Due to the increasing use of immunosuppressant therapy, Pneumocystis jirovecii pneumonia (PJP) has become an emerging concern in human immunodeficiency virus (HIV)-negative patients. In this study, we conducted a retrospective study of 96 hospitalized patients with PJP from January 2015 to June 2019 at three tertiary comprehensive hospitals in Southern China. Information was collected regarding patient demographics, clinical manifestations, risk factors, laboratory analyses, radiological images, and treatment outcomes. PJP infection was most commonly found in middle-aged men. Kidney diseases (35.5%) and connective tissue diseases (38.7%) were the predominant risk factors for PJP. About half of the patients (48.4%) received glucocorticoid, immunosuppressant, and/or chemotherapy in a low dose or in a short-term (< 3 months). None of the patients had previously received trimethoprim-sulfamethoxazole (TMP-SMX) for PJP prophylaxis. All patients had two or more clinical manifestations (cough, dyspnea, fever, and chest pain). Biochemical investigations of CRP, ESR, PaO2, LDH, and KL-6 showed that over 90% of the patients exceeded the reference range of indicators. Our analyses revealed the dominant risk factors (HIV, kidney diseases, and connective tissue diseases) and the most consistent biochemical indicators (LDH, BG, and KL-6) for PJP. Moreover, early prophylaxis, diagnosis, and treatment should contribute to improve the survival of these PJP patients.

中文翻译：

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华南地区三级三级综合医院耶氏肺孢子菌肺炎特征分析

由于越来越多地使用免疫抑制剂治疗，耶氏肺孢子菌肺炎（PJP）已成为人类免疫缺陷病毒（HIV）阴性患者中新出现的问题。在本研究中，我们对2015年1月至2019年6月在华南地区3家三级综合医院住院的96例PJP患者进行了回顾性研究。收集有关患者人口统计、临床表现、危险因素、实验室分析、放射图像和治疗结果的信息。PJP 感染最常见于中年男性。肾脏疾病（35.5%）和结缔组织疾病（38.7%）是PJP的主要危险因素。大约一半的患者（48.4%）接受低剂量或短期（< 3 个月）糖皮质激素、免疫抑制剂和/或化疗。没有患者之前接受过甲氧苄氨嘧啶-磺胺甲恶唑 (TMP-SMX) 来预防 PJP。所有患者均有两种或两种以上临床表现（咳嗽、呼吸困难、发热、胸痛）。CRP、ESR、PaO2、LDH、KL-6等生化检查显示，90%以上的患者指标超出参考范围。我们的分析揭示了 PJP 的主要危险因素（HIV、肾脏疾病和结缔组织疾病）和最一致的生化指标（LDH、BG 和 KL-6）。此外，早期预防、诊断和治疗应有助于提高这些 PJP 患者的生存率。