{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:04:48Z","timestamp":1791821088807,"version":"4.3.4"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To investigate the clinical characteristics and identify risk factors for severe\n                      <jats:italic>Pneumocystis jirovecii<\/jats:italic>\n                      pneumonia (PJP) in human immunodeficiency virus (HIV) -negative patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included 39 non-HIV PJP patients diagnosed by next-generation sequencing (NGS) of bronchoalveolar lavage fluid (BALF) at Taizhou Municipal Hospital between June 2019 and March 2025. Patients were divided into severe (n=18) and non-severe (n=21) groups based on disease severity. Continuous variables were analyzed using Student\u2019s t-test or Mann-Whitney U test, while categorical variables were compared with Fisher\u2019s exact test. Variables showing statistical significance (P&amp;lt;0.05) were subsequently included in multivariable logistic regression analysis to identify differences in clinical characteristics between the two groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean age of the entire cohort was 62.59\u00a0\u00b1\u00a012.59 years, and 64.10% (25\/39) were male. The severe group had significantly higher case-fatality rate than the non-severe group (61.1% vs. 0%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.001). Serum procalcitonin (PCT) [0.285 (0.113, 0.643) vs. 0.070 (0.045, 0.110) ng\/mL;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.003] and lactate dehydrogenase (LDH) [554.00 (465.25, 702.00) vs. 269.00 (246.50, 378.00) IU\/L;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.001] levels were significantly elevated in the severe group compared with the non-severe group. BALF-based NGS detected co-infections in 76.92% (30\/39) of cases, predominantly bacteria (35.90%, 14\/39) and Cytomegalovirus (CMV) (30.77%, 12\/39) infections. The severe group showed significantly higher CMV co-infection rates than the non-severe group (55.56% vs. 9.52%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.006). Multivariable logistic regression analysis revealed that elevated LDH levels (OR\u00a0=\u00a01.863, 95% CI 1.153-3.009;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.011) and CMV co-infection (OR\u00a0=\u00a011.477, 95% CI 1.186-111.109;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.035) were independent risk factors for severe PJP.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Pneumocystis jirovecii<\/jats:italic>\n                      pneumonia in non-HIV demonstrated a substantial case-fatality rate. BALF-based NGS may facilitate the detection of co-infections. Elevated LDH levels and CMV co-infection emerged as independent predictors of progression to severe PJP.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1710074","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T04:44:14Z","timestamp":1779943454000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical characteristics of Pneumocystis jirovecii pneumonia in non-HIV patients: a retrospective study"],"prefix":"10.3389","volume":"16","author":[{"given":"Mengyuan","family":"Li","sequence":"first","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Taizhou Municipal Hospital (Taizhou University Affiliated Municipal Hospital), School of Medicine, Taizhou University","place":["Taizhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junsu","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Taizhou Municipal Hospital (Taizhou University Affiliated Municipal Hospital), School of Medicine, Taizhou University","place":["Taizhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuting","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Taizhou Municipal Hospital (Taizhou University Affiliated Municipal Hospital), School of Medicine, Taizhou University","place":["Taizhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chongyang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Taizhou Municipal Hospital (Taizhou University Affiliated Municipal Hospital), School of Medicine, Taizhou University","place":["Taizhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianhua","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Taizhou Municipal Hospital (Taizhou University Affiliated Municipal Hospital), School of Medicine, Taizhou University","place":["Taizhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Taizhou Municipal Hospital (Taizhou University Affiliated Municipal Hospital), School of Medicine, Taizhou University","place":["Taizhou, China"]},{"name":"Taizhou Key Laboratory of Infection and Tumor Immunology, Taizhou Municipal Hospital","place":["Taizhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1016\/j.jiac.2020.12.017","article-title":"Blood urea nitrogen-to-serum albumin ratio and A-DROP are useful in assessing the severity of pneumocystis pneumonia in patients without human immunodeficiency virus infection","volume":"27","author":"Akahane","year":"2021","journal-title":"J. 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