{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:19:45Z","timestamp":1792189185666,"version":"4.4.0"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2021,10,4]],"date-time":"2021-10-04T00:00:00Z","timestamp":1633305600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The role of respiratory coinfections at diagnosis of Pneumocystis jirovecii pneumonia (PcP) on clinical impact has been underestimated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective observational study was conducted January 2011 to April 2019 to evaluate respiratory coinfections at diagnosis of PcP patients in 2 tertiary care hospitals. Coinfection was defined by identification of pathogens from P. jirovecii-positive samples.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 7882 respiratory samples tested for P. jirovecii during the 8-year study, 328 patients with diagnosis of PcP were included. Mean age was 56.7 (SD 14.9) years, 193 (58.8%) were male, 74 (22.6%) had positive HIV serology, 125 (38.1%) had viral coinfection, 76 (23.2%) bacterial coinfection, and 90-day mortality was 25.3%. In the overall population, 90-day mortality was independently associated with solid tumor underlying disease (odds ratio [OR], 11.8; 95% confidence interval [CI], 1.90\u201378.0; P = .008), sepsis-related organ failure assessment score (SOFA) at admission (OR, 1.62; 95% CI, 1.34\u20132.05; P&amp;lt; .001), and cytomegalovirus (CMV) respiratory coinfection (OR, 3.44; 95% CI, 1.24\u20132.90; P = .02). Among HIV-negative patients, respiratory CMV coinfection was associated with worse prognosis, especially when treated with adjunctive corticosteroid therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Respiratory CMV coinfection at PcP diagnosis was independently associated with increased 90-day mortality, specifically in HIV-negative patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiab460","type":"journal-article","created":{"date-parts":[[2021,9,9]],"date-time":"2021-09-09T23:07:51Z","timestamp":1631228871000},"page":"868-880","source":"Crossref","is-referenced-by-count":31,"title":["Epidemiology and Clinical Impact of Respiratory Coinfections at Diagnosis of\n                    <i>Pneumocystis jirovecii<\/i>\n                    Pneumonia"],"prefix":"10.1093","volume":"225","author":[{"given":"Romain","family":"L\u00e9cuyer","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, University Hospital of Nantes and Centre d'Investigation Clinique 1413, INSERM, Nantes, France"},{"name":"EA 1155, Laboratory of Targets and Drugs for Infections and Cancer, L'Institut de Recherche en Sant\u00e9 2-Nantes Biotech, Nantes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nahema","family":"Issa","sequence":"additional","affiliation":[{"name":"Intensive Care and Infectious Disease Unit, Groupe Saint-Andr\u00e9, University Hospital, Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benoit","family":"Tessoulin","sequence":"additional","affiliation":[{"name":"INSERM, U1232, Universit\u00e9 de Nantes, Service d\u2019H\u00e9matologie, University Hospital, Nantes, 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