{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T17:36:57Z","timestamp":1785346617417,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Pneumocystis jirovecii<\/jats:italic>\n                      pneumonia (PCP) is a significant opportunistic infection in solid organ transplant (SOT) recipients. However, the impact of respiratory coinfections on outcomes in this population remains unclear.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 112 SOT recipients diagnosed with PCP from April 2018 to March 2024. Respiratory coinfections were defined as identification of significant pathogens in respiratory specimens within 3 days of PCP diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 112 SOT recipients with PCP, 50.0% required intensive care unit (ICU) admission, and the 30\u2010day and 90\u2010day mortality rates were 12.5% and 17.9%, respectively. Respiratory coinfections were identified in 46 patients (41.1%), including cytomegalovirus (CMV, 30.4%), bacteria (14.3%), and non\u2010CMV viruses (13.4%). Bacterial coinfection was significantly associated with increased 30\u2010day mortality (adjusted odds ratio [aOR], 5.27; 95% confidence interval [CI], 1.15\u201326.27;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.03) and 90\u2010day mortality (aOR, 4.84; 95% CI, 1.29\u201319.35;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.02). CMV coinfection was independently associated with prolonged hospital stay (adjusted ratio, 2.42; 95% CI, 1.67\u20133.50;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), higher ICU admission rates (aOR, 2.95; 95% CI, 1.04\u20139.03;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.05), and increased need for mechanical ventilation (aOR, 3.01; 95% CI, 1.10\u20138.83;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.04), but not with mortality. Non\u2010CMV viral coinfection was associated with significantly increased odds of ICU admission (aOR, 19.03; 95% CI, 2.67\u2013254.90;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.01) and mechanical ventilation (aOR, 21.21; 95% CI, 2.96\u2013298.12;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.01), without a significant impact on mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In SOT recipients with PCP, bacterial coinfection was associated with higher mortality, while CMV and non\u2010CMV viral coinfections were mainly associated with morbidity. Respiratory co\u2010pathogens may indicate illness severity; whether pathogen\u2010directed strategies can modify outcomes requires further study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tid.70177","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T10:57:58Z","timestamp":1769425078000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Respiratory Coinfections on Outcomes of\n                    <i>Pneumocystis jirovecii<\/i>\n                    Pneumonia in Solid Organ Transplant Recipients"],"prefix":"10.1111","volume":"28","author":[{"given":"Jihyo","family":"Lim","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases Asan Medical Center University of Ulsan College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heungsup","family":"Sung","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Asan Medical Center University of Ulsan College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"So Yun","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Asan Medical Center University of Ulsan College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Euijin","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Asan Medical Center University of Ulsan College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seongman","family":"Bae","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Asan Medical Center University of Ulsan College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiwon","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Asan Medical Center University of Ulsan College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min Jae","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Asan Medical Center University of Ulsan College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong Pil","family":"Chong","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Asan Medical Center University of Ulsan College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung\u2010Han","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Asan Medical Center University of Ulsan College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang\u2010Ho","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Asan Medical Center University of Ulsan College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang Soo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Asan Medical Center University of Ulsan College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang\u2010Oh","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Asan Medical Center University of Ulsan College of Medicine  Seoul Republic of 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