{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T06:31:35Z","timestamp":1787725895527,"version":"build-2784847793"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"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. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Pneumocystis jirovecii<\/jats:italic>\n                      pneumonia (PJP) is a life-threatening opportunistic infection in immunocompromised patients. BALF cytomegalovirus (CMV) co-detection is frequently observed in PJP patients, but its clinical characteristics and prognostic impact in non-HIV populations remain unclear.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this single-center retrospective cohort study, we enrolled 62 non-HIV patients with confirmed PJP between 2019 and 2023. BALF CMV co-detection was defined as detectable CMV DNA in bronchoalveolar lavage fluid via metagenomic next-generation sequencing (mNGS), combined with compatible respiratory symptoms and chest computed tomography abnormalities. The Benjamini\u2013Hochberg false discovery rate (FDR) correction was applied for multiple comparisons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 31 patients (50.0%) had BALF CMV co-detection. The 28-day all-cause mortality was significantly higher in the CMV co-detection group than in the PJP-only group (54.84% vs. 19.35%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.008), and dyspnea was more prevalent (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.024). After FDR correction for 39 laboratory parameters, only fibrinogen remained significantly lower in the co-detection group (\n                      <jats:italic>q<\/jats:italic>\n                      \u202f=\u202f0.039), while (1,3)-\u03b2-D-glucan (BDG) and D-dimer showed independent associations with CMV co-detection in multivariable analyses. mNGS revealed more concurrent viral and fungal pathogens in the co-detection group, and multiple co-pathogens were more frequent in non-survivors within this subgroup. Interleukin-6 (IL-6), procalcitonin (PCT) and D-dimer were identified as independent prognostic factors for 28-day mortality in the CMV co-detection subgroup.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this single-center retrospective cohort, BALF CMV co-detection is associated with substantially elevated unadjusted 28-day mortality in non-HIV patients with PJP. These findings are hypothesis-generating; IL-6, PCT and D-dimer show potential as exploratory prognostic markers. Comprehensive mNGS-based pathogen screening combined with biomarker monitoring may facilitate risk stratification in this high-risk population, pending validation in larger prospective cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1921801","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T06:03:18Z","timestamp":1787724198000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical characteristics and prognostic factors in non-HIV patients with Pneumocystis jirovecii pneumonia and BALF cytomegalovirus co-detection: a retrospective cohort study"],"prefix":"10.3389","volume":"14","author":[{"given":"Chaomin","family":"Guo","sequence":"first","affiliation":[{"name":"Laboratory Medicine Department, The First Medical Center, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yajiao","family":"An","sequence":"additional","affiliation":[{"name":"Laboratory Medicine Department, Cengong County People's Hospital","place":["Guizhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingyun","family":"Ye","sequence":"additional","affiliation":[{"name":"Laboratory Medicine Department, The First Medical Center, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanning","family":"Ma","sequence":"additional","affiliation":[{"name":"Laboratory Medicine Department, The First Medical Center, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Zhao","sequence":"additional","affiliation":[{"name":"Laboratory Medicine Department, The First Medical Center, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lifeng","family":"Wang","sequence":"additional","affiliation":[{"name":"Laboratory Medicine Department, The First Medical Center, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Ma","sequence":"additional","affiliation":[{"name":"Laboratory Medicine Department, The First Medical Center, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingze","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics, The Second Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miaoyu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Wang","sequence":"additional","affiliation":[{"name":"Laboratory Medicine Department, Hainan Branch, Chinese PLA General Hospital","place":["Sanya, Hainan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiyong","family":"Yang","sequence":"additional","affiliation":[{"name":"Laboratory Medicine Department, The First Medical Center, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liyan","family":"Ye","sequence":"additional","affiliation":[{"name":"Laboratory Medicine Department, The First Medical Center, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liuyang","family":"Yang","sequence":"additional","affiliation":[{"name":"Laboratory Medicine Department, The First Medical Center, Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1056\/nejm199001183220304","article-title":"The risk of pneumocystis Carinii pneumonia among men infected with human immunodeficiency virus type 1. 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