[Pneumocystis jiroveci pneumonia: Clinical characteristics and mortality risk factors in an Intensive Care Unit].
OBJECTIVE
To describe the epidemiological characteristics of the population with Pneumocystis jiroveci (P. jiroveci) pneumonia, analyzing risk factors associated with the disease, predisposing factors for admission to an intensive care unit (ICU), and prognostic factors of mortality.


METHODS
A retrospective observational study was carried out, involving a cohort of patients consecutively admitted to a hospital in Spain from 1 January 2007 to 31 December 2011, with a final diagnosis of P. jiroveci pneumonia.


METHODS
The ICU and hospitalization service of Hospital del Mar, Barcelona (Spain).


RESULTS
We included 36 patients with pneumonia due to P. jiroveci. Of these subjects, 16 required ICU admission (44.4%). The average age of the patients was 41.3 ± 12 years, and 23 were men (63.9%). A total of 86.1% had a history of human immunodeficiency virus (HIV) infection, and the remaining 13.9% presented immune-based disease subjected to immunosuppressive therapy. Risk factors associated to hospital mortality were age (51.8 vs. 37.3 years, P=.002), a higher APACHE score upon admission (17 vs. 13 points, P=.009), the need for invasive mechanical ventilation (27.8% vs. 11.1%, P=.000), requirement of vasoactive drugs (25.0% vs. 11.1%, P=.000), fungal coinfection (22.2% vs. 11.1%, P=.001), pneumothorax (16.7% vs. 83.3%, P=.000) and admission to the ICU (27.8% vs. 72.2% P=.000).


CONCLUSIONS
The high requirement of mechanical ventilation and vasoactive drugs associated with fungal coinfection and pneumothorax in patients admitted to the ICU remain as risk factors associated with mortality in patients with P. jiroveci pneumonia.
Servicio de Enfermedades Infecciosas, Hospital del Mar, Universidad Autónoma de Barcelona, Barcelona, España. Electronic address: mafe115@gmail.com.
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Solano L
Servicio de Medicina Intensiva, Hospital del Mar, Barcelona, España.
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Alvarez Lerma
Departamento de Farmacia, Hospital del Mar, Barcelona, España.
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Grau
Laboratorio de referencia de Catalunya Mas Blau, El Prat de Llobregat, Barcelona, España.
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Segura
Servicio de Enfermedades Infecciosas, Hospital del Mar, Universidad Autónoma de Barcelona, Barcelona, España.
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Aguilar
D018806:APACHE; D000328:Adult; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000453:epidemiology; D045363:Pneumocystis carinii / Q000302:isolation & purification; D011020:Pneumonia, Pneumocystis / Q000453:epidemiology* / Q000382:microbiology; D011030:Pneumothorax / Q000453:epidemiology; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
D014662:Vasoconstrictor Agents
Human immunodeficiency virus; Intensive care unit; Neumonía; Pneumocystis jiroveci; Pneumonia; Unidad de cuidados intensivos; Virus de la inmunodeficiencia humana