Pneumocystis pneumonia in French intensive care units in 2013–2019: mortality and immunocompromised conditions
Authors' conclusion
The number of PCP cases requiring ICU admission in France has risen sharply. While the yearly count of severe PCP cases in HIV-infected patients has remained steady, this rise predominantly affects cancer patients, with a recent surge observed in patients with autoimmune inflammatory diseases, affecting one in five individuals.
Study context
- Population
- Adults with Pneumocystis pneumonia (PCP) admitted to French intensive care unit (ICUs), 2013–2019
- Participants
- 4,055 adults
- Exposure
- HIV-positive vs HIV-negative patients with severe PCP
- Outcome
- Incidence of severe PCP (ICU admission)
- Follow-up
- 2013 to 2019
Methodological detailsnationwide, administrative database (PMSI)
- Nationwide
- Administrative database (PMSI)
Main finding
As reported in the abstract
Incidence of severe PCP, 2013 vs 2019 (/100,000 adult inhabitants)
0.85 to 1.32
P < 0.0001
Proportion of hospitalized PCP cases requiring ICU admission, 2014 vs 2019
17.8 to 21.3%
P < 0.001
Proportion of HIV-negative patients
60.6% to 74.4%
P < 0.0001
Observational data: associations, not effects.
Further findings
| Outcome | HIV | HIV-negative | aOR (95% CI) | |
|---|---|---|---|---|
| In-hospital mortalityMultivariable logistic analysis | 28.5% | 49.7% | 0.30 (0.17–0.55) | |
| 0.10.31310Adjusted odds ratio (log scale) |
Factors strongly associated with hospital mortality
- Age, Simplified Acute Physiologic Score II, congestive HF, coagulopathy, solid organ cancer, cirrhosis
Autoimmune inflammatory diseases in HIV-negative patients
- Proportion of HIV-negative patients with autoimmune inflammatory diseases
- 19.9%
Original publication
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