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Lung-disease should be new risk factor for pneumocystis pneumonia, GPs advised

Patients with pre-existing lung disease should be included as a new risk group for pneumocystis pneumonia, say HPA researchers.

The study

HPA researchers used the Hospital Episode Statistics database to identify patients with a diagnosis of P. jirovecii pneumonia infection, and also accessed the LabBase2 database for laboratory-confirmed cases of the same infection. All data was taken for a period from January 2000 to December 2010.

The findings

The Hospital Episode Statistics database recorded 2,258 cases of pneumocystis pneumonia during the study period. The number of cases increased from 157 in 2000 to 352 in 2010, a significant average annual increase of 9%. 81% of the patients with a diagnosis of pneumonia could be classified according to a defined risk category – 40.6% had a haematologic malignancy and 17.5% had pre-existing lung disease.

What does it mean for GPs?

The researchers said that ‘on the basis of these data, we propose pre-existing lung disease as a new pneumocystis pneumonia risk category.’ They added that one of a number of possible explanations for the increase in pneumonia cases is ‘an increase in the number of potentially vulnerable patients who did not receive appropriate prophylactic therapy’. They concluded by saying that, to ensure adherence to current guidelines and to ensure that preventive prophylaxis is optimal for all at-risk groups, ‘auditing of prescribing practices for patients known to be at risk is warranted.’

Emerging Infectious Diseases 2013, online March


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