01 Set Pneumocystis jirovecii Pneumonia (PCP) at Major Risk of Death in Chronic Obstructive Pulmonary Disease: a Retrospective Analysis on 116 Cases

Alessandra Ricciardi

Introduction. Pneumocystis jirovecii (PJ) is an opportunistic fungus causing PJ pneumonia (PJP), a severe lung infection mostly affecting immunocompromised patients. PJP may have an adverse outcome and previous studies reported that non-HIV with PJP has a more acute and severe course than HIV with PJP.
Methods. Data on 116 PJP inpatients were retrospectively collected during the period from 2011-2015 in “Tor Vergata” University Hospital of Rome. Demographic, clinical, radiological and genotype characteristics were considered. Statistical analysis was performed using IBM SPSS.
Results. Seventy out of 116 patients (60.3%) were male aged >50 years old (mean 54.4 years old, range 20-87); 44 (37.9%) were onco-hematologic patients (receiving chemotherapy or haematological stem cell transplantation); 19 (16.4%) had COPD; 26 (22.4%) were HIV-positive; 9 (7.8%) had solid cancer; 4 ( 3.4%) underwent a solid organ transplant; 14 (12.1%) patients had other clinical. The outcome was available in 114 out of 116 (98.3%) patients: 29 out of 114 (25.4%) died due to PCP related respiratory failure. Of these, 9 (31%) were affected by COPD, while 8 (27.6%) had onco-hematologic neoplasms, 4 (13.8%) had solid cancer, 3 (10.3%) had HIV and 5 (17.2%) had other immunodeficiency illness. At univariate analysis, a negative PJP outcome statistically correlated with age>50 (p=0.04) and type of pathology (p=0.04). A significant higher number of patients with COPD died respect to the other groups (p=0.01).
Conclusion. The higher risk of death for PJP in COPD, demonstrated by our retrospective study, leads to carefully consider PJP in the differential diagnosis of worsening lung function in these patients.