302409/
https://www.ncbi.nlm.nih.gov/pubmed/37367596
http://dx.doi.org/10.3390/jof9060660
_version_ 1785065038082473984
author Ayling-Smith, Jonathan
Backx, Matthijs
Grant, Elizabeth
Dhillon, Rishi
Duckers, Jamie
Hood, Kerenza
White, P. Lewis
author_facet Ayling-Smith, Jonathan
Backx, Matthijs
Grant, Elizabeth
Dhillon, Rishi
Duckers, Jamie
Hood, Kerenza
White, P. Lewis
author_sort Ayling-Smith, Jonathan
collection PubMed
description Pneumocystis pneumonia (PcP) is a serious complication of many significant immunocompromising conditions. Prior incidence estimates in Wales are based on PcP’s presentation in the HIV and transplant populations. The objectives were to describe the incidence of PcP in Wales using laboratory reporting measures and assess the impact of underlying immunosuppression cause on mortality. All positive PCR results for PcP between 2015 and 2018 were identified. The total number of unique positives with clinical and radiological correlation was 159 patients, a mean of 39.75 annually. The healthcare records of these patients were reviewed. The mortality at one month was 35.2% and 49.1% at one year. HIV remains the commonest cause of immunosuppression but has lower mortality than non-HIV conditions (12% vs. 59% at one year, p < 0.00001). Non-HIV conditions were categorised as life-threatening and non-life threatening but had a non-significant mortality (66% vs. 54%; p = 0.149), highlighting the negative impact of PcP. An incidence of PcP in Wales of 1.23–1.26 cases per 100,000 has been identified, 32–35% greater than the upper limit previously estimated. There is high mortality in non-HIV patients regardless of immunosuppression cause. A heightened awareness of PcP in these groups will hasten diagnosis and potentially improve mortality.
format Online
Article
Text
id pubmed-10302409
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-103024092023-06-29 Gaining an Understanding of Pneumocystosis in Wales Ayling-Smith, Jonathan Backx, Matthijs Grant, Elizabeth Dhillon, Rishi Duckers, Jamie Hood, Kerenza White, P. Lewis J Fungi (Basel) Article Pneumocystis pneumonia (PcP) is a serious complication of many significant immunocompromising conditions. Prior incidence estimates in Wales are based on PcP’s presentation in the HIV and transplant populations. The objectives were to describe the incidence of PcP in Wales using laboratory reporting measures and assess the impact of underlying immunosuppression cause on mortality. All positive PCR results for PcP between 2015 and 2018 were identified. The total number of unique positives with clinical and radiological correlation was 159 patients, a mean of 39.75 annually. The healthcare records of these patients were reviewed. The mortality at one month was 35.2% and 49.1% at one year. HIV remains the commonest cause of immunosuppression but has lower mortality than non-HIV conditions (12% vs. 59% at one year, p < 0.00001). Non-HIV conditions were categorised as life-threatening and non-life threatening but had a non-significant mortality (66% vs. 54%; p = 0.149), highlighting the negative impact of PcP. An incidence of PcP in Wales of 1.23–1.26 cases per 100,000 has been identified, 32–35% greater than the upper limit previously estimated. There is high mortality in non-HIV patients regardless of immunosuppression cause. A heightened awareness of PcP in these groups will hasten diagnosis and potentially improve mortality. MDPI 2023-06-13 /pmc/articles/PMC10302409/ /pubmed/37367596 http://dx.doi.org/10.3390/jof9060660 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ayling-Smith, Jonathan
Backx, Matthijs
Grant, Elizabeth
Dhillon, Rishi
Duckers, Jamie
Hood, Kerenza
White, P. Lewis
Gaining an Understanding of Pneumocystosis in Wales
title Gaining an Understanding of Pneumocystosis in Wales
title_full Gaining an Understanding of Pneumocystosis in Wales
title_fullStr Gaining an Understanding of Pneumocystosis in Wales
title_full_unstemmed Gaining an Understanding of Pneumocystosis in Wales
title_short Gaining an Understanding of Pneumocystosis in Wales
title_sort gaining an understanding of pneumocystosis in wales
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10302409/
https://www.ncbi.nlm.nih.gov/pubmed/37367596
http://dx.doi.org/10.3390/jof9060660
work_keys_str_mv AT aylingsmithjonathan gaininganunderstandingofpneumocystosisinwales
AT backxmatthijs gaininganunderstandingofpneumocystosisinwales
AT grantelizabeth gaininganunderstandingofpneumocystosisinwales
AT dhillonrishi gaininganunderstandingofpneumocystosisinwales
AT duckersjamie gaininganunderstandingofpneumocystosisinwales
AT hoodkerenza gaininganunderstandingofpneumocystosisinwales
AT whiteplewis gaininganunderstandingofpneumocystosisinwales