Clinical Characteristics and Prognosis of the Modified Probable <i>Pneumocystis jirovecii</i> Pneumonia in Korean Children, 2001–2021
There are few data about <i>Pneumocystis jirovecii</i> pneumonia (PCP) in children, particularly in developed countries. This study investigated the clinical characteristics and prognosis of the clinical PCP in non-HIV-infected Korean children. Children with positive results for the stai...
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| Format: | Article |
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MDPI AG
2022-10-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/9/10/1596 |
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| author | Kyoung Sung Yun Bin Anh Sung Hwan Choi Kyung Taek Hong Jung Yoon Choi Ki Wook Yun Hyoung Jin Kang Eun Hwa Choi |
| author_facet | Kyoung Sung Yun Bin Anh Sung Hwan Choi Kyung Taek Hong Jung Yoon Choi Ki Wook Yun Hyoung Jin Kang Eun Hwa Choi |
| author_sort | Kyoung Sung Yun |
| collection | DOAJ |
| description | There are few data about <i>Pneumocystis jirovecii</i> pneumonia (PCP) in children, particularly in developed countries. This study investigated the clinical characteristics and prognosis of the clinical PCP in non-HIV-infected Korean children. Children with positive results for the staining and/or polymerase chain reaction (PCR) for <i>P. jirovecii</i> between 2001 and 2021 were identified. Patients were grouped into clinical PCP, which comprised proven and modified probable cases, and non-PCP groups. Modified probable PCP (mp-PCP) indicate the case which <i>P. jirovecii</i> was detected by conventional PCR rather than real-time PCR test. The differences in demographic and clinical characteristics were analyzed between the groups. A total of 110 pneumonia cases with positive results for <i>P. jirovecii</i> PCR and/or stain were identified from 107 children. Of these, 28.2% were classified as non-PCP, 12.7% of proven PCP, and 59.1% of mp-PCP. Compared with the non-PCP group, the mp-PCP group had a significantly higher rate of solid organ transplantation (3.2% vs. 24.6%), fever (58.1% vs. 76.9%), tachypnea (25.8% vs. 66.2%), dyspnea (48.4% vs. 83.1%), desaturation (48.4% vs. 80.0%), and bilateral ground-glass opacity on chest radiograph (19.4% vs. 73.8%). However, when the mp-PCP group was compared with the proven PCP group, there was no statistically significant difference. For children with clinical PCP, age under 5 years of age (odds ratio [OR] 10.7), hospital-onset (OR 6.9), and desaturation as initial symptom (OR 63.5) were significant risk factors for death in multivariable analysis. Modified probable PCP might reliably reflect true PCP in terms of patient’s demographic, clinical features, treatment response, and prognosis. Immunocompromised children with hospital-onset pneumonia who are younger than 5 years of age and have desaturation would be more cautiously and aggressively managed for survival through the screening for <i>P. jirovecii</i> by conventional PCR on appropriate lower respiratory specimens. |
| first_indexed | 2024-03-09T20:27:23Z |
| format | Article |
| id | doaj.art-96ab40a5ecb44a8096c8747095eeef45 |
| institution | Directory Open Access Journal |
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| language | English |
| last_indexed | 2024-03-09T20:27:23Z |
| publishDate | 2022-10-01 |
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| spelling | doaj.art-96ab40a5ecb44a8096c8747095eeef452023-11-23T23:33:29ZengMDPI AGChildren2227-90672022-10-01910159610.3390/children9101596Clinical Characteristics and Prognosis of the Modified Probable <i>Pneumocystis jirovecii</i> Pneumonia in Korean Children, 2001–2021Kyoung Sung Yun0Bin Anh1Sung Hwan Choi2Kyung Taek Hong3Jung Yoon Choi4Ki Wook Yun5Hyoung Jin Kang6Eun Hwa Choi7Department of Pediatrics, Seoul National University Children’s Hospital, Seoul 03080, KoreaDepartment of Pediatrics, Seoul National University Children’s Hospital, Seoul 03080, KoreaDepartment of Pediatrics, Seoul National University Children’s Hospital, Seoul 03080, KoreaDepartment of Pediatrics, Seoul National University Children’s Hospital, Seoul 03080, KoreaDepartment of Pediatrics, Seoul National University Children’s Hospital, Seoul 03080, KoreaDepartment of Pediatrics, Seoul National University Children’s Hospital, Seoul 03080, KoreaDepartment of Pediatrics, Seoul National University Children’s Hospital, Seoul 03080, KoreaDepartment of Pediatrics, Seoul National University Children’s Hospital, Seoul 03080, KoreaThere are few data about <i>Pneumocystis jirovecii</i> pneumonia (PCP) in children, particularly in developed countries. This study investigated the clinical characteristics and prognosis of the clinical PCP in non-HIV-infected Korean children. Children with positive results for the staining and/or polymerase chain reaction (PCR) for <i>P. jirovecii</i> between 2001 and 2021 were identified. Patients were grouped into clinical PCP, which comprised proven and modified probable cases, and non-PCP groups. Modified probable PCP (mp-PCP) indicate the case which <i>P. jirovecii</i> was detected by conventional PCR rather than real-time PCR test. The differences in demographic and clinical characteristics were analyzed between the groups. A total of 110 pneumonia cases with positive results for <i>P. jirovecii</i> PCR and/or stain were identified from 107 children. Of these, 28.2% were classified as non-PCP, 12.7% of proven PCP, and 59.1% of mp-PCP. Compared with the non-PCP group, the mp-PCP group had a significantly higher rate of solid organ transplantation (3.2% vs. 24.6%), fever (58.1% vs. 76.9%), tachypnea (25.8% vs. 66.2%), dyspnea (48.4% vs. 83.1%), desaturation (48.4% vs. 80.0%), and bilateral ground-glass opacity on chest radiograph (19.4% vs. 73.8%). However, when the mp-PCP group was compared with the proven PCP group, there was no statistically significant difference. For children with clinical PCP, age under 5 years of age (odds ratio [OR] 10.7), hospital-onset (OR 6.9), and desaturation as initial symptom (OR 63.5) were significant risk factors for death in multivariable analysis. Modified probable PCP might reliably reflect true PCP in terms of patient’s demographic, clinical features, treatment response, and prognosis. Immunocompromised children with hospital-onset pneumonia who are younger than 5 years of age and have desaturation would be more cautiously and aggressively managed for survival through the screening for <i>P. jirovecii</i> by conventional PCR on appropriate lower respiratory specimens.https://www.mdpi.com/2227-9067/9/10/1596<i>Pneumocystis jirovecii</i> pneumoniachildrenrisk factor |
| spellingShingle | Kyoung Sung Yun Bin Anh Sung Hwan Choi Kyung Taek Hong Jung Yoon Choi Ki Wook Yun Hyoung Jin Kang Eun Hwa Choi Clinical Characteristics and Prognosis of the Modified Probable <i>Pneumocystis jirovecii</i> Pneumonia in Korean Children, 2001–2021 Children <i>Pneumocystis jirovecii</i> pneumonia children risk factor |
| title | Clinical Characteristics and Prognosis of the Modified Probable <i>Pneumocystis jirovecii</i> Pneumonia in Korean Children, 2001–2021 |
| title_full | Clinical Characteristics and Prognosis of the Modified Probable <i>Pneumocystis jirovecii</i> Pneumonia in Korean Children, 2001–2021 |
| title_fullStr | Clinical Characteristics and Prognosis of the Modified Probable <i>Pneumocystis jirovecii</i> Pneumonia in Korean Children, 2001–2021 |
| title_full_unstemmed | Clinical Characteristics and Prognosis of the Modified Probable <i>Pneumocystis jirovecii</i> Pneumonia in Korean Children, 2001–2021 |
| title_short | Clinical Characteristics and Prognosis of the Modified Probable <i>Pneumocystis jirovecii</i> Pneumonia in Korean Children, 2001–2021 |
| title_sort | clinical characteristics and prognosis of the modified probable i pneumocystis jirovecii i pneumonia in korean children 2001 2021 |
| topic | <i>Pneumocystis jirovecii</i> pneumonia children risk factor |
| url | https://www.mdpi.com/2227-9067/9/10/1596 |
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