Pneumocystis Pneumonia in an Irish University Hospital Setting: A Five Year Review 2015-2020

Title: Pneumocystis Pneumonia in an Irish University Hospital Setting: A Five Year Review 2015-2020
Author(s): O. Shinners O. Holmes R. Tyrrell S. Shahsavari A. Scott U. Khan T. Teoh J. Powell A. O’Brien
Institution: University Hospital Limerick
Poster: Click to view poster
Category: General Respiratory and Sleep
Abstract: Pneumocystis Pneumonia (PCP), an opportunistic infection, is caused by the atypical fungus Pneumocystis jirovecii. PCP is seen in patients with underlying immunodeficiency, cancer patients receiving treatment, transplant recipients and those on medications such as steroids and other immunosuppressants[1}.

This study aims to investigate the incidence of PCP over a 5 year period in a University Hospital and to identify the method of diagnosis and associated patient demographics.

PCP positive cases were extracted via the Laboratory Information Management System outlining patient age and method of diagnosis. A retrospective chart review was carried out on positive PCP cases examining; immunosuppressant status and type, relevant background history, prophylaxis status, treatment and associated mortality.

51 of 274 samples analysed were positive (18.61%). Method of diagnosis included; bronchial washings (62.75%), sputum (35.29%) and nasopharyngeal swab (1.96%). Of 46 patient charts subsequently reviewed; no patient was on prophylaxis at time of diagnosis, 50% were on immunosuppressing agents, 73.91% received treatment with Trimethoprim/sulfamethoxazole and a mortality of 26.08% was recorded. Most common underlying conditions included; malignancy (41.3%), respiratory disease (33.6%) and HIV (10.87%).

Over 5 years, an average of 10 PCP positive samples were identified per annum. Patients with underlying malignancy represent the largest cohort of cases.

1. Patterson, L., Coyle, P., Curran, T., Verlander, N.Q. and Johnston, J. Changing epidemiology of Pneumocystis pneumonia, Northern Ireland, UK and implications for prevention, 1 July 2011–31 July 2012. Journal of Medical Microbiology, 2017, 66;11