Gaining an Understanding of Pneumocystosis in Wales

Ayling-Smith, Jonathan; Backx, Matthijs; Grant, Elizabeth; Dhillon, Rishi; Duckers, Jamie; Hood, Kerenza; White, P. Lewis

doi:10.3390/jof9060660

Open AccessArticle

Gaining an Understanding of Pneumocystosis in Wales

by

Jonathan Ayling-Smith

^1,2,*

,

Matthijs Backx

³

,

Elizabeth Grant

¹,

Rishi Dhillon

³,

Jamie Duckers

⁴

,

Kerenza Hood

²

and

P. Lewis White

^3,*

¹

Cardiff and Vale University Health Board, University Hospital of Wales, Cardiff CF14 4XW, UK

²

College of Biomedical and Life Sciences, Cardiff University, Cardiff CF10 3AT, UK

³

Public Health Wales, Cardiff CF10 4BZ, UK

⁴

All Wales Adult Cystic Fibrosis Centre, University Hospital Llandough, Penarth CF64 2XX, UK

^*

Authors to whom correspondence should be addressed.

J. Fungi 2023, 9(6), 660; https://doi.org/10.3390/jof9060660

Submission received: 10 April 2023 / Revised: 8 June 2023 / Accepted: 10 June 2023 / Published: 13 June 2023

(This article belongs to the Special Issue Fungal Diseases in Europe)

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Abstract

Pneumocystis pneumonia (PcP) is a serious complication of many significant immunocompromising conditions. Prior incidence estimates in Wales are based on PcP’s presentation in the HIV and transplant populations. The objectives were to describe the incidence of PcP in Wales using laboratory reporting measures and assess the impact of underlying immunosuppression cause on mortality. All positive PCR results for PcP between 2015 and 2018 were identified. The total number of unique positives with clinical and radiological correlation was 159 patients, a mean of 39.75 annually. The healthcare records of these patients were reviewed. The mortality at one month was 35.2% and 49.1% at one year. HIV remains the commonest cause of immunosuppression but has lower mortality than non-HIV conditions (12% vs. 59% at one year, p < 0.00001). Non-HIV conditions were categorised as life-threatening and non-life threatening but had a non-significant mortality (66% vs. 54%; p = 0.149), highlighting the negative impact of PcP. An incidence of PcP in Wales of 1.23–1.26 cases per 100,000 has been identified, 32–35% greater than the upper limit previously estimated. There is high mortality in non-HIV patients regardless of immunosuppression cause. A heightened awareness of PcP in these groups will hasten diagnosis and potentially improve mortality.

Keywords: Pneumocystis; PcP; incidence; HIV; non-HIV; Wales

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MDPI and ACS Style

Ayling-Smith, J.; Backx, M.; Grant, E.; Dhillon, R.; Duckers, J.; Hood, K.; White, P.L. Gaining an Understanding of Pneumocystosis in Wales. J. Fungi 2023, 9, 660. https://doi.org/10.3390/jof9060660

AMA Style

Ayling-Smith J, Backx M, Grant E, Dhillon R, Duckers J, Hood K, White PL. Gaining an Understanding of Pneumocystosis in Wales. Journal of Fungi. 2023; 9(6):660. https://doi.org/10.3390/jof9060660

Chicago/Turabian Style

Ayling-Smith, Jonathan, Matthijs Backx, Elizabeth Grant, Rishi Dhillon, Jamie Duckers, Kerenza Hood, and P. Lewis White. 2023. "Gaining an Understanding of Pneumocystosis in Wales" Journal of Fungi 9, no. 6: 660. https://doi.org/10.3390/jof9060660

APA Style

Ayling-Smith, J., Backx, M., Grant, E., Dhillon, R., Duckers, J., Hood, K., & White, P. L. (2023). Gaining an Understanding of Pneumocystosis in Wales. Journal of Fungi, 9(6), 660. https://doi.org/10.3390/jof9060660

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

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